The Association Between Creativity and Psychopathology: Part IV

Current Directions: Creativity and Schizotypy

           There has been a shift in recent years regarding the type of psychopathology at the center of the “mad genius” debate. While early studies focused on mood disorders, many current lines of research are investigating the relationship between creativity and schizotypy—a continuous, personality variable that describes proneness to psychosis (Claridge & McDonald, 2009). Nettle (2006) explains that factor analysis of traits associated with schizophrenia and schizotypal/borderline personality disorders reliably load onto four factors: Unusual Experiences (involves positive symptoms of schizophrenia such as hallucinations, magical thinking, and perceptual aberrations), Cognitive Disorganization (difficulty concentrating, moodiness), Introvertive Anhedonia (a negative symptom like the anhedonia described for schizophrenia), and Impulsive Nonconformity (violent, reckless, and self-abusive behaviors). The Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) is one of the best-validated and most often used measures of schizotypy, and it contains 104 items relating to the traits of interest.

Nettle (2006) describes two theories pertaining to the nature of the creativity-schizotypy linkage. One suggests that the relationship is an inverted U shape; in this model, creativity first increases along with schizotypy, but then it decreases as the psychosis becomes severe (which is consistent with our discussion of mood disorders, in which debilitating depression actually stifles creativity). An alternative comes from the two-factor approach of Barron (1972, as cited in Nettle, 2006), who argued that creativity results from a combination of psychopathology and ‘ego strength’, a measure that includes resilience, self-control, and ability to cope with stress. Ego strength would therefore serve as the mediator that determines whether schizotypy turns into psychopathology or creative output. Because Schuldberg (1990, as cited in Nettle, 2006) found that positive schizotypy symptoms correlate positively with creativity while negative symptoms correlate negatively with creativity, ‘ego strength’ should increase as negative symptoms decrease. For the O-LIFE, then, creativity should show a positive association with Unusual Experiences but a negative association with Introvertive Anhedonia. To investigate this possibility, Nettle (2006) administered the O-LIFE to participants from the general population, psychiatric patients, and a group of creative individuals.

In order to examine the differences between creative domains, Nettle (2006) included mathematicians as well as poets and visual artists in his study. Mathematicians have been shown to score more highly on measures of autistic traits and convergent thinking (see Nettle, 2006, for relevant citations), which seems to be the opposite personality profile of most creative individuals, who often score highly on divergent thinking tasks. Thus, Nettle (2006) hypothesized that the mathematicians in his study might show patterns opposite to those of the artistic groups (i.e. low Unusual Experiences and possibly higher Introvertive Anhedonia). Using self-report data, participants were categorized into four groups based on level of artistic creativity (in poetry and visual art): non-participant, hobbyist, serious, and professional. All participants were also categorized as mathematicians or non-mathematicians. Finally, based on questionnaire responses, participants were also divided into four psychopathology categories: none, non-psychotic affective conditions (e.g. depression and anxiety), schizophrenia, and bipolar disorder. Note that psychopathology and creativity group categorizations were independent of one another, so a particular individual could be simultaneously a serious visual artist and a bipolar patient (Nettle, 2006).

Results of Nettle’s (2006) study provided some support for the two-factor model of Barron (1972). Creative groups scored as high as schizophrenic patients on Unusual Experiences and Cognitive Disorganization, but lower than controls on Introvertive Anhedonia, suggesting that “artistic groups and psychiatric patients share divergent thought, but they differ in that the latter are troubled with negative symptoms such as avolition and anhedonia, whilst the former are unusually free of these traits” (p. 886). In addition, as predicted, mathematicians scored significantly lower than controls on the positive symptom dimensions of schizotypy (Unusual Experiences and Cognitive Disorganization) as well as Impulsive Nonconformity, and there was a trend toward higher scores for mathematicians on Introvertive Anhedonia. This supports the hypothesis that mathematicians’ personality profiles have contrasting features to the artistic profile, and the findings are consistent with “Baron-Cohen’s work on systemizing as a core feature of autistic spectrum disorders” (p. 887). Nettle (2006) concludes that these results support the link between vulnerability to psychopathology and artistic creativity, but that further research is needed to understand this association within a broad range of ‘creative’ endeavors (e.g. music and drama, or involvement in the natural sciences).

 

References:

Claridge, G. & McDonald, A. (2009). An investigation into the relationships between convergent and divergent thinking, schizotypy, and autistic traits. Personality and Individual Differences, 46, 794-799.

Nettle, D. (2006). Schizotypy and mental health amongst poets, visual artists, and mathematicians. Journal of Research in Personality, 40, 876-890.

The Association Between Creativity and Psychopathology: Part III

Creativity and Mood Disorders

          The works of Andreasen, Jamison, and Ludwig focused primarily on the hypothesized link between creativity and mood disorders, and the majority of anecdotal evidence supporting a creativity-psychopathology link involved cases of major depression and bipolar disorder (schizophrenia, anxiety disorders, and other mental illnesses were given much less attention in the literature). Verhaeghen, Joormann, and Khan (2005) state that “a wide range of studies using diverse methods clearly suggest a connection” between creative behavior and mood disorders, though, unsurprisingly, this proclamation is followed by citations for Andreasen (1987), Ludwig (1994; 1995), and Jamison (1993) (p. 226). While Verhaeghen and colleagues accepted these well-known studies as empirically sound, they also expressed puzzlement regarding one facet of the purported connection: even though correlation does not equal causation, implicit in the conclusions of the “Big Three” is the assumption that psychopathology leads to enhanced creativity. This seems counterintuitive given that the defining symptoms of depression—anhedonia, lack of motivation, loss of energy, inability to concentrate, etc.—are the antithesis of what creativity requires. With the help of some relevant anecdotes, the authors assert that depressive episodes actually decrease creative productivity, and therefore they hypothesize that a direct relationship between the two is unlikely. They suggest that a third variable—namely, self-reflective rumination—mediates the link between creativity and depression (Verhaeghen et al., 2005).

          The researchers predicted that self-reflective rumination would be correlated with both depressive symptomatology and creative behavior, and they used multiple measures of the creativity construct, including a self-report questionnaire on creative interests, the Abbreviated Torrance Test for Adults (ATTA; Goff & Torrance, 2002), and select items from the Purdue Creativity Test (PCT; Lawshe & Harris, 1960) (as cited in Verhaeghen et al., 2005). The questionnaire assessed interest in and seriousness about various artistic and creative activities, such as painting, writing, drawing, photography, acting, etc. The ATTA presented participants with three activities. In the first of these, participants were asked to imagine what would happen if they ‘could walk on air or fly’ and to make a list of problems that this might create. In the second and third activities, participant were presented with a variety of abstract shapes and asked to use the shapes to create ‘unusual’ and ‘interesting’ pictures and to give each picture a title. The ATTA is scored on three scales: “Fluency is the number of distinct answers generated. Originality is the number of responses that do not appear on the list of common answers provided by the test manual. Elaboration is the number of details contained within the answers; the test manual provides strict scoring criteria for these” (p. 227). Finally, the PCT presented participants with abstract line drawings and asked, ‘What is this?’ The total number of responses generated in two minutes were tallied for the fluency score (Verhaeghen et al., 2005).

          Measures of depressive symptomatology included the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977, as cited in Verhaeghen et al., 2005), a self-report questionnaire in which participants reported the frequency of specific depressive symptoms within the past week, as well as a checklist of past depressive symptoms, for which participants were instructed to indicate whether they had experienced any of 10 symptoms within the past year, for a period of two weeks or longer. Self-reflective rumination was evaluated using a ‘5-item subset of nondepression-related items’ from the Ruminative Responses Scale (RRS; Nolen-Hoeksema & Morrow, 1991, as cited in Verhaeghen et al., 2005); these items were chosen to try to isolate pure rumination-as-reflection, or ‘reflectiveness,’ from rumination that is tied directly to depression (p. 228).

          As predicted, results indicated that the correlation between depression and creativity was not direct, but rather due to the link between both of these variables and self-reflective rumination. This relationship can be conceptualized in a couple of different ways: A writer with a biological diathesis for depression may spend a lot of time introspecting and ruminating, and this, in turn, may increase the risk of symptom expression. Alternatively, individuals suffering from depression are more likely to ruminate, and some of these individuals might express these feelings via creative outlets, such as writing. The authors propose a model in which depression explains some of the variance in creative behavior, but only through its relationship with rumination, and the majority of the variance in self-reflective rumination is unexplained by past depression. They theorize that self-reflective rumination itself could influence creative behavior through two pathways: motivation and ability. Reflectiveness might promote seriousness about creative endeavors, which would increase an individual’s motivation to become proficient in a given domain. Or, because self-reflectiveness increases creative fluency, it could have a direct effect on creative ability through increased production of novel/original ideas (Verhaeghen et al., 2005).  

          The authors conclude that, even though depressive and bipolar disorders appear to be “linked” to creativity, depressive symptomatology is not responsible for this link—self-reflective rumination is the mediator, and positive affect therefore must be responsible for any enhanced productivity. They suggest that depressive symptoms might influence the content of creative works, and, during periods of improved functioning in which the creative process is not hindered, this content emerges during creative production (Verhaeghen et al., 2005). This is an interesting new way to think about the nature of the potential link between mood disorders and creativity, but the underlying assumption of the study—that the correlation between mental illness and creativity has been empirically validated—must garner more evidence before too many conclusions can be drawn.

{Next up–Current Directions: Creativity and Schizotypy…}

References:

Verhaeghen, P., Joormann, J., & Khan, R. (2005). Why we sing the blues: The relations between self-reflective rumination, mood, and creativity. Emotion, 5(2), 226-232.

For more on creativity and mood disorders:

Santosa, C. M., Strong, C. M., Nowakowska, C., Wang, P. W., Rennicke, C. M., & Ketter, T.A. (2007). Enhanced creativity in bipolar disorder patients: A controlled study. Journal of Affective Disorders, 100, 31-39.

Strong, C. M., Nowakowska, C., Santosa, C. M., Wang, P. W., Kraemer, H. C., & Ketter, T. A. (2007). Journal of Affective Disorders, 100, 41-48.

The Association Between Creativity and Psychopathology: Part II

On “Creative Mythconceptions: A Closer Look at the Evidence for the ‘Mad Genius’ Hypothesis” by Schlesinger (2009)

            Most people believe that the link between creativity and mental illness has been scientifically “proven,” but this belief is unfounded, according to Schlesinger (2009), who says that the issue is by no means settled, and may never be settled due to the difficulties of conducting research on the topic. Schlesinger (2009) critically reviews the work of the three biggest names in the field and argues that their “landmark” studies contain serious methodological flaws that have, until now, been overlooked or underemphasized by the scientific community. She states:

Many people—including too many mental health professionals and textbook writers—continue to assume that an invariable connection between great creativity and pathology has already been proven. This conviction draws its primary strength from two sources: (a) the influential claims of psychiatrists Nancy Andreasen and Arnold Ludwig and psychologist Kay Redfield Jamison, and (b) the lack of equally strong, visible, and recurring professional statements to the contrary. (p. 62)

            Schlesinger (2009) condemns modern researchers for citing the seminal works of Andreasen (1987), Jamison (1989; 1993), and Ludwig (1995) without critically analyzing their methodologies, and she rather pointedly insinuates that the prominent trio is often cited by researchers who haven’t actually read the original publications. Schlesinger expresses her disappointment that many authors trumpet the words of Andreasen, Jamison, and Ludwig as if their suppositions are verified facts rather than tenuous speculations. She wryly alleges that one text had to borrow a quote from Nietzsche in order to “compensate for its lack of hard data” (p. 63). After relaying the quote—‘One must harbor chaos within oneself to give birth to a dancing star’—Schlesinger condenses the sentiments of her entire thesis into a single, sarcastic question: “Who needs science when we have such compelling poetry to make the case?” (p. 63).

When the “scientific” evidence of Andreasen, Jamison, and Ludwig is scrutinized, it becomes clear that Schlesinger’s critiques—blunt and facetious though they may be—deserve serious consideration. According to Schlesinger, Andreasen’s famous study began in 1972 but was not published until 1987. After fifteen years of data collection, Andreasen only managed to amass a whopping N of 30 (27 of these were male). All experimental participants were faculty members from the Iowa Writers’ Workshop, and Andreasen herself interviewed them about their own mental health histories as well as the pathologies of their closest relatives. Andreasen’s interview was self-constructed and lacked empirical validation, and her diagnostic criteria were only available for review upon request. Participants in the non-writer control group worked in areas such as law, administration, and social work—professions that Andreasen personally believed did not require high levels of creativity (Schlesinger, 2009).

Despite the clear flaws of this design—questionable validity of measures/constructs, high risk of experimenter bias, small sample size, and low external validity, to name a few—Andreasen’s ‘stunning’ report that 80% of the writers in her study suffered from mood disorders, compared to only 30% of the non-writers, spread quickly and soon became fodder for news stories and media dramatizations (Schlesinger, 2009). While Andreasen later acknowledged a few limitations of her study, she attempted to divert further criticism by reporting that 2 of her 30 writers eventually committed suicide. In Andreasen’s words: ‘the issues of statistical significance pale before the clinical implications of this fact’ (p. 64). Schlesinger, however, seems to think that the myriad of methodological weaknesses and dearth of significant results in Andreasen’s (1987) study have remained the key areas of concern (Schlesinger, 2009).

Similar methodological criticisms apply to the works of Kay Jamison, who has also been a great champion of the link between creativity and psychopathology, specifically focusing on mood disorders. Schlesinger (2009) notes that Jamison’s (1989) study used a small, handpicked sample; there was no control group; and all conclusions were based on self-report data, which was collected during interviews by Jamison, who apparently utilized unofficial diagnostic criteria. Despite these weaknesses, Jamison’s findings were, at first glance, even more remarkable than Andreasen’s: Jamison reported that her creative participants sought treatment for affective illness at a rate 30x greater than that of the general population. However, it does not take long for Schlesinger to add, “The 50% figure for disordered poets is equally astonishing, unless you know that it represents only nine people, news that tends to disappear when the study is quoted—along with the fact that her 12.5% total for depression-medicated visual artists refers to just one person” (Schlesinger, 2009, p. 65). Clearly, sample size was as much of a problem for Jamison as it was for Andreasen.

Schlesinger was not the first to comment upon these deficiencies. In his book, Creativity and Madness: New Findings and Old Stereotypes, Albert Rothenberg (1990) states:

Two presumably objective studies by Drs. Kay Jamison and Nancy Andreason…have been consistently discussed in popular as well as professional publications as having proven a connection between affective illness—depression, mania, or both together—and creativity, despite the fact that the first had not been published or reviewed in a scientific journal until quite recently, and the other had a flawed research methodology. The need to believe in a connection between creativity and madness appears to be so strong that affirmations are welcomed and quoted rather uncritically. (p. 150)

            Rothenberg (1990) later asserts that creative eminence is in no way associated with a particular personality type or disposition; rather, he reports that, in his own research, the only trait present in creative individuals across the board was motivation. Still, Rothenberg’s (1990) criticisms did not sway popular opinion, and, four years after Jamison’s initial study, she published a book entitled, Touched with Fire: Manic Depression and the Artistic Temperament, which became, in Schlesinger’s (2009) words, the “proverbial bible” in the creativity and mental illness debate (p. 63). Of course, the majority of evidence in Jamison’s book is anecdotal, and some of the claims are simply educated guesswork. For example, Jamison includes a table entitled ‘Probable Cyclothymia, Major Depression, or Manic-Depressive Illness’ that lists the names of 166 dead writers, artists, and composers, whom Jamison personally “diagnosed.” Never mind that archive-based, retrospective diagnoses should be viewed with caution on principle alone—the lack of a bibliography completely precludes any attempt for readers to assess the validity of Jamison’s sources and diagnostic criteria. Most concerning is that the word ‘Probable’ tends to disappear whenever the list is referenced (Schlesinger, 2009), and thus Touched with Fire only added fuel to a flame that was already spreading too quickly.

Finally, Arnold Ludwig, the author of a (1995) book entitled The Price of Greatness: Resolving the Creativity and Madness Controversy, was heavily influenced by the writings of Jamison, and his support for the link between creativity and mental illness is no less questionable, again due to methodological flaws. Ludwig read the New York Times biographies of 1,004 famous individuals in an attempt to identify psychological commonalities that might have contributed to their achievements. Yet he treated the biographies as if they were objective sources, rather than acknowledging that the biographers must have had their own personal and professional agendas at the time of composition. In addition, he lumped military, scientific, social, and political eminence in the same category as artistic eminence; his evaluations were based upon variables that were largely undefined and subjective (e.g. ‘oddness’); he contradicted himself throughout the text regarding whether or not he actually supported a link between affective disorders and creativity; and, like Jamison, he failed to include a bibliography (Schlesinger, 2009).

Given that Andreasen, Jamison, and Ludwig’s investigations all contained substantial flaws and limitations, Schlesinger concludes that “there is still no clear, convincing, scientific proof that artists do, in fact, suffer more psychological problems than any other vocational group” (p. 69). We should therefore find it troublesome that our culture’s endorsement of the “mad genius” hypothesis has been based almost exclusively on the claims of Andreasen, Jamison, and Ludwig—claims that do not hold up well under scientific scrutiny. These three figures have had an enormous influence on the rest of the field, and this reality must be acknowledged as we evaluate and interpret the findings of more recent publications.

(Search “Psychopathology” at the top of the page to find the other posts in this series!)

References:

Schlesinger, J. (2009). Creative mythconceptions: A closer look at the evidence for the “mad genius” hypothesis. Psychology of Aesthetics, Creativity, and the Arts, 3(2), 62-72.

Rothenberg, A. (1990). Creativity and madness: New findings and old stereotypes. Baltimore: The John’s Hopkins University Press.

 

Also see:

Andreasen, N. C. (1987).  Creativity and mental illness: Prevalence rates in writers and their first-degree relatives. American Journal of Psychiatry, 144, 1288-1292.

Jamison, K. R. (1989). Mood disorders and patterns of creativity in British writers and artists. Psychiatry, 52, 125-134.

Jamison, K. R. (1993). Touched with fire: Manic-depressive illness and the artistic temperament. New York: Free Press.

Ludwig, A. M. (1995). The price of greatness: Resolving the creativity and madness Controversy. New York: The Guilford Press.

New Book on the Bookshelf

Check out the “Psychology” page on the Bookshelf to see a description of Poets on Prozac, the collection of essays that I referenced in my last post…

The Association Between Creativity and Psychopathology: Part I

On Creativity and Mental Illness: An Evaluation of Past and Present Research on the ‘Mad Genius’ Hypothesis

 “No great genius has ever existed without some touch of madness.” ~Aristotle

“Everything we think of as great has come to us from neurotics.” ~Marcel Proust

“We of the craft are all crazy…” ~Lord Byron

           Society has been fascinated by the apparent link between creativity and madness since antiquity, as Aristotle’s quote implies. If we restrict the depth of our analyses to observations of eminent artists and their creations, the line separating madness and brilliance appears thin, the “mad genius” hypothesis valid. For example, “The Yellow Wallpaper” by Charlotte Perkins Gilman draws the reader into a spiral of insanity so authentic that a connection between creativity and psychopathology seems logical, if not undisputable. Stories of famous poets, painters, and novelists who have struggled with mental illnesses provide powerfully convincing support for the link, and anecdotal evidence dominates many discussions on the topic. Virginia Woolf, Vincent Van Gogh, Sylvia Plath, Edgar Allen Poe—all of these artists were exceptional in their fields, and it is frequently reported that their commonalities extend beyond creative eminence: each one also battled debilitating mental illness.

Creative geniuses mystify us, and we are often so taken by their abilities that we cannot help but speculate as to the origin of their talents. Attributing artistic brilliance to eccentricities of the mind seems to have become common practice, but our culture’s fixation on, and romanticized view of, the “mad genius” is not without consequences. Correctly or not, a painter whose productivity suddenly increases may be rumored to be manic; a poet whose verses explore the darker side of the human psyche might be called depressed. Not only does the popular notion of the “mad genius” increase the chances that we will make premature assumptions regarding the mental health of artists, it also heightens the risk that creative individuals will be irreversibly stigmatized by such labels. What’s more, many artists themselves are convinced there’s a link between creativity and psychopathology, and these beliefs may reduce the likelihood that they will seek treatment for mental disorders, for fear that their muses will be chased away, their sources of inspiration rendered inaccessible. Here are two illustrative quotes from the book Poets on Prozac, a collection of essays about mental illness and the creative process:

 “I was afraid that Prozac might stifle me, inhibit those voyages, subtly change the mental structure of my brain in a way that would keep me from the wild, intuitive jump.” ~Jesse Millner

 “Which brings me to wonder about the function of psychotropic drugs and whether in some cases they actually hinder a creative person from getting in touch with his or her dark, depressive side, actually get in the way of that dormancy some call depression, which may actually be a period of important creative gestation for what comes next.” ~David Budbill

           That such beliefs may be pervasive in our society provides a justifiable motivation for a more systematic evaluation of the literature. Thus, we shall ask: How is creativity defined, and could different types of creativity be associated with different psychological profiles? What does the empirical evidence support—a link between creativity and psychopathology, or a lack thereof? What is the current focus of research in this area? And–because the answer has so many implications for the creatively predisposed–how did the endorsement of the “mad genius” hypothesis become so widespread in the first place?

The latter question shall be our starting point, for we must understand the history of this intriguing debate in order to evaluate the current climate. It would be unwise to judge the quality of a house without first inspecting its foundation…

(Search “Psychopathology” in the box at the top of the page to find posts 2-4 in this series!)

References:

Berlin, R. M. (2008). Poets on Prozac: Mental illness, treatment, and the creative process. Baltimore: The Johns Hopkins University Press.

Site’s Still Active!

“The strokes of the pen need deliberation as much as the sword needs swiftness.” 
~Julia Ward Howe

 

Yes, dear readers, this is why it’s been ages since my last post–I’ve been deliberating, you see.

Okay, that may be a bit of a lie. I mentioned this in one of my last posts, but let me reiterate–grad school is BUSY! I barely have time to eat, sleep, and waste time on Facebook, let alone write new blog posts. But, there is good news: I’m taking a graduate course this semester entitled “Psychopathology,” and, for my final paper, I’ve chosen to write about the “mad-genius hypothesis”–the speculated link between mental disorder and creativity (think Virginia Woolf, Sylvia Plath, Vincent van Gogh). This means I will be reading a plethora of research articles on the topic and will have some very interesting new posts for you between now and the end of the semester.

For now, check out a few related  links below. Keep in mind, however, that most of these articles are based on anecdotal, rather than empirical, evidence, and even the claims grounded in research may be controversial. So put on your skeptical glasses and click away:

http://www.psychologytoday.com/articles/199901/troubled-talent

http://www.psychologytoday.com/articles/199507/portrait-the-artist-manic-depressive

http://www.psychologytoday.com/articles/200705/genius-and-madness

Thanks for continuing to visit the site; be sure to pass the link along to friends and family who might be interested as well, and check back soon!

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