The Four Sub-Types of ADHD


Recently, I wrote a post about the four neural sub-types of depression. That classification was based on resting stage fMRI comparing depressive patients with controls; I hope someone does similar studies for other psychiatric conditions.

English: Symptoms of ADHD described by the lit...

English: Symptoms of ADHD described by the literature (Photo credit: Wikipedia)

The current post is an attempt to delineate what may come out in such a study if done for ADHD. I will be focusing on ADHD as it manifests in children, adolescents as well as adults.

I will be mostly relying on factor analytical studies of ADHD that have typically revealed 3 to 4 underlying factors.

ADHD has typically been diagnosed by looking at symptoms from inattentive or hyperactive-impulsive domains. You can find the DSM-5 criteria here. And its sub-types are combined presentation, predominantly inattentive presentation and predominantly hyperactive-impulsive presentation.

As per some studies, a majority (as much as 90 %) of ADHD subjects have inattentive symptoms while a few have hyperactive-impulsive symptoms. This is analogous to the depression findings that predominately depressive patients have a core pathology marked by low mood ; and subtypes marked by say anergia, anhedonia and anxiety.

However, factor analytical studies have presented a more nuanced picture. As per this study [pdf] there are four underlying factors of ADHD.

  1. Inattentive/ cognitive problems
  2. Hyperactivity/restlessness
  3. Impulsivity/ emotional lability
  4. Problems with self-concept

The first there factors are well established and quite apparent. To impulsivity description I may just add sensation-seeking too. The problems with self concept is something like low self-confidence/ self esteem, possibly due to continued underachievement and problems at school/ work. I would like to add another dimension to this fourth problems with self concept factor – that of disruptive/ defiant behavior possibly due to self-concept issues.

And I am sure in future, in future, when brain basis and neutral subtypes are more easily available for ADHD, we will find these four subtypes.

Before we leave, its important to note that ADHD lies on a continuum and its a matter of degree than a matter of kind .

Also, ADHD confers benefits too like enhanced creativity and some work has shown that creativity can be mistaken for ADHD in kids.

The above four sub-types may then be classified by their positive poles too:

  1. Daydreaming/broadened attention
  2. High energy and enthusiasm
  3. risk-taking and emotional sensitivity
  4. independent and idiosyncratic

All the above are also traits associated with the creative person. ADHD & creativity are indeed very closely related and its time we stopped seeing differences like ADHD in purely pathological terms.

Creativity components and other musings

The Mona Lisa.

The Mona Lisa. (Photo credit: Wikipedia)

The Mouse Trap readers will be glad to know that I have started writing a column over at The Creativity Post, titled ‘The muses and the furies’ where i will talk about creativity and the thin line dividing genius and madness.

My first post focuses on delineating the components of creativity. Here is an excerpt:

I propose that creativity is made of four factors:

1. The first factor is SURPRISE: whether one produces something that continues captivating attention, even though it becomes familiar over time. This may result from rare and remote association of ideas or a recombination process that brings familiar things together in an unfamiliar/unexpected way. This is the ability to think beyond conventional boundaries or categories, loosen up the associations and make remote associations between and within categories. This is also related to flexibility with which you can walk across categories and disciplines. An example might be Mona Lisa by Da Vinci or putting a urinal in an art gallery.

2. The second factor is ORIGINALITY: whether one produces something that is really unique and novel and unheard of before. This is creativity that is not just combinatorial but perhaps associated with transforming and transcending. As pre Pribram novelty is a result of new rearrangements of old ideas. If the first factor is about combination, this may be thought of as permutation or reordering. This is related to originality scores. An example might be cubism by Picasso where the face/familiar objects are rearranged, sort of.

3. The third factor is BEAUTY: whether one produces something that is appealing and aesthetically satisfying. Beauty lies in the eyes of beholder and is related to subjective preferences. Identifying beauty is a fast and frugal process and as per one conception, we find something beautiful, if we can process it easily (that is why average faces are more beautiful- ease of processing). This is related to fluency scores or the ease with which you can ideate. Expressionisms by Monet et al looks beautiful because it’s easy on eyes.

4. The fourth factor is of UTILITY: whether one produces something that is useful. As evident from the alternate uses task the utility of something is ambiguous and context dependent and yet measured objectively and not subjectively. Creativity is the ability to deal with this inherent ambiguity, be comfortable with it and look at things from multiple simultaneous perspectives to find useful contexts in which to use/ apply it. This is the ability to see if the solution actually solves the problem. Also the ability to elaborate an idea and add details to it, so as to make it useful/ relevant. Here, one can focus on one stream of thought/ idea and take it to logical conclusion, adding details and making it complex. The Miniature art of India, that has elaborate details, is an example of this form, and is useful in reconstructing history.

Read the full text here.

While we are talking about creativity, I recently engaged with Sam McNerney in a debate about whether a focus on small c creativity detracts from addressing  the really important questions of Genius. Again an excerpt follows:

While I agree with Sam, whole-heartedly, that big C creativity merits a concerted focus, I also believe that small c is the way we will inch closer to the enigma of genius. It’s true that myths about creativity — that it is easy, natural for some, mostly cognitive in nature — should be dispelled in favor of a more rounded account of genius that takes grit, positivity, endurance, effort and curiosity into account. It is equally true that we can only reveal the essence of the creative process — that it involves recombination to produce surprise element, or transformations to produce novelty element, that great works of art/creativity are selected for by arbitrary aesthetic preferences as well as utilitarian concerns — by focusing closely on the small, everyday c creativity and the processes underlying them.

Lest I be misunderstood, my objection to Sam is on two counts: one, that the perpetuating myth of anguished art and tormented genius is as counterproductive as any other myth. Most creators/ innovators are likely to have positive frames of mind that treat failures as learning opportunities; I’m not saying they don’t struggle or work hard, but they don’t, necessarily, see the struggle as painful, but rather see it as challenging and enriching.

Second, a focus on small c creativity is as necessary as a focus on Big C creativity — as that approach is more likely to yield early fruits and help in identification of mechanisms.


Read the full argument here.

Another debate in which I recently engaged was with Douglas Fields (his ‘The other Brain’ was earlier reviewed on the mouse trap) – in which I argued that academic success was multi-factorial and good grades and test scores are not an either/or proposition . Excerpt follows:

Thus I would suggest that all academic success, however they are measured, are dependent on four factors: innate ability or intelligence, self-control and hard work, grit and motivational resilience and finally, a positive, incremental mindset. While some academic outcomes, like achievement test results (e.g., SATs) may depend disproportionately on innate ability and mindset (test results and transfer of learning), other outcomes—like grades—may depend more on personality factors like self-control and grit/motivation.

Read the full text here.


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Autism and ADHD: the intelligent and the creative child!
A new study by Ruthsatz and Urbach is doing the rounds nowadays. That study has nothing to do with Autism or ADHD per se. The study focuses on child prodigies and finds that they have high levels of intelligence, enhanced working memory and that they pay attention to details.

What the study also found was high level of autistic relatives and high scores on Autism spectrum for the prodigies. The relation between autism and prodigiousness was mediated by the endo-phenotype ‘paying attention to detail’ and none of the other symptoms of ASD seemed to play a role.

Many savants also are high on ASD and have exception working as well as long term memory. There too they pay excessive attention to details and are fascinated by speical interests.


On the other hand there is gathering literature that suggests that the ADHD kid is basically on the creative side of the spectrum – restless, trying multiple strategies,  having diffused and peripheral attention, and to an extent novelty and sensation seeking.

Also, if one thinks about that for a minute, autism and ADHD seem to be opposed on a number of dimensions. The three basic features of ADHD are 1) inattentiveness and distractibility vs  too much focus and fascination for an object shown by Autistic kid 2) impulsiveness vs restricted and repetitive motions and interests of the autistic kid and finally 3) hyperactivity vs restrained interactions and communications of the autistic kid.

There is also some data from fly models that suggest that autism and ADHD are opposites in a sense.

I may even go ahead and stick my neck and say that while autism is primarily characterized by emotion of Interest/ fascination/ attention ; ADHD is characterized by emotion of Wonder/Awe/surprise.

One theory of autism suggests that the social and communicative difficulties arise as the child hides in a cocoon to prevent over-stimulation and sensory overload; a theory of ADHS says that the child is under-stimulated and needs stimulants like Ritalin to achieve baseline of activation and sensory stimulus.

Another popular theory of autism posits that it arises primarily due to ‘weak central coherence’, or inability to see the context/ gestalt/ ‘the big picture’. The ADHD kid on the other hand is hypothesized to use a lot of peripheral attention and daydreams missing what is being centrally taught in the classroom.

And that brings me to the root of the differences in my opinion; while the Autism spectrum is characterized by a local processing style, the ADHD-psychotic spectrum is characterized by a global  processing style.

Some clarifications are due here. I believe ADHD to fall on the psychotic spectrum and have been proposing the autism and psychosis as opposites on a continuum model for close to eternity.

Also, when I say global/local processing styles I dont restrict the application to perception alone, but extend it to include cognitive style too.

There is a lot of work that has been done on global/ local processing styles with respect to perception, using Navon letter tasks and it is fairly established that normally people lean towards the global processing style.

Forrester et al extend this to cover there GLOMOSYS system that posits two basic types of perceptual/cognitive style- global and local.

It is instructive to pause and note here that psychosis is associated with a global processing style while autism with attention to details.

It is also instructive to pause and note that similar to autism-psychosis continuum , it seems Intelligence and creativity are also in a sense opposed to each other. Also while creativity  is associated with broad cognitive style that is divergent; intelligence is conceived of as narrow and focused application of abilities.

That brings me to my final analogy: while autistic kids may have pockets of intelligence and savantism and may be driving the evolution of intelligence; it is the ADHD kids who are more likely to be creative and are driving the evolution of creativity.

The romantic notion that psychosis is the price for creativity may not be untrue.

Joanne Ruthsatz, & Jourdan B. Urbach (2012). Child prodigy: A novel cognitive profile places elevated general intelligence,
exceptional working memory and attention to detail at the root
of prodigiousness Intelligence DOI: 10.1016/j.intell.2012.06.002

Jens F¨orster, & Laura Dannenberg (2010). GLOMOsys: A Systems Account of Global Versus Local Processing Psychological Inquiry, DOI: 10.1080/1047840X.2010.487849

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Creativity and Intelligence

This post is to highlight two articles I had written some time back for my Psychology Today blog The Fundamental Four.

The first article focused on determining the underlying structure of creativity and intelligence, partly by looking at how they are defined and measured, and came up with the following schema for creativity:

1. The first factor is of UTILITY: whether one produces something that is useful. As evident from the alternate uses task the utility of something is ambiguous and context dependent. Creativity is the ability to deal with this inherent ambiguity, be comfortable with it and look at things from multiple simultaneous perspectives to find useful contexts. Politics (leadership) epitomises this ability. This is also related to speed and fluency with which you can hold multiple representations or generate multiple ideas. Taken to an extreme this may result in flight of ideas and racing thoughts typical of mania. Relating to personality constructs this is measured by feelings/ actions facets of openness to experience. The product associated with this type of creativity is typically an invention. In terms of existing schemata, you use multiple schemas simultaneously or let the member belong to multiple categories.
2. The second factor is ORIGINALITY: whether one produces something that is appealing and aesthetically satisfying and original. Originality sometimes lies in making remote associations (think mixing of metaphors etc). Creativity is the ability to think beyond conventional boundaries or categories, loosen up the associations and make remote associations between and within categories. Art epitomises this ability. This is also related to flexibility with which you can walk across categories and disciplines. Taken to extreme this may lead to apophenia (or seeing patterns everywhere and correlating everything in a loose framework), over-inclusive delusions, and scizotypy or even full blown schizophrenia. Relating to personality constructs this is measured by aesthetics facets of openness to experience. The product associated with this type of creativity is typically a new stylistics. In terms of existing schemata, you loosen your schemata boundaries and let them overlap.
3. The third factor is SURPRISABILITY: whether one produces something that is really unique and novel and unheard of before. Surprisabililty is creativity that is not just combinatorial but perhaps associated with transforming and transcending. The role of imagination is prominent here. Also serendipity and latent thinking is more prominent here. Mythmaking / religion epitomises this ability. This is also related to originality where a truly unique take is evident. Fantasy and role playing are important. Constructs like distractibility and latent inhibition are also relevant here. Taken to extreme this may result in attention problems associated with ADHD always being enthralled by something novel rather than paying attention to routine but boring stuff. Relating to personality constructs this is measured by fantasy facets of openness to experience. The product associated with this type of creativity is typically a social innovation. In terms of existing schemata, you transform your schemata and create new categories by principle of accommodation.

A similar, tripartite structure, for intelligence was also arrived at:

To sum up, The three broad factors of intelligence are:



1. Processing speed: related to inductive part of Gf, selective attention and set updating. This is measured using problem solving especially puzzles. This is also the algorithmic mind using the method of simulation (Stanovich). This parallels fluency/utility facet of creativity.
2. (Working) memory: related to crystallized Gc, sustained attention and set shifting. This is measured using ability to recognise explicit patterns and analogies. This is also the remembering mind using the method of serial associative cognition (Stanovich). This parallels flexibility/ beauty facet of creativity.
3. Planning: related to deductive part of Gf, divided attention and set initiation. This is measured using abstract reasoning and inhibition tasks like the stroop task. This is also the reflective mind using the method of TASS override (Stanovich). This parallels originality/novelty facet of creativity.

In the second article I related this tripartite structure to the underlying BVSR process as follows:

So, how does BVSR lead to creativity?


Blind means unsighted or unplanned or something which comes out of such a blind process will not be expected but necessarily involve leaps and be non-obvious and surprise us with the serendipitous results. Thus blindness ensures Surprisability.


Variation means recombination or transformations or some such process that leads to new and novel variants. Thus variation guarantees Originality.


Selection means separating wheat from the chaff based on either subjective criteria like Beauty or objective criteria like Truth. In either case the idea retained will be either true or adaptive/useful. In other words, Selection necessitates Utility.


Retention means developing the selected idea to completion, validating it and using similar means again. Typical means may include trying to replicate the phenomenon. Given that the BVS part of BVSR may work unconsciously it is hard to replicate or deliver the same creative performance again; the same may not be true of a scientific discovery though. We will not focus on retention here which has to do with repetition of the act, in my opinion, and not that relevant to the creative process.


As you move towards more sighted variant of BVSR, you move from creativity to intelligence.
With that in mind I propose the following table for creativity and intelligence





and the following for intelligence…


Of course you should read the original Psychology today blog posts to get the full context.

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Building Brainpower: The Power of Mind maps

Mind mapThis is a book review of Building Brainpower: turning grey matter into gold by Dilip Mukerjea.

Mind mapping is a technique that I have been fascinated with ; I have tried my hands with some online mind mapping tools like the FreeMind and have also tried a few offline mind maps, but before reading this book was largely unaware of how to create a great and memorable mind map. My mind maps were monochromatic and mostly words.

Dilip , who has learnt Mind Mapping from none other than Tony Buzan, shows you the right way to mind map (using a central figure, use colors, use figures etc so that both sides of minds – the literal left side and the figurative right side are utilized to the hilt)  . He walks the reader through many mind mapping exercises that make you conversant with the technique.


The subject of the mind map exercises are themselves a bundle of techniques designed to help you read/ write better etc. and he provides example mind maps that delineate the techniques in an easy to remember format. He shows and not tells and leads by example.


Mind mapping is the second part of the book. the first part of the book is on overview od brain science. Here apart from repeating some obvious fluff like the fact that we use only 1% of our brain (god , when will this myth die) , he is mostly able to stick to the facts and gives an accurate assessment of how our brains function and how they have evolved. /e also deals to some length with the right brain-left brain asymmetry but does not go too much overboard; considering that one of the main advantage of mind mapping is using both the halves, we can grant him that much liberty.

The format of the book is pretty good. there is a lot of colour, a lot of figures and mind mas and a lot of white spaces where you can do mind mapping yourself.

there are two other sections in the book focusing on puzzles and brainteaser and it is healthy workout for your brain.


Overall , I have little patience with those writers or books that claim to phenomenally increase your brain power , but I am quite sympathetic to this book and recommend this to anyone who wants to learn the right way to  Mind Map.


Mind mapping is an extremely powerful technique and there is none better than dilip from which to learn it. If you’re really interested in utilising both your brains for mapping out pieces of your life or remembering difficult to master associations, then money spent on this book would be worth it.

However this book will be most useful to those who will actually  practise the exrcises and try their hands actively on mind mapping; if your interest is theoretical or you shy from exercises you will not be able to reap that much benefit from the book.

Full disclosure: I got this book for free for reviewing and am intrigued by the Mind Mapping methods.

This review is a part of the Book Reviews Program at Participate now to get free books!

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