Posts tagged creativity

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.

Manic Depressive Leaders in a Time of Crisis

S. Nassir Ghaemi, in his book, A First Rate Madness: Uncovering the links between  Leadership and Mental Illness, makes a case for the fact that while ‘normal’ leaders are good in times of stability and peace; in times of crisis, mentally ill or mentally abnormal people make for better leaders.

He does this via historical analysis of leaders like Gandhi, Martin Luther King jr, Franklin D. Roosevelt, Winston Churchill, Abraham Lincoln etc. Some of these leaders he classifies as being predominantly depressive, others as manic while the rest as being of bipolar proclivity. In the book he writes:

The depressed person is mired in the past; the manic person is obsessed with the future. Both destroy the present in the process.

He lists four traits that distinguish a manic/depressive leader from other normal leaders: Empathy, ResilienceCreativity and Realism! I can easily map these to the ABCD dimensions: empathy is an Affective trait (the ability to feel emotions), resilience is more about Behaviors (bouncing back from failures), creativity is related to Cognition (ability to think in a divergent manner) while realism can be linked to Desire/Dynamism (do we do realistic assessments).

He claims, and I find that claim very attractive and true, that depressive people typically are better at empathy and realism, that is, they have heightened empathy and realism as compared to the normal population; in a similar vein, manic people are typically better at creativity and resilience than the normal population.

If one views depression and mania  as somewhat opposed to each other. at least on on some dimensions, it goes without saying that depressive people may be less creative (they are typically stuck in ruts)/resilient (they often cant cope and sometime stake the extreme step of suicide); similarly, in a manic phase, people may be less realistic (may even become psychotic losing touch with reality)/ empathetic (may not be able to get inside the head of others).

While a depressive or manic phase may be debilitating, the relatively ‘normal’/symptom free period may confer advantages on depressives, manics or bipolars by making them leverage their resilience, creativity, realism and empathy, especially to tide over crisis.

Why should it be the case that in normal periods a ‘normal’ leader may help, but in a crisis only an ‘abnormal’ leader may be able to rise to the occasion? The answer lies in evolution and genetic diversity. Consider moths that are generally gray in color, but some are darker (closer to black) while some others lighter (white in color) . The majority gray moths are the ‘normal’ moths, while the minority black and white are abnormal ones. Now these moths are exquisitely adapted to their environments, and typically gray moths will flourish. However if the area has suddenly become polluted such that darker color moths are now less easier to detect than the gray moths by the predators, then dark moths will thrive at the cost of  light moths.

A similar analogy can be applied to humans. Normal leaders are adapted to stable conditions; while in times of crisis, more atypical brains may suffer greater advantage.

So next time you select a leader, be mindful of whether its a change/crisis situation or a stable situation; if a crisis/ change situation, you may do well to do some reverse discrimination and select a mentally ill/ abnormal person as a leader!!

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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Cognitive control: when less is more!

Yesterday I wrote a post about ADHD and creativity and how the frontal lobes hypo-function and dopamine may be the mediating factors involved.  Today I serendipitously came across this article by Thomson-Schill et al in which they posit that frontal cortex hypofunction during childhood is beneficial, on average, as it enables convention learning and thus linguistic acquisition.

What they basically mean is that frontal cortex has been found to be involved in cognitive control i.e. in higher cognitive functions like planning, flexible thinking etc ; and the frontal cortex does this by biasing the competitive responses elicited by a stimuli by goals /existing beliefs / other task related information that is maintained in the working memory. To take an example, cognitive control is often measured by tasks such as the stroop task. the strrop task measures how well you are able to suppress the prepotent response tendency of naming the color-term itself by the task-relevant constraint that you name the color of the term instead. when a color term like ‘green’ is presented in Red color, then the green as well as red linguistic response compete with each other. In the absence of frontal biasing in teh direction of color ie.e red, we are apt to name the color-term itself i.e green by default which is the habitual response. Children , who have less well-developed frontal cortices generally perform poorer at the stroop task than adults as their frontal cortex does not bias or tilt the scales in favor of the color used rather than the color-term presented.

The authors claim that this inability to bias results on the basis of pre-existing knowledge/beliefs leads to a greater ability to learn. They posit that learning conditions (that maximize competition )  are different from performance conditions (where one response needs to be selected or competition minimized) and the child’s brain is optimized for learning by not having frontal inhibition and control. An example they give is filtering noise form signal which the child are able to do, but adults can’t. for eg. if a new language has a phrase ‘et tu brute’ and 75 % of times it is in this form and 25% of times it is of the form ‘et tu vous Brute’, then adults will tend to probability match and select the utterance/ utter themselves phrase ‘et tu brute’ 75% of times and ‘et tu vous Brute’ 25 % of times. This is because when they want to utter the phrase their existing knowledge that sometimes the other phrase is also used, makes them sensitive to variations. In child’s brain on the other hand a competition between the two phrases takes place and as there is no moderating influence involved, the outcome hundred percent of the time is ‘et tu brute’. Thus, they are able to learn conventional meaning of a phrase/word etc more easily than an adult who gets bogged down by variations. Thus sometimes, less is more!

However the reason I got hooked to this study is the implications they draw for ADHD/Autism and creativity. I’ll quote them verbatim on the issue:

Central to our proposal is the claim that the timing of PFC development has been the target of selection and, therefore, that variations in timing are functionally meaningful. Recent neuroimaging studies have revealed potentially important differences in the timing of PFC development across typical and atypical individuals. Variations in the trajectory of PFC maturation (based on repeated measures of cortical thickness) have been associated with cognitive measures in typically developing children (Shaw et al., 2006). Children with attention-deficit hyperactivity disorder (ADHD) exhibit a delay in cortical maturation that is most prominent in the PFC (Shaw et al., 2007). In contrast, children with autism spectrum disorders (ASD) undergo early maturation of the PFC (Carper, Moses, Tigue, & Courchesne, 2002). A better understanding of the implications of these timing changes for both learning and performance may illuminate some of the behavioral and cognitive patterns associated with these diagnoses (e.g., impaired acquisition of social conventions in ASD), as well as offer a fertile ground for testing the validity of our hypothesis that typical PFC development involves a trade-off in favor of learning to the detriment of performance in infancy and early childhood.

This gels quite nicely with what I have been speculating for some time, that ADHD and Autism are opposed and that ADHD is childhood equivalent of psychosis. ADHD kids are bound to be good learners, more divergent creative and have better social and linguistic skills. Autistic kids on the other hand would be better performers (say child prodigies in memory etc) , more convergent thinkers, and have less social and linguistic skills- one mechanism of which may be lesser ability to learn social and linguistic conventions- like the usage of metaphorical terms.

On creativity this is what the authors say:

Creativity—the ability to approach an object or a situation from an alternative perspective—may benefit from the unsupervised competition that occurs in the absence of prefrontal control. Consider one common assessment of creative thinking, the Alternative Uses Task: When attempting to think of ways to use an object in some atypical way, adults struggle. In this case, an active PFC might, paradoxically, hinder flexible thinking, because the representation of the object is sculpted by prior experience and expectations. Interestingly, young children are immune to this kind of functional fixedness (German&Defeyter, 2000). Successful performance in similar tasks of ideational fluency has been associated with EEG changes in prefrontal regions (e.g., Mo¨lle, Marshall, Wolf, Fehm, & Born, 1999). Furthermore, patients with PFC damage solve insight-problemsolving tasks better than do their healthy counterparts (Reverberi, Toraldo, D’Agostini, & Skrap, 2005). This apparent flexibility of behavior can be interpreted as a stimulus-driven response: A mind that is at the mercy of its environment is not shaped by expectations or beliefs. This interpretation highlights a parallel between functional fixedness and probability matching, in that both of these ‘‘adult’’ phenomena involve biasing stimulus–response associations based on expectations. This proposal suggests new avenues of investigation into the processes that support creative thought and into putative relations between creativity and psychological disorders associated with hypometabolic prefrontal function (i.e., a state of lower energy consumption in the PFC, as in bipolar disorder, for example).

The above analysis of creativity in terms of hypofunction of frontal cortex bodes well for my theories of creativity-ADHD relationships as well as creativity-psychosis (bipolar etc) relationship, both of which involve developmental or functional hypofucnction of frontal cortex.

Thompson-Schill, S., Ramscar, M., & Chrysikou, E. (2009). Cognition Without Control: When a Little Frontal Lobe Goes a Long Way Current Directions in Psychological Science, 18 (5), 259-263 DOI: 10.1111/j.1467-8721.2009.01648.x

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