Creativity and psychopathology: are there similar mental processes involved in creativity and in psychosis-proneness?

The putative link between creativity and psychopathology is nearly as legendary and mysterious as the long-standing view from antique mythology according to which eminent creative achievements were perceived as the result of a “higher power,” mostly caused by inspiration by muses. In fact, there are many illustrative examples of creative people who suffer(ed) from serious mental disorders, leading some authors to the notion that “. . . madness may be the price for possessing one of themost sublime human gifts” (BarrantesVidal, 2004, p. 59). Within the scientific domain, literature reviews came to quite different conclusions, assuming no, only a weak or even a strong association between creativity and psychopathology (Barrantes-Vidal, 2014, p. 170), ranking this topic into the most controversially discussed issues in the field of creativity. Nevertheless, there appears to be some consensus that at least less severe manifestations of psychopathology are associated with creativity (e.g., BarrantesVidal, 2004; Claridge and Blakey, 2009; Nelson and Rawlings, 2010). As we will briefly indicate in the following, especially people who are prone to psychosis (characterized in its most severe manifestation by e.g., delusions, hallucinations, disorganized thought, negative symptoms; see e.g., Heckers et al., 2013, for a review of the domains of psychopathology that define psychosis) have been found to show elevated levels of creativity. CREATIVITY AND PSYCHOSIS-PRONENESS According to Carson (2011) empirical evidence for an association between creativity and psychopathology can be found from the latter half of the last century onward, stimulated by two separate studies. Heston (1966) investigated the psycho-social adjustment of children of mothers with schizophrenia relative to matched control subjects and he reported that the former were “notably successful adults” (p. 819), as they possessed artistic talents and showed imaginative adaptations to life. Some years later, Karlsson (1970) reported that relatives of psychotic patients (schizophrenics, manic depressives) had a higher rate of listing in Who is Who, both based on a general listing and on creative endeavors. Since then, researchers began to examine the incidence of psychopathology in highly successful, creative achievers. As one of the landmark studies in this field, Andreasen (1987) for instance found a higher rate of mood disorders (involving bipolar disorder) in prominent writers as compared to a matched control group. Most interestingly, there was also a higher prevalence of mood disorders and creativity in the first-degree relatives of the writers as compared to the relatives of the control subjects, suggesting that the “mad genius” trait might be genetically heritable (Andreasen, 1987). Recent epidemiological studies with large sample sizes confirm the association between professional authors and psychiatric disorders, especially schizophrenia and bipolar disorder, and indicate a familial association between overall creative professions for schizophrenia, bipolar disorder, anorexia nervosa, and possibly autism (Kyaga et al., 2011, 2013). The idea that at least some facets of psychopathology could be associated with creativity has also received some support from the psychometric research tradition. Eysenck’s (1995) psychoticism (P) dimension for instance, a personality trait involving cold, un-empathic, aggressive, and impulsive behavior, has been observed as being substantially associated with various creativity-related demands, particularly with the originality facet of creativity (Abraham et al., 2005; Fink et al., 2012; for review see Acar and Runco, 2012). Eysenck’s P dimension is thought to underlie a variety of psychotic disorders (Eysenck, 1995; but see also Chapman et al., 1994) and it “. . . differs from psychosis by not being pathological and hence enabling people to use remote associations in a constructive way (Eysenck, 1995, p. 244). While individuals scoring low on P are characterized by e.g., conformity or conventionality, high P scorers show traits such as impulsivity, aggression or hostility, and therefore a high tendency toward unconformity, which could possibly provide some explanation for the observed relationship between originality and psychoticism.