Lecture psychiatric disorders 14: bright side of mental illness - Creativity & Psychiatric conditions

Question 1

What is the diathesis-risk model?

Answer 1

That disease is caused by multiple small contributions from several genes (predisposition), all interacting with environmental stressors.

diathesis = risk

Question 2

A study (Swedish study) was performed where they looked into the jobs of people with mental disorders (schizophrenia, bipolar disorder or unipolar depression) and where they wanted to know whether these people and their family had a creative job. What was the conclusion?

Answer 2

• They saw that the odds ratio (OR) in individuals with schizophrenia and individuals with unipolar depression and their family was close to one, meaning that these individuals had no increased chances of having a creative job compared to ‘healthy’ individuals.
• They saw that individuals with bipolar disorders and healthy siblings of people with bipolar disorder or schizophrenia were overrepresented in creative professions.

Note that: non-affected first-degree relatives of people with schizophrenia or bipolar disorder demonstrated the highest increased creativity and this gradually decreases with increasing familial distance to these individuals.

Question 3

A study (Swedish study) was performed where they looked into the jobs of people with mental disorders and where they wanted to know whether these people had a creative job. What happens when the results were adjusted for IQ?

Answer 3

That all the differences in chances for creative jobs seen before got stronger.

Question 4

A study (Swedish study) was performed where they looked into the jobs of people with mental disorders and where they wanted to know whether these people had a creative job. What do these results suggest?

Answer 4

• That there’s an association between creativity and psychiatric disorders.
• That there’s a genetic explanation to the familial co-segregation of creativity and psychopathology rather than an environmental explanation.

Question 5

What is creativity?

Answer 5

• The ability to produce something that is novel and useful or meaningful.
• Scientifically, creativity is seen as divergent thinking (creative generation of multiple answers to a set of problem).
• The ability to transcend traditional ideas, rules, patterns or relationships and to create meaningful new ideas, forms, methods, interpretations, etc.

Question 6

Before we can find any associations between creativity and eccentric behavior, we need empirically validated measures of both creativity and eccentricity.

What empirically validated measures are there for creativity?

Answer 6

• Creative Achievement Questionnaire (a measure of lifetime creative achievements)
• Divergent thinking tasks, a measure of ability to think creatively (which requires a large number of responses or solutions to a problem)
• Creative Personality Scale

Question 7

Before we can find any associations between creativity and eccentric behavior, we need empirically validated measures of both creativity and eccentricity.

What empirically validated measures are there for eccentricity?

Answer 7

Scales that assess schizotypal personality

Question 8

What is a schizotypal personality?

Answer 8

People with a schizotypal personality:

• Odd beliefs and magical thinking (telepathy, sixth sense, conspiracy theories)
• Ideas of reference (secrete message in conversation, mild paranoia)
• Unusual perceptual experiences (distortions in perception, déjà vu, hearing voices whispering in the wind, out-of-body experience)
• Social anhediona (preference for solitary activities, social isolation, physically and emotionally unavailable)
• Eccentricity (odd or flamboyant clothing, speech patterns may be stilted, intellectualized, symbolic and filled with unusual phrasing that others have difficulty understanding

Question 9

Schizotypal personality is not immediately a disorder. When does it become a disorder?

Answer 9

When there’s acute discomfort and functional problems in maintaining relationships. So schizotypal personality is a milder version of schizotypal personality disorder.

Question 10

What is seen in relatives of people with schizophrenia?

Answer 10

That relatives more often have a schizotypal personality (disorder)

Question 11

What can be concluded so far based on the previous questions in regard to schizophrenia?

Answer 11

That there’s a continuum in the schizophrenia spectrum → schizotypal personality → schizotypal personality disorder → schizophrenia

Question 12

What is seen in the association between a schizotypical personality and creativity?

Answer 12

• That a high score on the Schizotypical Personality Scale is associated with higher levels of creativity.
• And vice versa, creative individuals tend to score higher on the Schizotypical Personality Scale than less creative individuals.

Question 13

Just read, since I think this is clear/logical now.

Answer 13

Ok

Question 14

What is meant with the schizophrenia paradox?

Answer 14

We know that schizophrenia is associated with impaired physical health and drastically reduced probability of reproduction, but also that schizophrenia has a high heritability of 80%. So this would state that schizophrenia would go extinct. But this not the case, for schizophrenia and for its risk gene variants.

Question 15

What does the schizophrenia paradox suggest?

Answer 15

That there might be beneficial effect of gene variants, translating in beneficial traits that most probably manifest in healthy relatives (balancing selection hypothesis).

Question 16

What is the balancing selection hypothesis and why does it fit with the results from the Swedish study?

Answer 16

That risk gene variants have adaptive advantages that increase fitness. It fits with the Swedish study in which association with creativity peaks in first-degree relatives of those with a mental disorder, rather than in the patients themselves.

Question 17

How can creativity be evolutionairy advantageous?

Answer 17

• Creativity provides the ability to work out inventive solutions for life-threatening conditions.
• Creativity (art, music, dance, etc.) can bring people together.
• Peacock tail phenomenon → artistic creativity attracts mates

Question 18

So we now know that there’s an association between creativity and schizotypal behavior. So two options/causes are left for this association:

• Schizotypal personality directly causes creativity

Or

• A third factor increases both the probability of schizotypal behavior and the probablity of creative behavior.

Explain which of the two causes is more likely.

Answer 18

It’s more likely that there’s a third factor that increases the probability for schizotypal behavior and creativity. This is because, not every schizotypal person is creative. So there’s no direct relation between the two.

And also; cognitive mechanisms that underlie schizotypal personality also promote creative thinking.

Question 19

What is cognitive disinhibition?

Answer 19

Failure to ignore irrelevant information, which indicates that there’s a reduced cognitive filtering.

Question 20

Which brain area is important for cognitive and sensory filtering?

Answer 20

Thalamus

Question 21

What does a reduced cognitive filtering lead to?

Answer 21

An increased amount of unfiltered stimuli that reach the cortex, which creates more conscious awareness. This results in odd thoughts, hallucinations, strange perceptual experiences and delusional thoughts (and even psychosis).

Question 22

What does a reduced cognitive and sensory filter mean for creativity?

Answer 22

It means that more material is put into conscious awareness, which can lead to reprocessing and recombined in novel/original ways → creative ideas.

Question 23

What would be the reason why people with schizophrenia do not produce creative ideas?

Answer 23

The ability to use cognitive disinhibition in a creative way depends on the presence of additional cognitive abilities associated with a high level of functioning. This means that besides having cognitive disinhibition, you also need to be able to view and evaluate your creative/new ideas in a critical and realistic way.

Question 24

What is needed to view and evaluate your creative/new ideas in a critical and realistic way so that you’re able to use cognitive inhibition for creativity?

Answer 24

A high IQ and high working memory capacity.

Note: having these characteristics is a “protective mechanism” to prevent psychosis.

Question 25

How can you measure cognitive filtering?

Answer 25

• Behavioral level → neurocognitive tests
• Brain level → neuro-imaging studies (latent inhibition task)
• DNA level → gene variants/polymorphisms

Question 26

Behavioral level

A meta-analysis was performed on people with high IQ, where they measured latent inhibition in people with high creative achievements and lower creative achievers. What was concluded?

Note: a decreased latent inhibiton have been generally associated with the tendency towards psychosis.

Answer 26

That people with a high creative achievement had lower latent inhibition task scores compared to lower creative achievers.

Question 27

Brain level

A study was performed where they looked into healthy individuals (with no psychiatric disorders). These individuals may have no mental disorders, but they do differ in how creative they are.

They asked these people to perform divergent thinking tasks, where they then measured the density of the D2 receptors in the thalamus, striatum and PFC.

What was found?

Answer 27

In the thalamus they found that the lower the density of the D2 receptors, the higher the divergent thinking.

Question 28

What is the relationship between the amount of D2 receptors and thalamic filtering?

Answer 28

• A high amount of D2 receptors, means more thalamic filtering
• A low amount of D2 receptors, means a decrease in thalamic filtering

Question 29

DNA level

Here, a study was performed where they looked at the polymorphism of neuregulin 1 (NRG1). This gene affects neuronal development, synaptic plasticity, glutamatergic neurotransmission and glial functioning and is a candidate gene for psychosis. We know from previous studies, that the T/T genotype is associated with an increased risk of psychosis. But what else is seen in this study in regard to this genotype?

Answer 29

That a T/T genotype is also associated with creativity in people with high intellectual and academic performance.

Question 30

What hypothesis is there for the reason why a T/T genotype of NRG1 can lead to higher creativity?

Answer 30

This genotype results in cogntivie disinhibition by reduction of the filtering of the prefrontal cortex.