Creativity and ADHD

For many years, pundits have declared that although ADHD causes many hardships, it does have a side benefit: creativity.

Previous research has suggested that adults with ADHD may be more creative than adults without ADHD (White & Shah, 2006).

A current study by professors Holly White (University of Memphis, TN) and Priti Shah (University of Michigan, MI) replicated these previous findings. The study was published in the Journal of Personality and Individual Differences (January 2011).

To the skeptic, “creativity” is a nebulous term. Like art, what is creative to one person is not creative to another. Thus, standardized tests were developed that focus on qualitative and quantitative areas of creativity called “divergent” and “convergent” thinking. Divergent thinking is the brain’s ability to produce out of the box, spontaneous, and frequently, original ideas or solutions. Convergent thinking, as the name implies, is the antithesis of divergent thinking. Convergent thinking is the brain’s ability to dispense with non-essential data, move to the heart of the problem and quickly parse options to find one correct solution. Convergent thinking is the type of skill needed for most standardized testing. It would not be helpful if you were a marketing specialist thinking of new ideas for your client.

White and Shah recruited  30 university students with ADHD and 30 without. They used a standardized measure of creativity called the Abbreviated Torrance Test for Adults (Goff & Torrance, 2002). In addition to the Abbreviated Torrance Test, the students completed the Creative Achievement Questionnaire ("CAQ"). This questionnaire asks highly specific questions about achievements in 10 creative domains among which include science, drama, writing, and humor, etc. The questions in the CAQ are designed to remove or limit subjective responses. For example, a question on the CAQ: Whether the subject’s “work has won a prize at a juried art show.” Thus, the answer reveals information from a more objective outside source.

Doctors White and Shah also wished to investigate whether these standardized measures actually extrapolated to real-world creative achievement among adults with ADHD. This would answer whether ADHD really does have side benefit.

When the researchers examined the data from all 10 domains combined, they found that the students with ADHD had significantly higher scores than those without the diagnosis. According to White, a distinctive pattern also emerged: ADHD subjects were more likely to excel at certain creative domains than at others — especially the performing arts. While the data were not statistically significant, a clear trend could be seen: domains where inhibition is not necessary seem to be the areas where these students excel, especially theater and drama. This makes sense because scientists have known that inhibitory control is lacking in most ADHD individuals. They are chastised for speaking out of turn at the office or school. They have difficulty controlling impulsive behaviors. It would make sense that they would thrive in an environment that necessitates they behave without inhibition.

Interestingly, White noted that she could find no significant differences between ADHD students on medication and ADHD students who were not. She had no answers for this riddle.

"ADHD," she says, “tends to just increase the amount of collisions between all of your ideas, so at any given time, you have more potential processes being activated and you’re less likely to rule out any options. It’s hard to know where this operates—like someone coming up with an idea and saying, ‘No, that’s not a good idea,’ and not even writing it down, versus, they don’t even think about it because they’re inhibiting it. But the key seems to be the inhibitory control—the same thing that allows somebody to not be distracted—which possibly could put a mental wall between what is right in front of them and other possibilities.”

There are limitations to a study like this. White and Shah specifically worked with students who had achieved or accomplished all requirements necessary to be admitted to university. Therefore, the trends she sees pertain specifically to them. ADHD students who flunked out of school, were incarcerated, etc. which prevented them from attending university were not included. That would make an interesting study because we’d know what affect family support, direction, and education play in success and creativity.

So, the bottom line here is: yes ADHD students can be more creative, but the research points only to a limited group of students. Is this an upside? For some yes. For others, we just don’t know yet.

Misdiagnosing ADHD

According to a study released by the University of Michigan, nearly 1 million children in the United States are potentially misdiagnosed with ADHD.

The research was conducted, not by a medical group, but by economist Todd Elder  in the Journal of Health Economics (Elder et al. The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates. Journal of Health Economics, 2010; DOI: 10.1016/j.jhealeco.2010.06.003).

Elder found that the youngest or often the most immature children are misdiagnosed with the ADHD label simply because of their age and exhibited maturity. Elder also found that these children are significantly more likely than their older classmates to be prescribed medications like Ritalin to control their behavior. Using a sample of 12,000 children, Elder examined the difference in ADHD diagnosis and medication rates between the youngest and oldest children in a grade. He found that the youngest kindergartners were 60 percent more likely to be diagnosed with ADHD than the oldest kindergarten children. Elder followed that group of children and found that they were more than twice as likely to be prescribed stimulant medication by the time they reached the fifth and eighth grades.

Currently, about  4.5 million children are diagnosed with ADHD. Elder concludes that about 20 percent  or about 900,000 children have likely been misdiagnosed.

In a press release from the University of Michigan, Elder said that such inappropriate treatment is particularly worrisome because of the unknown impacts of long-term stimulant use on children’s health. Elder is also concerned that misdiagnosis wastes an estimated $320 million-$500 million a year on unnecessary medication. He estimates that between $80 million-$90 million of it is paid by Medicaid.

"If a child is behaving poorly, if he’s inattentive, if he can’t sit still, it may simply be because he’s 5 and the other kids are 6," said Elder. "There’s a big difference between a 5-year-old and a 6-year-old, and teachers and medical practitioners need to take that into account when evaluating whether children have ADHD."

ADHD has no pathology, no biological marker in the brain that clearly demonstrates its existence. Thus, its diagnosis is always subjective. While teachers are not permitted to make this diagnosis, their perceptions and opinions serve as the initial step to a diagnosis made by a doctor.

"Many ADHD diagnoses may be driven by teachers’ perceptions of poor behavior among the youngest children in a kindergarten classroom," he said. "But these ‘symptoms’ may merely reflect emotional or intellectual immaturity among the youngest students."

According to Science Daily, Elder’s paper will be published in the Journal of Health Economics in conjunction with a related paper by researchers at North Carolina State University, Notre Dame and the University of Minnesota that arrives at similar conclusions as the result of a separate study.