Psychology of Aesthetics, Creativity, and the Arts

Psychopathology in World-Class Artistic and Scientific Creativity

Gregory J. Feist, Daniel Dostal, and Victor Kwan
Online First Publication, October 21, 2021. http://dx.doi.org/10.1037/aca0000440

CITATION
Feist, G. J., Dostal, D., & Kwan, V. (2021, October 21). Psychopathology in World-Class Artistic and Scientific Creativity.
Psychology of Aesthetics, Creativity, and the Arts. Advance online publication. http://dx.doi.org/10.1037/aca0000440
 Psychology of Aesthetics, Creativity, and the Arts
© 2021 American Psychological Association
ISSN: 1931-3896 https://doi.org/10.1037/aca0000440

Psychopathology in World-Class Artistic and Scientific Creativity

Gregory J. Feist1, Daniel Dostal2, and Victor Kwan1

1
Department of Psychology, San Jose State University
2
Department of Psychology, Faculty of Arts, Palacký University Olomouc

The role of psychopathology in creative achievement has long been a debated topic in both popular culture
and academic discourse. Yet the field is settling on various robust trends that show there is no one answer.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Conclusions vary by level and kind of creativity and level and kind of psychopathology. The current study
This document is copyrighted by the American Psychological Association or one of its allied publishers.

sought to replicate previous findings that linked lifetime rates of psychopathology to world-class levels of crea-
tivity. A total of 199 biographies of eminent professionals (creative artists, creative scientists, eminent athletes)
were rated by raters who were blind to the identity of the eminent person on 19 mental disorders using a 3-
point scale of not present (0), probable (1), and present (2). Athletes served as an eminent but not creative
comparison group to discern whether fame, independently of creativity, was associated with psychopathology.
Results showed that artists exhibited higher lifetime rates of psychopathology than scientists and athletes in the
more inclusive criterion for psychopathology (i.e., it was either probable or present), whereas both artists and
athletes exhibited higher rates than scientists in the stricter criterion for psychopathology (i.e., it was present).
Apart from anxiety disorder, athletes did not differ from the U.S. population in lifetime rates of psychopathol-
ogy, whereas artists differed from the population in terms of alcoholism, anxiety disorder, drug abuse, and
depression. These data generally corroborate and replicate previous biographical research on the link between
artistic creativity and life-time rates of psychopathology.
Keywords: creativity, mental illness, psychopathyology, artists, scientists

Supplemental materials: https://doi.org/10.1037/aca0000440.supp

The stereotype of the mad genius has been a popular notion for great genius without some mixture of madness” (Aristotle, as para-
quite some time. Brilliant yet mad artists, such as Vincent van phrased by Seneca, 2007; cf. Motto & Clark, 1992).
Gogh, innovators such as Howard Hughes, and mathematicians Thus the creative genius may be at once naïve and knowledgeable,
such as Isaac Newton have inspired this view throughout history being at home equally to primitive symbolism and to rigorous logic.
(Brownstein & Solyom, 1986; Jeste et al., 2000; Perry, 1947). The He is both more primitive and more cultured, more destructive and
list of geniuses with mental illness could go on and on. Of course, more constructive, occasionally crazier and yet adamantly saner, than
the list of creative geniuses not afflicted with mental illness would the average person. (Barron, 1963, p. 224)
no doubt be at least as long. The range of conclusions on the ques- “Psychopathology and creativity are closely related, sharing
tions are highlighted in the following four quotes: “There is no many traits and antecedents, but they are not identical, and out-
right psychopathology is negatively associated with creativity”
(Simonton, 2006). “Despite centuries of professional attention, the
link between creativity and madness remains more stereotype than
Gregory J. Feist https://orcid.org/0000-0002-3123-1069 science” (Schlesinger, 2017, p. 60).
Daniel Dostal https://orcid.org/0000-0001-5489-7907 Anecdotal evidence is just that—anecdotal. But is there truly a
This research was in partial fulfillment of the Master’s Thesis for Victor legitimate empirical link between psychopathology and creative
Kwan. Portions of these findings were presented in 2019 at the Southern genius? Over the last 10 to 15 years, the field has begun to settle
Oregon University Creativity Conference, Ashland, Oregon, and in 2016 to the on various robust trends that show there is no one answer to the
Ecole Polytechnique Federale de Lausanne (EPFL), Lausanne, Switzerland. question of creativity and mental health. Conclusions vary by level
The authors thank Abiola Awolowo, Brian Barbaro, Kimya Behrouzia, and kind of creativity and level and kind of psychopathology
Catherine Erickson, Evander Eroles, Janet Dai, Adrian Davis, Sheila (Baas et al., 2016; Beaussart et al., 2017; Fisher, 2015; Glazer,
Greenlaw, Jennifer Kang, Illhame Khabar, Thomas Lu, Caitlyn Ma, Dat
2009). As Simonton (2014, 2017a, 2017b, 2019) has recently dem-
Nguyen, Elizabeth Shallal, Kimia Sohrabi, Eldita Tarani, Ryan Willard,
onstrated, all of these positions may have validity, with both linear
and Laura Weber. Data collection was sponsored by a grant from the
Research Foundation, San Jose State University. We have no conflicts of
and nonlinear relationships. As is true of all entrenched scientific
interest to disclose. debates, there must be some truth to each side otherwise one side
Correspondence concerning this article should be addressed to Gregory would die off very quickly. The current study sought to replicate
J. Feist, Department of Psychology, San Jose State University, One and extend previous biographical findings that linked lifetime rates
Washington Square, San Jose, CA 95192-0120, United States. Email: greg of psychopathology to world-class levels of creativity by examin-
.feist@sjsu.edu ing the moderating effects of the relationship.

1
 2 FEIST, DOSTAL, AND KWAN

Creativity Post (1994) also drew a similar conclusion from biographical analysis
of more than 200 world-famous creative people. The sample in this
Creativity researchers have most regularly described creativity as study was restricted to deceased subjects of biographies reviewed by
consisting of two qualities, namely originality/novelty and mean- the New York Times. These biographies were then examined for signs
ingfulness/usefulness (Amabile, 1996; Feist, 2017; Runco & Jaeger, of psychopathology in each eminent professional and correlated with
2012; Sternberg, 1988). A creative endeavor must not only be dif- each domain of expertise. The results showed that people who excelled
ferent from what has been previously performed in a given domain at creative endeavors such as poetry and fiction writing experienced
but also useful. In this case, the term “usefulness” can also mean higher rates of psychopathology than scientists or politicians.
beautiful or provocative for artwork and literature. Some have To be sure, partly owing to inconsistent empirical results, not all
argued that the term “usefulness” could be replaced by the word scholars agree there is a connection between high levels of creativ-
“meaningful” (Feist, 2017). With this change in terminology, the ity and psychopathology (Sawyer, 2011; Schlesinger, 2009, 2017;
need to qualify “useful” as also beautiful or provocative is no longer Thys et al., 2014). The most outspoken and harshest critique
necessary. Products of both art and science can be meaningful,
comes from Schlesinger (2009, 2012, 2017). She essentially dis-
whereas a piece of artwork would not necessarily be useful. Mean-
misses the entire field and literature on creativity and “madness”
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ingful makes clear that the meaning is in the evaluator, and this can
as based on nothing more than poorly conducted and flawed
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be the general public, experts, peers, or historians, among others.

research (e.g., biographies are dismissed as little more than “gos-
In the last 10 years, however, a few creativity researchers have
sip”), even going so far as to call it a “hoax” (Schlesinger, 2012).
argued for three, rather than two, factor definitions of creativity.
She takes particular issue with three of the key figures in the field,
Simonton (2013, 2016), for example, has proposed a logical quan-
Andreasen, Jamison, and Ludwig. Andreasen (1987) had too few
titative model whereby a creative idea or solution is a multiplica-
participants, relied on personal relationships with participants, and
tive function its originality, utility, and surprisingness. More
overgeneralized results. Jamison’s (1996) “autopsy subjects” of
formally, and omitting the i subscript for each individual idea, cre-
166 deceased artists, writers, and musicians is challenged. Schle-
ativity c = (1 – probability p) utility u (1 – prior knowledge of util-
singer critiques three of the 166 subjects (Michelangelo, Emerson,
ity v) and where p, u, v, and c each range from 0 to 1. The
and Cole Porter) and yet fails to provide a more general and struc-
compelling aspect of this formulation is its multiplicative function,
tured critique of the participant selection. Her methodological
whereby any value of 0 for p, u, or v results in an idea that is not at
criticisms have some validity because no research is without limi-
all creative.
tations and flaws, but Schlesinger does her arguments a disservice
when she makes many absolutist statements that no one really
Psychopathology and Creativity
claims, such as the supposedly common belief that “no one
Research and theory on psychopathology and creativity are receives the gift of genius without the curse of depression” (Schle-
growing and contentious. A recent edited volume entitled Creativ- singer, 2017, p. 60) or that much of the research gets propagated
ity and Mental Illness captures the history, current state of the without people reading the original articles.
field, and the wide range of views on the topic (Kaufman, 2017).
Although the ancient Greeks (Aristotle in particular) were the first Moderating Effects in the Relationship Between
people in the Western world to examine the nature of creativity Creativity and Psychopathology
and its association with “melancholia,” it was not until the Roman-
tics in literature in the 1830s that the argument was made for any The apparent contradictory set of results gains clarity when we
connection between serious mental affliction and creative genius begin to look more closely at the reasons for the mixed, moderat-
(Becker, 2017). ing, and complex findings. One study, for example, reported that
The modern literature on the topic was jumpstarted in the 1980s and gender moderates the relationship between creativity and psycho-
1990s with the work of Andreasen, Jamison, Richards, and Ludwig. In pathology, with positive results only holding for men (Martín-Bru-
her early investigations, Andreasen (1978, 1987) reported qualified fau & Corbalán, 2016). More general findings highlight four
relationships between creativity, especially literary creativity, and men- common moderating effects in the relationship between creativity
tal illness, making use of historical, familial, and genetic studies. Jami- and psychopathology (Baas et al., 2016; Beaussart et al., 2017;
son (1996) reported historical, biographical, and literary evidence for Feist, 2012; Fisher, 2015; Glazer, 2009; Silvia & Kaufman, 2010;
the association between artistic creativity and mood disorders, most Simonton, 2017a, 2019):
specifically bipolar disorder. Jamison et al., (1980) also examined the • degree of creativity

relationship between creativity and bipolar illness in noncreative peo- • domain of creativity (art v. science)
• degree of psychopathology
ple and found that the hypomanic period led to heightened creativity.
• domain of psychopathology
Richards and colleagues (1988) also found that it was mild levels of
mania (hypomania) and bipolar (cyclothymia) that were most strongly Degree of Creativity
associated with creative thinking. Large-scale biographical examina-
tions by Ludwig and Post in the 1990s reported associations between Creative achievement exists on a wide spectrum, from minor to
artistic creativity and lifetime rates of mental illness. Ludwig (1992, major contribution. For decades, researchers who study creativity
1995) examined more than 1,000 eminent professionals, including, but have realized there is a need for distinguishing levels of creativity.
not limited to, artists, writers, scientists, and musicians and revealed To label someone creative is nearly meaningless if it does not dif-
that extremely creative individuals, especially in the visual and literary ferentiate historical genius global level creativity from minor, indi-
arts, exhibited elevated rates of various lifetime psychopathologies. vidual, everyday creativity. As Kaufman and Beghetto (2009)
 PSYCHOPATHOLOGY AND CREATIVITY 3

argued, there are at least four distinct levels of creativity that are arts in particular (writing (fiction and nonfiction), poetry, and visual
more or less developmental. First, there is mini-c creativity, that arts; see Figure 1). The performing artists (musicians and dancers)
is, personal level of creativity, where someone is creating ideas or had moderately elevated rates of psychopathology, whereas the for-
behaviors that are novel and meaningful to him or her only. If that mal artists (architects) were not different from the general popula-
person goes on to produce novel products, ideas, or behaviors that tion. He argued and reported, therefore, that it is the more
involve solving everyday problems creatively, we would call that expressive, intuitive, and subjective creative professions where psy-
little-c creativity. This could involve activities such as making a chopathology and creativity should be and was most likely to be
new meal, creatively making use of materials around the house to associated. The more formal, logical, precise, and objective profes-
build a play structure, or writing an essay for a class. Next, we sions should be and were less likely to see psychopathology. In
move to people who make a living doing creative work, such as short, in the expressive arts, personal meaning, subjectivity, and
writers, musicians, scientists, architects, actors, and painters, but emotion play a motivational role in ways not common in the more
whose acclaim and impact are regional rather than national or formal creative professions. Further analysis within the artistic
international. This is Pro-C creativity, for “professional.” In other forms revealed consistently higher rates of psychopathology in the
words, the circle of people who find it meaningful or useful is rela- emotive/expressionistic styles than in the formal/realism styles. To
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be sure, these are correlational findings, so whether those with men-

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tively narrow. It has not yet changed the course of the discipline or
started a new branch of the discipline. Lastly, there is Big-C crea- tal and mood disorders are drawn to artistic careers or the other way
tivity, or genius level or historically significant creativity. These around has yet to be established.
are people who change the course of their fields, may have biogra- Other scholars have reported similar patterns whereby scientists
phies written about them, and often earn award and recognition suffer relatively low lifetime rates of psychopathology, whereas
from their peers for doing the best work in their field, and some- the other professions, especially the arts, had elevated rates of
times are studied by historians. In short, these four levels of the mental illness compared with base-rates in the general population
creative spectrum move from smallest to largest social/cultural (Damian & Simonton, 2015; Post, 1994; Simonton, 2014). A bio-
circle: self, family, region, and nation/world. graphical replication of the mental health status of 40 jazz musi-
As we discussed at the outset, there are different degrees of cre- cians from the 1940s and 1950s replicated Ludwig’s basic finding
ativity, different kinds of creativity, and how one defines and (Wills, 2003). Wills found elevated rates on chemical dependency,
measures it matters (Reiter-Palmon & Schoenbeck, 2020). One mood disorders, and anxiety disorders in jazz musicians. Heroin
reason for conflicting results in the literature on creativity and psy- addiction was also elevated in Will’s jazz sample, with 52% sam-
chopathology is the fact that degrees of creativity are conflated. ple having heroin problems at some point during their lives.
The size of the effect seems to be directly related to the degree or The one exception to this general finding with scientists may be
level of creativity, with the effect being largest in Big-C creative autism-spectrum disorder (ASD), predominantly in the high-func-
samples and smallest in little-c creative people. Moreover, method tioning range (Baron-Cohen et al., 2007; Billington et al., 2007;
of research is related to these two levels, with most little-c samples Focquaert et al., 2007; Thomson et al., 2015; Wei et al., 2017). We
being studied psychometrically or experimentally and Big-C or should point out, however, that most of this research on ASD and
Pro-C samples being studied historiometrically, biographically, or science and technology is with interest and careers in STEM (sci-
epidemologically (Johnson et al., 2012; Paek et al., 2016; Rich- ence, technology, engineering, and math) and not necessarily highly
ards, 1990; Silvia & Kimbrel, 2010; Taylor, 2017). For example, creative scientists and technologists. We are interested in examining
in a large Swedish national-population sample that included tens whether this relationship holds at high levels of scientific achieve-
of thousands professional (Pro-C) creative artists and scientists, ment and creativity.
Kyaga and colleagues (2011) reported significant associations Although Ludwig (1992) argued that psychopathology explained
between creative professions and being treated for bipolar disorder very little variance in terms of scientific achievement, there are cer-
or having a sibling or parent treated for schizophrenia. Moreover, tain circumstances where psychopathology may exist in scientific
in a study of an undergraduate (little-c creativity) sample, Silvia creativity. A good demonstration of this is the analysis by Ko and
and Kimbrel (2010) found that anxiety and depression could only Kim (2008) of 76 scientific geniuses from Simonton’s sample. Ko
explain 3% of the variance in creative thinking. Finally, Johnson and Kim predicted and found that the relationship between scien-
and colleagues (2012) conducted an extensive qualitative review tific creativity and psychopathology would be moderated by the
of the literature on bipolar disorder and creativity and found stron- kind of contribution the scientist made, namely whether it preserved
ger effects with Big-C than little-c creativity. or rejected paradigms. Specifically, scientists without pathology
were more creative when they made paradigm-preserving than par-
Domain of Creativity (Art Versus Science)
adigm-rejecting contributions. Paradigm-preserving is a contribu-
One of the main empirical findings from the literature on creativ- tion that advances but does to change a field’s direction. Paradigm-
ity and psychopathology is the stronger effect size between artistic rejecting contributions do in fact change a field’s direction. Those
than scientific creativity and psychopathology (Damian & Simon- with psychopathology, especially psychotic disorders, were more
ton, 2015; Ludwig, 1995, 1998; Post, 1994). Trauma, stress, mood creative (based on biographical/encyclopedia index ratings) when
disorders, and fear of death each seem to motivate artistic creativity they made paradigm-rejecting rather than paradigm-preserving
in a way they do not motivate scientific creativity or innovation in contributions. In addition, this moderator analysis more than
business. For instance, Ludwig’s later analyses (Ludwig, 1998) doubled the variance explained (18% vs 8%) by psychopathol-
made clear that lifetime rates of psychopathology are mostly ele- ogy in scientific creativity compared with Ludwig’s (1992) sam-
vated in the arts compared with the sciences, and in the expressive ple. An implication of these results is that psychopathology may
 4 FEIST, DOSTAL, AND KWAN

Figure 1
Categories of the Arts and Sciences and Prevalence of Mental Illness
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Note. Dark Gray: . 70%. Light Gray: . 60% , 70% White: , 60%. Adapted from Ludwig,
1998. See the online article for the color version of this figure.

be detrimental to their creative contribution only to scientists search for meaning and understanding, to make sense of one’s
who make paradigm preserving contributions. external rather than world.
Taylor (2017) discussed important ways how art and science
may be different: art requires less formal education and has more
Degree of Psychopathology
flexible work schedules (Simonton, 2010; Simonton & Song, It has become clear with the accumulation of research that high
2009) and hence does not exclude people with mood disorder; levels of mental illness are generally at odds with high levels of
poets, writers, and so forth more likely to experience trauma, men- creativity in any field, including art. Even when creativity and ill-
tal health problems in childhood; Ludwig (1998) suggests “occu- ness go together in certain people, it is mostly during periods of
pational drift” owing to emotional expressiveness required for relative calm and milder dysfunction that creative behavior may
different professions. In addition, we argue for internal versus coexist with pathology. In short, there is a nonlinear relationship
external experiences and meaning and understanding. That is, art between illness and creativity, with mild to moderate levels of pa-
—especially the expressive arts of literature and visual arts—is of- thology being most associated with creative achievement (Abra-
ten based in internal emotional/traumatic/stressful personal experi- ham, 2017; Acar et al., 2018; Feist, 2012; Kinney & Richards,
ences that lead to a need/motive to understand, give meaning to, or 2017; Simonton, 2017a; Swain & Swain, 2017; Wuthrich & Bates,
to express these experiences in artistic form, whether it be music, 2001). Jamison’s well-known book Touched With Fire (Jamison,
dance, poetry, visual art, or fiction writing (Akinola & Mendes, 1996), for instance, presented historical evidence for an associa-
2008; Gardner, 1973; Forgeard et al., 2017; Thomson, 2017). It tion between bipolar disorder and creativity, especially in literature
may not always be traumatic experiences, but at the least involves (i.e., Big-C creative people). However, she also made clear that it
a need or desire to express one’s perceptions of the world and their was those with milder forms (cyclothymia) that were most crea-
place in it (Forgeard et al., 2017). Science, on the other hand, is of- tive. Other researchers have come to the same conclusion, namely
ten driven by a need to understand and figure out the external that the relationship between creativity and bipolar disorder, schiz-
world, especially in the physical sciences. Scientists most often ophrenia, and schizotypy is mostly curvilinear (Acar et al., 2018;
ask: “What is that? Why? How can we explain that?” That is a Cox & Leon, 1999; Gostoli et al., 2017; LeBoutillier et al., 2014;
 PSYCHOPATHOLOGY AND CREATIVITY 5

Ruiter & Johnson, 2015). For instance, Kinney and Richards meta-analysis of studies published between 1987 and 2014 that
(2017) reported support for the nonlinear inverted-U hypothesis in examined mood disorders (bipolar, cyclothymia, major depression)
which creative thought and behavior were maximum at mild levels in creative samples reported a Hedges g = .64 (95% CI [.45, .82]),
of bipolar disorder (cyclothymia) and were relatively low at the meaning creative people are nearly two thirds of a standard deviation
low and high ends of the disorder. Moreover, it was first degree higher in mood disorder than noncreative people. When examining
relatives of those suffering from bipolar who tended to exhibit simple correlational studies on creativity scales and mood disorder in
highest levels of creativity. students and adults, however, Taylor (2017) reported a very small
After reviewing literature on affective traits and creativity, Feist effect (g = .09; 95% CI [.01, .17]). In short, the effect size was mod-
proposed a quadratic model of mental health and creativity, that erated by level of creativity. Flaherty (2005) reviewed a large range
makes clear the complex relationship (cf. Feist, 2012; see Figure 2). of neuroscientific evidence suggesting that frontal-temporal-limbic
The peaks of creativity tend to be with little and moderate levels of brain activity as well as dopaminergic activation are implicated in the
psychopathology, with valleys of creativity coming when psycho- relationship between creative drive and mood disorders. More specif-
pathology is low-medium and again high (cf. Feist, 2012). ically, Flaherty proposed a two-dimensional model with frontal-tem-
poral activity being on the x axis and dopaminergic activity being on
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Domain of Psychopathology
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the y axis. As abnormal temporal lobe activity and dopaminergic ac-

tivity both increase, mania, psychosis, and creative drive increase. As
Not only degree but also domain of pathology matters. In gen-
abnormal frontal activity increases and dopaminergic activity
eral, it is clear from research that particular forms of psychopathol-
decreases, creative blocks become more likely.
ogy are more associated with high levels of creative achievement
The relationship holds in the other direction too. Other studies
than other forms. The milder forms of mood disorders, including
have reported higher rates of creativity among bipolar patients
depression and bipolar disorder as well as milder forms of psy-
(Richards, 1994; Richards et al., 1988; Santosa et al., 2007; Simeo-
chotic disorders (schizotypy), appear to be among the more robust
nova et al., 2005). For example, when compared with healthy con-
correlates of creative achievement.
trols, patients with bipolar disorder scored higher on the Barron-
Mood Disorders Welsh Art Scale (BWAS) measure of creativity (Santosa et al.,
2007; Simeonova et al., 2005). Of note, however, is Taylor’s
Of all psychological disorders, perhaps none is more often empiri- (2017) finding that people with mood disorder are not necessarily
cally connected to creativity than mood disorders, especially bipolar more creative than those without mood disorder (g = .08; 95% CI
depression (and its less severe offshoot, cyclothymia). The general [
.00, .16]). Kaufmann and Kaufmann (2017) reviewed research
finding is there is an elevated rate of bipolar disorder exists among on the complex association between mood, mood disorders, and
creative people compared with general population (Andreasen, 1987; creative thought and behavior. Both positive and negative affect
Andreasen & Glick, 1988; Fodor & Laird, 2004; Furnham, Batey, and mood can be associated with creativity.
Anand, & Manfield, 2008; Gostoli et al., 2017; Jamison, 1996; Jami- An important qualification to the bipolar-creativity connection is
son et al., 1980; Johnson et al., 2012; Johnson, Murray, et al., 2015; that it seems to be more mania than depression that is associated
Johnson, Tharp, et al., 2015; Nowakowska et al., 2005; Ramey & with creative thought and behavior (Andreasen & Glick, 1988;
Weisberg, 2004; Richards, 1994; Taylor, 2017). Taylor’s (2017) Jamison, 1996; Jamison et al., 1980). Given the quickness and

Figure 2
Nonlinear Model of Degree of Creativity and Psychopathology
 6 FEIST, DOSTAL, AND KWAN

fluency of ideas that occur during mania, its relationship with crea- pathology in the association between creativity and mental illness.
tivity is understandable (Jamison, 1996; Richards, 1994). Moreover, More specifically, they proposed and found meta-analytic evidence
numerous studies support the idea that milder hypomanic states are that approach-based pathologies (positive schizotypy and risk of
most clearly correlated to creative thinking and achievement (Furn- bipolar) were more strongly and positively associated with high lev-
ham et al., 2008; Ruiter & Johnson, 2015; Schuldberg, 1990). els of creativity. Positive schizotypy consists of unusual experiences
The relationship between unipolar depression and creativity is and impulsive nonconformity, whereas negative schizotypy consists
less robust than bipolar. Paek and colleagues (2016) conducted a of cognitive disorganization and withdrawn schizoid traits. In addi-
meta-analysis that included 27 studies that reported results on tion, avoidance-based pathologies (e.g., anxiety, negative schizo-
depression and creativity. These 27 studies consisted of 103 effect typy, and depressive mood) were associated with lower levels of
sizes on over 14,000 participants. The mean effect size was essen- creativity. Similarly, Acar and Sen (2013) in a meta-analysis found
tially zero (r = .04; 95% CI [
.08, .16]). Silvia and Kimbrel small negative effect sizes between creativity and negative schizo-
(2010) reported the same very small effects between depression typy (r =
.09; 95% CI [
.12,
.06]; k = 76) and a small positive
and various forms of creativity in a college student sample. Some association with positive schizotypy and creativity (r = .14; 95% CI
research that broke nonclinical depression down into components
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[.12, .17]; k = 121).

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of rumination, self-reflective pondering, and brooding found that

rumination and self-reflective pondering but not brooding were
associated with creativity (Verhaeghen et al., 2005, 2014). Note, The Current Study
however, that all of these studies were conducted with students The primary purpose of the current study is to update and
and were little-c creative samples. attempt to replicate the results of Ludwig (1992, 1995, 1998) and
Similar small effects between trait anxiety and creativity have to test a more complex model of creativity and psychopathology.
been reported (Silvia & Kimbrel, 2010). For example, Paek and col- Not only is the Ludwig sample itself over 25 years old, but the
leagues (2016) also included in their meta-analysis research 32
subjects examined were required to be deceased, further distancing
studies that reported results on anxiety and creativity. These 32
them from their contemporaries. Therefore, an update and exten-
studies consisted of 60 effect sizes on more than 15,000 partici-
sion of the study is now in order. Additionally, the professional
pants. As was true with depression, the mean effect size between
categories proposed in Ludwig (1992, 1995, 1998) required
anxiety and creativity was not significantly different from zero (r =
reworking in the current study. For instance, several of the profes-

.05; 95% CI [
.16, .06]).
sions listed under social sciences, such as historian and philoso-
Psychotic Disorders pher, are not actually sciences at all and are frequently grouped
with humanities. The current study also improves on the previous
The psychotic disorders—schizophrenia, schizotypy, schizoaf-
methodology, which was vulnerable to researcher bias owing to
fective disorder, among others—also have a complex and not easy
the investigator’s awareness of the hypotheses (Ludwig, 1992).
to summarize relationship with creativity. With anecdotal excep-
Another goal of the current study is to see whether Ludwig’s find-
tions such as John Nash, full blown schizophrenia is seldom linked
ings from 20 years ago and with a different sample still hold and
to creativity (cf. Nasar, 2011; Rothenberg, 1990). Kyaga and col-
leagues (2011) reported that people who had first degree relatives replicate in a more current sample. More importantly, Ludwig did
suffering from schizophrenia and bipolar disorder were overrepre- not compare eminent famous creative people against eminent fa-
sented in creative professions. Moreover, Eysenck (1993, 1995) mous noncreative people, and simply analyzed his data with chi-
proposed and found some support for the idea that the nonclinical squares for inequalities between groups. We decided, therefore, to
personality trait and psychoticism is associated with creative hold fame constant in our comparison group of famous athletes
thought and behavior. Psychoticism is a nonpathological rather (with published biographies) to determine whether fame more than
than clinical personality trait consisting of consistent social isola- creativity could explain the presence or absence of mental illness
tion, aloofness, hostility, and unusual thoughts and behaviors. in our sample. In short, by having a control group that was eminent
Feist (1998) found support for this idea in a meta-analysis on the and famous (i.e., biography-worthy) and yet not creative, we could
personality correlates of creativity. rule out pure fame and eminence as a confounding explanation in
As numerous scholars have pointed out, however, psychoticism any relationship between creativity and psychopathology.
is too broad and diverse a construct to consistently be related to cre-
ative thought and behavior (Batey & Furnham, 2008; Carson et al., Hypotheses
2003; Mason et al., 1995; Nettle, 2006). They argue that psychoti-
cism’s specific and somewhat more clinical cousin, schizotypy, is 1. World-class creative artists will have elevated rates of any
more robustly related to creativity. Schizotypy is a personality dis- lifetime mental illness relative to creative scientists and famous
order in which subclinical symptoms of psychosis are exhibited, athletes (controls).
such as unusual experiences, magical thought, eccentric behavior, 2. The mental health difference between artists and scientists
and cognitive disorganization (Claridge et al., 1996). In little-c crea- will be most pronounced on mood/affective disorders (anxiety,
tive and Big-C creative samples, schizotypy is associated with crea- depression, bipolar) and chemical dependency, with artists
tive thought (Acar & Runco, 2012; Acar & Sen, 2013; Baas et al., expected to have higher rates than scientists.
2016; Batey & Furnham, 2008; Burch et al., 2006; LeBoutillier et 3. Creative scientists should show elevated rates of being on the
al., 2014; Nettle, 2006; Schuldberg, 1990). Baas and colleagues high functioning end of the autism spectrum relative to athlete
(2016), for instance, argued for a moderation effect by type of controls.
 PSYCHOPATHOLOGY AND CREATIVITY 7

Method and 1.5% Asian-Pacific Islander. In 2016 when the data were col-
lected, the U.S. demographics were 60% White-Caucasian, 18.5%
Subjects and Materials Latinx, 13% Black/African American, 6% Asian American (U.S.
Census Bureau, 2019).
The list of potential creative and eminent scientists, artists, and Each subject was placed into either a scientific, artistic, or ath-
athletes for inclusion in the study came from rankings in diction- letic domain. Scientific domains were defined as technology/
aries, encyclopedias, and best-of lists. The original list, after merg- invention, mathematics, physics, chemistry, biology/medicine,
ing 163 source lists and removing duplicates, contained 17,689 psychology, and social sciences (anthropology and sociology).
distinct names. Each “best-of” source list was ranked by a member Earth scientists (e.g., geologists, oceanographers, climatologists)
of the research team (D.D.) on a 3-point scale for trustworthiness, were excluded because of a lack of biographies. Artistic domains
with a 1 being of questionable validity, 2 being more subjective, were defined as visual arts, fiction writing, poetry, acting, musical
and a 3 being very trustworthy. The primary criterion for a code of performance, and musical composition. Using these career group-
3 was whether the list was created by experts in the field and/or ings, the current sample consisted of 104 artists, 68 scientists, and
was of international award such as the Nobel Prize. A code of 2 27 athletes (see Table 1). The entire sample had a median year of
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

was awarded if the list were created by professionals in the field birth of 1919 with an average birth year of 1921. The range of
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(e.g., a poll among more than a hundred contemporary leading birth years was 1873 to 1979. Of the 199 subjects in the final list,
physicists conducted by Physics World magazine, Dunani & 46 (23%) were alive at end of data collection in 2016. For the 153
Rodgers, 1999), whereas a code of 1 was awarded for lists made participants who had died, the average age of death was 72 (me-
by amateurs or based on unclear methodology. One such example dian = 75; mode = 81; range 25 to 98). For the 46 participants who
of an unclear methodology is the “Greatest Mathematicians of All were alive, the average age was 71.70 (median = 73; mode = 75;
Time” list published on server thetoptens.com.1 range 41 to 89). Ninety-three percent of the sample was married at
Next, an index of eminence was calculated for each potential least once (mean age of first marriage = 27.13). There was no ca-
subject within each domain as a sum of trustworthiness scores of reer domain difference in mean age of first marriage. Artists
all lists in the domain containing the subject’s name. To prevent (59%) were more likely to have divorced than scientists (38%).
overlap with Ludwig’s (1992) sample, subjects must have either
died after 1950 or been born before 1980, if they were still alive. Procedure
The 45 most eminent professionals in each domain were selected
Biography Selection and Preparation
as potential subjects in the sample. Individuals who tied for the
45th most eminent position were included in the sample. This pro- After the subject-pool was narrowed down to subjects who had
cedure led to a total of 766 potential subjects. Professionals in usable biographies written about them, we purchased each biogra-
multiple domains were sorted in the category in which they ranked phy either in digital or bound format. If the book was in bound for-
in a higher position. mat, we then detached its binding and scanned the entire body of
After the list of potential subjects was obtained, the next step the text (excluding front- and rear-matter) into readable ORC/digital
was to determine whether or not a viable and relevant biography format. Next, we cleaned the digital books by removing all images,
was written about that person. When available, e-versions (Kindle) headings, footers, foot notes and most tables and equations.
of biographies were purchased. If no e-version was available, hard
copies were purchased, had their bindings removed, and were digi- Pathology Selection
tally scanned via optical character recognition (OCR) conversion. Before ratings of pathologies could be made, the research team
To be selected for study, biographies had to be written for an adult discussed and decided which specific diagnostic illnesses would
audience and include information on the creator’s personal life be coded. For this process we mostly followed Ludwig by obtain-
and were not solely intellectual or work biographies. Moreover, ing the original variable list. Ludwig’s team coded mental health
autobiographies, biographies written by close relatives, biographi- status of immediate family members as well as the creative person.
cal chapters, letters, and memoires were excluded. Of the 766 We coded only the creative person. Moreover, we also added a
potential subjects, 391 did not have appropriate biographies writ- few illness categories that we believed Ludwig missed and might
ten about them, leaving a potential sample of 375. If there were be relevant as exploratory analyses, such as Asperger’s syndrome
more than one biography written about a person, we chose the one (high functioning autism) and synesthesia. The final list consisted
that had the most life-history information. Owing to time and of 19 diagnostic illnesses listed in the Diagnostic and Statistical
resource constraints, 199 of the 375 biographies were purchased Manual of Mental Disorders, 5th edition (DSM–5; American Psy-
for coding (18% female).2 Analyses revealed that the 199 biogra- chiatric Association, 2013; see Table 2).
phies were representative of the larger 375 sample on proportion
of artists, scientists, and athletes as well as proportion of deceased Paragraph Selection
subjects. The proportion of women however increased from 13% After each of the 199 biographies was scanned and cleaned, a
to 17.5% in the final sample of 199, v2(1) = 9.45, p = .002. Never- linguistic analysis program was created by the second author to
theless, the proportion of women in each subgroup did not change,
v2(2) = 1.34, p = .510. In the final sample, there was a higher per- 1
For complete Best of Lists, Awards, and Rankings, see https://doi.org/
centage of women in the arts than sciences or sports, 28%, 7% and 10.17605/OSF.IO/TFYDK.
4% respectively, v2(2) = 16.11, p , .01. The overall sample was 2
Raw data are posted on Open Science Framework at https://doi.org/10
83% White-Caucasian, 13% Black/African American, 2% Latinx, .17605/OSF.IO/TFYDK.
 8 FEIST, DOSTAL, AND KWAN

Table 1 Psychopathologies were rated on a 3-point scale of not present

Specific Domains and group Sizes (0), probable (1), and present (2) if they occurred at any point in
the creator’s lifetime. Rating present was used in cases where
Domain % White N of Men N of Women Total N
DSM–5 criteria were clearly met or where the subject was diag-
Artists 75 29 104 nosed professionally during their lifetime. If not enough infor-
Visual arts 100.0 8 1 9 mation was given in the biography to provide a clear diagnosis
Fiction writing 85.7 26 9 35
Poetry writing 90.9 9 4 11 from DSM–5 criteria and yet there was some evidence that a dis-
Acting 95.0 11 9 20 order was suspected, then raters gave that a probable rating. In
Music performance 46.2 18 8 26 short, a probable rating was provided whenever there was some
Music composition 100.0 3 0 3 but not overwhelming evidence of a disorder. Present was pro-
STEM 63 5 68
Technology/Invention 100.0 9 1 10 vided when a professional diagnosis was made during the per-
Mathematics 100.0 7 0 7 son’s lifetime or when the biographical evidence was very clear.
Physics 100.0 19 0 19 During training on the Ludwig sample, if raters initially fell
Biology/Medicine 100.0 6 1 7
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below the .80 reliability criterion, research meetings were held

Chemistry 100.0 4 1 5
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Psychology 100.0 11 0 11 with other raters and the lead researcher (G.J.F.) to discuss dis-
Social Sciences 100.0 7 2 9 crepancies and to reach consensus. For final nontraining ratings,
Comparison group 26 1 27 two independent and randomly assigned raters coded each biog-
Athletes 55.6 26 1 27 raphy. Any disagreement was adjudicated by a third rater (G.J.
Total 164 35 199
F.) to establish the final rating.

Results
automatically locate and highlight any of the 175 relevant key-
words related to 19 mental illness categories (see Appendix A in
Previous and Current Lifetime Rates of Disorders
the online supplemental materials). The initial list was based on
words used by Ludwig (1995) but was expanded through a discus- For sake of comparison, in Table 3 we present the population
sion between the investigators after a review of the DSM–5 and estimates of lifetime rates of psychological disorders published in
Stein and colleagues (2010). From either the biographical or pub- the literature. Two studies have reported large-scale national popu-
lic websites we obtained the following demographic variables: lation estimates of lifetime rates of any disorder. Kessler, Berglund,
profession/career, date of birth, date of death (if deceased), year of and colleagues (2005) reported a rate of 46.4% and Lev-Ran and
mother’s death, year of father’s death, birth order, race/ethnicity, colleagues (2013) reported a rate of 33.7% for any mood, anxiety,
gender, year of marriage (first), year of marriage (second), country personality or psychotic disorder. In this context, the lifetime rate in
of birth. our sample for creative artists and scientists was 49.7% (85 of 171)
Two trained graduate students further narrowed the biographical and for athletes was 48.1% (13 of 27), v2(2) = 2.39, ns. For artists
texts to include only paragraphs relevant for assessment of mental only, the percentage of “present” cases was 61/103 (59.2%), and
health of subject in question. For example, “depression” may have for scientists it was 24/68 (35.3%). Over the course of their lifetime,
been tagged by the program, but if it referred to the economic period artists were more likely to have at least one form of psychopathol-
of the 1930s then that paragraph would be excluded from further rat- ogy than scientists, v22(1) = 9.38, p = .002. Artists were not more
ing. Similarly, if key terms were tagged but referred to someone likely to have a lifetime bout of psychopathology compared with
other than the target creator, those paragraphs were also de-selected athletes (59% versus 48%, respectively) , v2(1) = 1.07, ns.
for further rating. When the less exclusive “probable” cases were also included, the
Pathology Ratings frequency of psychopathology increased to 126 of 171 (73.7%) in
the creative groups compared with 16 of 27 (59.3%) athletes, v2(1) =
In the fifth and final step, seven raters were selected and 2.39, ns. The observed frequencies on “probable” lifetime psychopa-
trained to identify possible psychopathologies in each biography thology for artists (83%), scientists (59%), and athletes (59%) were
excerpt. Raters could only begin once they met the .80 interrater
reliability with training data from Ludwig’s (1992, 1995). Poten- Table 2
tial raters were given paragraphs selected from a biography then List of Rated Psychopathologies
asked to code the given reading material for the psychopatholo-
gies described above. Ratings were compared against the origi- Rated psychopathologies
nal coding data from Ludwig’s study. Interrater reliability was Adjustment disorder Obsessive-compulsive disorder
measured using Gwet’s agreement coefficient AC1 (Gwet, 2008), Alcoholism Paraphilia
which was preferred over Cohen's kappa coefficient as it pro- Anxiety disorder Personality disorder (of any kind)
vides unbiased estimate even in case of strongly uneven occur- Autism spectrum disorder Posttraumatic stress disorder
Conduct disorder Schizophrenia/Psychotic disorders
rences of categories (Gwet, 2002; Wongpakaran, Wongpakaran, Depression/Depressive disorder Sleep disorders
Wedding, & Gwet, 2013). To keep raters blind and free of any Drug use/dependency Somatic disorder
previous bias, the name of the subject in question was replaced Eating disorder Suicide/Suicide attempt
with the word “Creator” in all biography excerpts. Subjects were Gambling disorder Synesthesia
Kleptomania
coded for lifetime prevalence of any of 19 psychopathologies.
 PSYCHOPATHOLOGY AND CREATIVITY 9

Table 3
Published Population Estimates of Lifetime Rates of Psychological Disorders
Author(s), Date Disorder Percent of population
Baca-Garcia et al. (2010) Suicide attempted: Male 1.75%
Suicide attempted: Female 2.95%
Suicide ideation: Male 6.00%
Suicide ideation: Female 7.60%
Hudson et al. (2007) Eating disorder: Male 2.80%
Eating disorder: Female 5.90%
Lev-Ran et al. (2013) Any mood, anxiety, psychotic, personality disorder 33.7%
Kessler, Berglaund, et al. (2005) Anxiety disorder 28.80%
Mood disorder 20.80%
Impulse-control disorder 24.80%
Substance abuse 14.60%
Any disorder 46.40%
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Merikangas et al. (2007) Bipolar I 1.00%

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Bipolar II 1.10%
Subthreshold bipolar 2.40%
Nock and Kessler (2006) Suicide (ideation/attempt) 2.70%
Perälä et al. (2007) Psychotic disorder (any kind) 2.29%
Robins et al. (1984) Any disorder 28.8% to 38.0%
Anxiety disorder 10.4% to 25.1%
Substance abuse disorder 15.0% to 18.1%
Affect-mood disorder 6.1% to 9.5%
Psychotic disorder 1.1% to 2.0%
Personality disorder 2.1% to 3.3%
Eating disorder 0.0% to 0.1%
Note. Robins et al. (1984), consisted of three samples from New Haven, CT, Baltimore, MD, and St. Louis, MO, and interviews were conducted between
1980 and 1982. Bolded text highlights the overall “any disorder” category.

different from chance, v2(2) = 14.68, p = .001. This effects stems conclusive. Finally, 52% of the artists and 24% scientists experienced
from artists having a higher lifetime rate than both scientists, v2(1) = the loss of a parent in childhood, v2(1) = 15.04, p , .001.
12.86, p , .001, and athletes, v2(1) = 7.45, p = .006.
Even though the overall frequency of any psychopathology was Planned Analyses
extraordinarily high, relative frequencies of individual disorders
rarely exceeded a few percent. Occurrences higher than 5% were Recall, the three main predictions were that compared with athletes
only observed in depression/depressive disorders (26%), alcoholism and scientists, artists as a whole would have elevated lifetime rates of
(16%), drug use/dependency (12%), and anxiety disorder (11%). psychopathology, especially in the mood disorders and substance
These compare with the rates of 28.8% for anxiety, 20.8% for abuse categories. We also predicted that scientists would have ele-
mood, and 14.6% for substance abuse in the general population vated rates of high functioning autism compared with athlete controls.
(Kessler et al., 2007; Kessler, Berglund, et al., 2005). To test these hypotheses, a Bayesian logistic regression3 was
For a more sophisticated analyses of these trends, for each listed used to model the relationship between mental disorder presence
psychopathology, a null hypothesis about the uniform distribution of and creativity domain. The dependent variable was an occurrence
its occurrences in compared groups was tested. In each comparison, a of particular mental disorder. We have used two separate models
chi-squared test with a Monte Carlo simulated p value was used with differently defined dependent variables for each disorder. In
because it has no assumptions about minimal expected frequencies the first one, the present cases only were coded as 1. In the second
(estimates were done with 106 replicates; Hope, 1968). We have one, both present and probable cases were coded as 1. The values
included both present and probable occurrences of psychopathology of the dependent variable were predicted with categorical factor
without differentiating between them into analysis. Observed frequen-
3
cies for each category and resulting p values are detailed in Table 4. Computations were performed in statistical program R with the
The results suggest that there are unequal frequencies between the do- rstanarm package (Stan Development Team, 2016). The student t-
distribution with 7 degrees of freedom and a scale parameter 2.5 was
main of eminent individual and the occurrence of Alcoholism, Drug chosen as a prior for all regression weights. The student distribution was
use/dependency, Gambling disorder, Suicide/suicide attempt and also preferred from the normal distribution because its heavy-tailedness enables
Depression/depressive disorders, Anxiety disorder, Sleep disorder and substantial differences from expected value. The location was set to zero in
all parameters with the exception of the intercepts in which case logits of
Autism spectrum disorder. Note that there were 21 significance tests
population prevalences according to Kessler, Berglund, and colleagues
performed, which results in substantial increase in familywise first (2005) and Nock and Kessler (2006) were used. The parameter estimations
type error rate. To keep familywise error rate under 5% Bonferroni were computed with NUTS sampling method (Hoffman & Gelman, 2014)
corrected p-values can be used. This correction suggests that the fre- on 8 MCMC chains each performing 6,000 iterations (2,000 in burning
phase). The e-values in favor of null hypothesis stating that odds ratio
quencies in Autism spectrum disorder (pBonf. = .271), Suicide/suicide
equals one were computed using fbst package (Kelter, 2020). Above
attempt (pBonf. = . 282), and Gambling disorder (pBonf. = .169) are not mentioned priors were used as the reference functions. For details see
different from expected, so we should not consider those results as Pereira and Stern (2020).
 10 FEIST, DOSTAL, AND KWAN

Table 4
Sample Frequencies of Lifetime Rates of Psychopathology Across Professional Domains
Psych. & Visual Artists,
Math. and Musicians and Physicists Social Writers, and
Athletes Biologists Technol. Actors and Chemists Science Poets
Disorder (n = 26) (n = 7) (n = 17) (n = 50) (n = 24) (n = 21) (n = 54) p
Synesthesia 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.2) 0.0 (0.0) 0.0 (0.0) 18.5 (18.5) 1.00
Adjustment disorder 0.0 (0.0) 0.0 (0.0) 0.0 (17.6) 0.0 (0.4) 0.0 (4.2) 0.0 (0.0) 0.0 (7.4) .152
Alcoholism 7.7 (11.5) 0.0 (0.0) 11.8 (11.8) 20.0 (14) 0.0 (4.2) 9.5 (9.5) 27.8 (38.9) .002
Drug use/dependency 7.7 (7.7) 0.0 (0.0) 5.9 (11.8) 26.0 (16) 0.0 (0.0) 4.8 (4.8) 11.1 (11.1) .002
Depressive disorders 7.7 (7.7) 14.3 (28.6) 23.5 (41.2) 20.0 (19) 20.8 (41.7) 23.8 (42.9) 48.1 (64.8) ,.001
Bipolar disorder 7.7 (7.7) 0.0 (0.0) 5.9 (11.8) 0.0 (0.4) 4.2 (4.2) 0.0 (0.0) 18.5 (5.6) .770
Anxiety disorder 7.7 (11.5) 0.0 (0.0) 11.8 (17.6) 0.8 (24.0) 8.3 (20.8) 0.0 (14.3) 13 (38.9) .046*
Obsessive compulsive 0.0 (0.0) 0.0 (0.0) 0.0 (11.8) 0.2 (0.6) 0.0 (4.2) 0.0 (0.0) 0.0 (5.6) .526
Schizophrenia 7.7 (7.7) 0.0 (0.0) 5.9 (5.9) 0.0 (0.2) 0.0 (0.0) 0.0 (4.8) 18.5 (18.5) .909
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Somatic disorder 7.7 (11.5) 0.0 (0.0) 0.0 (5.9) 0.0 (0.4) 0.0 (0.0) 0.0 (4.8) 18.5 (3.7) .587
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Autism spectrum disorder 0.0 (0.0) 0.0 (0.0) 0.0 (5.9) 0.0 (0.0) 0.0 (12.5) 0.0 (0.0) 0.0 (1.8) .038*
Suicide/suicide attempt 0.0 (0.0) 0.0 (0.0) 0.0 (5.9) 0.0 (0.4) 4.2 (12.5) 0.0 (0.0) 7.4 (11.1) .227
Sleep disorder 7.7 (15.4) 0.0 (14.3) 0.0 (5.9) 0.4 (1.2) 0.0 (0.0) 0.0 (0.0) 3.7 (16.7) .185
Eating disorder 0.0 (0.0) 0.0 (0.0) 0.0 (5.9) 0.0 (0.6) 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) .242
Personality disorder 7.7 (7.7) 0.0 (0.0) 5.9 (11.8) 0.6 (7) 8.3 (16.7) 0.0 (4.8) 0.0 (3.7) .261
Gambling disorder 15.4 (19.2) 0.0 (0.0) 0.0 (0.0) 0.2 (0.2) 0.0 (0.0) 0.0 (0.0) 3.7 (3.7) .008*
Conduct disorder 7.7 (7.7) 0.0 (0.0) 0.0 (0.0) 0.2 (0.4) 4.2 (16.7) 0.0 (0.0) 3.7 (3.7) .106
Kleptomania 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (18.5) 1.00
Posttraumatic stress 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.2) 0.0 (0.0) 0.0 (0.0) 18.5 (3.7) .852
Paraphilia 0.0 (0.0) 0.0 (0.0) 0.0 (0.0) 0.0 (0.2) 0.0 (0.0) 0.0 (0.0) 3.7 (3.7) .852
Any psychopathology 46.1 (57.7) 14.3 (28.6) 52.9 (70.6) 52.0 (78.0) 33.3 (62.5) 33.3 (57.1) 66.7 (87.0) .003*
Note. Percentages outside brackets involve present cases of psychopathology occurrence. Percentages inside the brackets include both present and proba-
ble cases. Column p contains Monte Carlo simulated p values testing null hypothesis that relative frequencies of present or probable psychopathology
occurrences are uniformly distributed across compared domains.
*pBonf . .05.

domain with seven levels listed in Table 1. Dummy variable cod- scientists had approximately the same odds as athletes. Artists were
ing was used with the group of athletes used as a reference group. most at risk for depression/bipolar (ORs = 6.28 and 9.19 for present
Besides the categorical independent variable, the gender and two and present/probable, respectively) compared with controls. The
quantitative covariates were included in the model to hold them only disorder for which scientists were at elevated risk was the more
constant: year of birth of each subject and the length of their life. inclusive present/probable rate for depression/bipolar (OR = 4.53).
If any biography was published during the life of the subject, the For all other disorders, scientists were either equally likely or less
age of the subject in the year of publication was used instead of likely to experience them compared with athlete controls. For exam-
age of their death, as the biography author did not have informa- ple, creative scientists were significantly less likely (ORs = .21 - .23)
tion about the subjects’ lives from that point. Both quantitative to be afflicted with substance related and addictive disorders than
covariates were centered and scaled to the z-score format. athletes.
The hypotheses about model parameters were tested with Full In Figure 4 we present results broken down by subgroups. As is
Bayesian Significance test (FBST; Pereira & Stern, 1999). This pro- evident in Figure 4, the elevated risk of mental illness in the artist
cedure uses e value (evidence value) as a measure of statistical signif- group primarily is a result of writers and visual artists. Looking at
icance (Pereira & Stern, 2020). In its simplest form, e-value in favor only “present” rates of specific disorders, writers and visual artists
of the null hypothesis stating parameter equals zero is close to the were 4.52 times more likely than athletes to suffer from any pres-
idea proposed by Thulin (2014): what is the maximal value of a ent mental illness over the course of their lifetime. In fact, no other
resulting in 1
a posterior credible interval not containing zero. subgroup was more or less at risk compared with athlete controls.
Keeping in mind this analogy between p values/confidence intervals In addition, it was primarily the writers and visual artists who
and e values/credible intervals, we also used value .05 for rejection were at increased risk of depression/bipolar (OR = 8.11), anxiety
of the null hypothesis. (OR = 7.53), and suicide/attempt (OR = 15.79).
Figure 3 shows the prevalence interval estimates (95% highest When we expand the analysis to include “probable” or “pres-
density regions) of the selected present or probable psychopatholo- ent” rates, results were much the same except for depression and
gies. Each creative domain was also compared with the control substance abuse. Musicians, actors, writers, visual artists, poets,
group of athletes. The odds ratios of psychopathology occurrence in mathematicians, and technologists were all more likely to be sus-
each group compared with the control are represented in the figures pected of having depression and/or bipolar compared with fa-
as text labels. The asterisk notation indicates e values lower than mous athletes (ORs = 3.82 – 10.86). Visual artists, writers and
.05, .01, and .001, respectively. Dot indicates nonsignificant result poets were more likely to suffer anxiety disorder (OR = 3.58)
with e value lower than .1. Figure 3 reports that artists were more and be suicidal or attempt suicide (OR = 6.18) than athletes.
than 2.71 times more likely to experience any mental illness over Moreover, physicists and chemists were less likely than athletes
the course of their life compared with eminent athletes, whereas to suffer substance related and addictive disorders (OR = .04).
 PSYCHOPATHOLOGY AND CREATIVITY 11

Figure 3
Prevalence of Selected Mental Disorders (Present and/or Probable) in Creative Artists and Scientists Compared
With Eminent Athletes
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There were no differences between the creative groups and ath- philosophy are scholarly subjects, they are not typically considered
letes in sleep disorders. sciences.
The current study also sought to streamline the process of finding
relevant information in books by digitizing each biography into a
Discussion searchable digital media. This would allow for the researchers to oper-
ate at an increased pace by eliminating irrelevant text very quickly.
The intention of the current study was to examine the more com-
Transforming each book into a digital format also made it possible to
plicated and moderated relationships between creativity and psycho-
censor the names of each creator to limit any previous knowledge that
pathology by updating and replicating Ludwig’s (1992) biographical
could bias the rating group.
analysis of world-class creative artists and scientists. Our expectation
The results of the current study generally corroborated the findings
was that artistic creative professions in general would possess higher reported in Ludwig’s and other studies, lending further support to
levels of psychopathology than creative scientists. We also predicted previously established hypotheses. Despite using an entirely new set
that scientists would not differ from the base rates of psychopathol- of subjects, not included in Ludwig’s (1992) sample, artists still pos-
ogy found in the U.S. population, whereas artists would. sessed higher rates of psychopathological traits than scientists, ath-
The current study controlled for researcher bias by removing letes, and the U.S. population in general. Scientists were consistently
the biographical material of its subjects’ identities. The previous rated lower on symptoms of psychopathology than artists, despite
study conducted by Ludwig (1992) was executed with the equal eminence. These results held true in both inclusive and exclu-
researcher knowing the identity of each subject, and may have sive requirements for classification into the mentally ill group. How-
been biased by previous working knowledge of each professional. ever, the difference between artists and athletes was not significant in
Certain professions that were given new classifications as the older the more exclusive interpretation of the data. Rates of drug abuse and
categorizations, as designated in Ludwig (1992, 1995), may have anxiety also differed between artists, scientists, and athletes depend-
been incorrectly assigned. For example, historians and philoso- ing on whether inclusive or exclusive criterion were used to define
phers were considered scientists by Ludwig. Although history and what constituted psychopathology. In both cases, fewer subjects
 12 FEIST, DOSTAL, AND KWAN

Figure 4
Prevalence of Selected Mental Disorders (Present and/or Probable) in Creative Domains and Athletes
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Note. Text labels indicate odds ratios for psychopathology occurrence in creative domains compared to the athletes. The aster-
isks indicate whether the 1-a centered highest density region for posterior density of regression weight contains zero (no effect)
when a equals 5% (*), 1% (**), or 0.1% (***).
 PSYCHOPATHOLOGY AND CREATIVITY 13

qualified for inclusion into the mentally ill group when exclusive cri- study, writers and publishers may be more inclined to pursue biog-
teria were used. However, the differences between groups grew raphies for particularly interesting people to tell more compelling
larger in the case of anxiety and smaller in the case of drug use, thus stories. Because someone with a history of psychopathology may
moderating the results. serve as a more desirable subject for a biography than someone
Artists also showed greater rates of alcoholism, drug abuse, who is not, healthier professionals may have fewer books written
depression, and OCD than those found in the U.S. population. Again, about them. Indeed, the study also contained a much smaller num-
statistical significance changed for a few of psychopathologies ber of scientists than artists, which may be due to writers and pub-
depending on the strictness of criterion for inclusion. Anxiety among lishers favoring more artists rather than scientists since the latter
artists was considered lower in the stricter assessment but still gained may be perceived as less interesting or hold less recognition in the
significance due to the high rate of anxiety reported in the U.S. popu- general public.
lation. Rates of OCD also fell for artists and scientists under stricter The level of fame could not be held constant through all three
criterion and detectable differences were no longer found. groups. Although some scientists such as Stephen Hawking and
Because we had a small comparison sample of famous but not Richard Feynman are particularly well known, not all eminent sci-
professionally creative athletes, we could also address the question entists are easily recognizable to the public (e.g., Alfred Tarski,
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

of whether fame itself—isolated from creativity—is a contributing Grigori Perelman, George Beadle). Most of the actors (e.g., Mar-
This document is copyrighted by the American Psychological Association or one of its allied publishers.

factor to psychopathology. Because athletes were generally less lon Brando, Robert DeNiro, Sophia Loren) and musicians (e.g.,
likely than artists and even scientists to develop psychopathology Ella Fitzgerald, Prince, Diana Ross, Johnny Cash) were well
at some point during their lives, we can tentatively conclude that known to the general public. Athletes, although more recognizable
fame per SE is not the driving force behind psychopathology. than scientists, tend to dwindle in fame after retirement. Because
There was one exception to this, namely anxiety. Athletes exhib- the careers of most athletes are particularly short, their highest
ited higher lifetime rates of anxiety disorders than the general pop- point of fame tends to come earlier in their lives rather than later.
ulation. An interesting question therefore becomes “Do higher This is incongruent with scientists as fame for their achievements
rates of anxiety precede or follow athletic fame?” That is, is anxi- tend to come later, after their work has been recognized. Both ath-
ety a cause or effect of athletic eminence? letes and scientists may also possess lower levels of fame than per-
Assuming the relationship between some forms of creativity formance artists such as musicians and actors.
and some forms of pathology are robust and real, then the ques- Another limitation of the current study is the gender imbalance
tion becomes why might these two traits covary? Recent litera- in the creative sample. The biographies of men in the sample out-
ture from biological and evolutionary approaches have numbered women 164 to 35 (18% female). There are historically
suggested biological bases and even potentially adaptive func- fewer biographies written about women than men, especially the
tions of the relationship between creative thought and behavior sciences. Moreover, women have been less likely to reach the
and psychopathology. For instance, research has reported a pol- highest levels of their professions, whether they have biographies
ymorophism of a particular gene involved in psychosis that is written about them or not—the famous “glass ceiling.” For exam-
associated with high levels of creativity and high IQ (Kéri, ple, women have historically been seriously underrepresented in
2009). The gene in question is neuregulin 1, which is a candi- mathematics and sciences. Only 8.8% 15.8% of tenure-track posi-
date gene for psychosis and affects neuroplasticity, glial func- tions among top universities are held by women in math-centric
tion, and neuronal development in general. One form of the domains (Ceci & Williams, 2011), and only 20% of physics PhDs
gene, the T/T genotype, was related to both high creativity and were awarded to women as recently as 2017 (Porter & Ivie, 2019).
risk for psychosis. Based on this and other evidence, Kozbalt During the time that many eminent people in this sample were
and colleagues (2017) argued that one possible reason why a most active professionally—the 1950s to 1980s—the percentage
maladaptive trait may still exist in humans is its shared genetic of women earning PhDs in physics was between 3% to 7% (Porter
linkage with creative behavior (cf. Akiskal & Akiskal, 2007; & Ivie, 2019). Yet not all professions are so imbalanced. For
Greenwood, 2020; Nettle, 2001, 2006; Power et al., 2015). Sim- example, our sample had five women of 68 (7%) in the STEM dis-
ilarly, other empirical and theoretical evidence supports the idea ciplines but 29 of 104 (28%) women in the arts. In acting, the cur-
that the milder levels of mental illness, for example cyclothy- rent sample had a ratio of nine of 20 (45%), and in musical
mia, confer advantages such as increase fluency of ideas that performance it was eight of 26 (31%).
make creative thought more likely (Carson, 2011; 2014; Green- This finding begs the question of why are women underrepre-
wood, 2020). Carson (2011, 2014), in fact, proposed that the sented in certain fields more than others and in particular at the top
“shared vulnerability” traits of openness, impulsivity, schizo- of their fields? There is an extensive scientific literature on this
typy, cognitive disinhibition, hypomania, and cyclothymia are question that goes well-beyond the scope of this article (Cheung &
the traits that connect psychopathology (risk factors) and crea- Halpern, 2010). Suffice it to say that social and cultural biases
tive (protective factors) behavior. In sum, there are various neu- about marriage, child rearing, and performance play a very large
rological, evolutionary, and adaptive factors that may undergird role in “glass ceiling” effect (Cheung & Halpern, 2010). For
the associations between some forms and degrees of creativity example, in a nationwide study, biology, chemistry, and physics
and some forms and degrees of psychopathology. professors were found to consider men as both more hirable and
competent (Moss-Racusin et al., 2012).
Caveats and Limitations Similarly, the sample was skewed racially, with being of
White-European ancestry (83% of our sample, compared with
A number of confounding variables limit the results of this 60% in the U.S. population). Indeed, 100% of the Science-Tech-
study. One such limitation is sample bias. In the case of the current nology group was White. Part of this bias comes from the bias in
 14 FEIST, DOSTAL, AND KWAN

published biographies, especially during the time frame of our highly creative people. The use of digital resources allowed for the
study. Moreover, basing research on biographies will inherently researchers to limit bias through the use of censors to hide the
require older samples given the delay between creative accom- identity of each creator. The classification and grouping of each
plishments and publication of a biography. Future research will profession were also reworked for further accuracy. As is true of
need to continue to determine whether these trends hold with all research, however, for each question answered, others arise and
more ethnically diverse samples. await further attention from future investigators. The topic of psy-
Additionally, determining how to interpret historical and bio- chopathology and world-class creative achievement is a rich and
graphical texts is a challenge for psychological study (Citlak, complex topic and will provide material for researchers for years
2016; Czechowski et al., 2016). Biographies still require interpre- to come.
tation as historians of certain types of professions may differ from
others in what report. Some professions may encourage exagger-
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