Creativity and psychosis vulnerability: An examination of similarities and differences in factors associated with early psychosis, professional creative and non-creative populations

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In a recent large case-control study, MacCabe and colleagues (2018) identified students studying creative subjects, as having significantly higher odds of developing schizophrenia and bipolar disorder than non-creative students. They assert that, it is this creativity that predates the onset of psychosis and advocate for further research. Given the aforementioned emerging research, the question of what enables an imaginative, sensitive, creative individual to continue on a productive path rather than a trajectory of delusions and psychosis is of increasing importance. Research into what distinguishes the clinical from creative and non-creative populations will be presented in this thesis. Research from a diverse sample of participants, including individuals with an experience of early psychosis (EP), creative professionals with subclinical psychotic symptoms (at-risk creative control ARCC), creative professionals with no psychotic symptoms (creative controls CC) and a non-creative control (NCC) population were examined. In three studies, measures of creativity, personality, schizotypy, cognition, anxiety and stressful life events were undertaken to determine what factors may differentiate the early psychosis (EP) from the creative population. On measures of creativity, personality, anxiety and schizotypy, the creative control (CC, ARCC) and early psychosis (EP) groups recorded significantly higher scores than those of the NCC group. In particular, the EP and ARCC groups were more closely aligned than expected. In terms of cognitive assessment the only difference recorded between the ARCC and EP cohorts was significantly higher results on spatial working memory (SWM) (but not IQ, executive function or negative priming) recorded by the ARCC. A further differentiating factor was the EP’s incidence of early childhood trauma and measures of perceived hardship compared to ARCC, CC and NCC. These results provide further evidence for the close association between creative professionals and those with psychosis. Furthermore it illustrates the need for careful mental health assessment and targeted psychological intervention for creative populations. A 𝘱𝘳𝘰𝘥𝘳𝘰𝘮𝘦 𝘮𝘰𝘥𝘦𝘭 𝘰𝘧 𝘷𝘶𝘭𝘯𝘦𝘳𝘢𝘣𝘪𝘭𝘪𝘵𝘺 is proposed to illustrate the differences between the two (ARCC and EP) populations. This model is suggested to form the basis for further longitudinal research and future assessment models. This research refines our understanding of the vulnerabilities and protective factors that differentiate early psychosis and creative individuals. Moreover it introduces innovative therapeutic approaches for intervention within clinical populations.
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