The link between hypomania risk and creativity: The role of heightened behavioral activation system (BAS) sensitivity

Highlights

• BAS sensitivity was associated with hypomania risk and symptoms.

• BAS sensitivity was also associated with creativity.

• BAS sensitivity mediated the relation between hypomania risk and creativity.

Abstract

Background

The relationship between bipolar disorder (BD) and creativity is well-known; however, relatively little is known about its potential mechanism. We investigated whether heightened behavioral activation system (BAS) sensitivity may mediate such relationship.

Methods

Korean young adults (N=543) completed self-report questionnaires that included the Hypomanic Personality Scale (HPS), the Behavioral Activation System(BAS) Scale, the Everyday Creativity Scale (ECS), the Positive Affect and Negative Affect Schedule (PANAS), and the Altman Self-Rating Mania Scale (ASRM). Correlational, hierarchical regression and mediation analyses using bootstrap confidence intervals were conducted.

Results

As predicted, BAS sensitivity was associated with self-reported creativity as well as hypomania risk and symptoms. Even when positive affect was controlled, BAS sensitivity predicted incrementally significant variance in explaining creativity. In mediation analysis, BAS sensitivity partially mediated the relation between hypomania risk and creativity.

Limitations

Reliance on self-report measures in assessing creativity and usage of non-clinical sample.

Conclusions

BAS sensitivity was related not only to mood pathology but also to creativity. As a basic affective temperament, BAS sensitivity may help explain incompatible sides of adaptation associated with BD.

Introduction

A substantial body of literature indicates the link between bipolar disorder (BD) and creativity (Galvez et al., 2011, Johnson et al., 2012d, Murray and Johnson, 2010 for reviews). There is converging evidence across diverse samples and different methodologies. Early autobiographical studies of famous artists who were ascertained or suspected to have had BD described that this disorder occasionally fueled artistic enthusiasm, particularly in (hypo)manic state, leading to creative eminence (Andreasen, 1987, Galvez et al., 2011, Goodwin and Jamison, 2007, Jamison, 1989, Ludwig, 1992). Subsequent self-report studies found that even non-eminent people suffering from or at risk for BD appear more creative in that they chose creative professions and hobbies more often (Schmidt et al., 2010, Tremblay et al., 2010, Vellante et al., 2011). Moreover, individuals diagnosed with or at risk for BD showed a more creative tendency in validated experimental tasks such as Barron Walsh Art Scale (Johnson et al., 2012d, Santosa et al., 2007, Schuldberg, 2001, Srivastava et al., 2010).

Drawing on considerable evidence supporting the link between BD and creativity, more research is directing its focus to the next-step question of which mechanisms underlie the link (Johnson et al., 2012d). What are the psychological variables that are implicated in both BD and creativity? Although this mechanism is not well-established yet, on a broad level, personality, affective, and cognitive characteristics such as openness to experience, positive affect, cyclothymia, divergent thinking, risk-taking, ambition and drive were proposed as variables that can explain such co-occurrence (Baas et al., 2008, Furnham et al., 2008, Johnson et al., 2012d, Johnson et al., 2015a, Johnson et al., 2015b, Murray and Johnson, 2010, Ruiter and Johnson, 2015, Strong et al., 2007).

We noted that behavioral activation system (BAS) sensitivity is an important but overlooked variable which may foster both benefits and costs of BD as a basic affective temperament, as we argue in the following section. In the BAS model of BD, heightened BAS sensitivity is conceptualized as a core psychological risk factor for developing mood pathology, especially (hypo)manic symptoms or episodes (Depue and Iacono, 1989, Fowles, 1988). A number of empirical studies have confirmed this hypothesis (Alloy and Abramson, 2010, Johnson et al., 2012b, Urošević et al., 2008 for reviews). However, a relatively unaddressed issue at the moment is whether elevated BAS sensitivity are absolutely maladaptive. Few studies investigated possible adaptive features associated with BAS sensitivity in BD. While BD is a serious psychiatric disorder notorious for a wide variety of dysfunctions such as alcohol/substance abuse, occupational difficulty, interpersonal and legal problems, and suicidal risk (Angst et al., 2002, Miklowitz and Johnson, 2006, Murray and Lopez, 1996), potential “sunny sides” of BD (Hantouche et al., 2003) were also documented including creativity. Here, BAS sensitivity as a “double-edged sword” (Johnson et al., 2012c) may be a meaningful construct for explaining the seemingly incompatible sides that BD imposes on human adaptation. Although BAS sensitivity is a vulnerability factor and course predictor of BD (Alloy et al., 2015), by definition, the BAS is a hypothetical neurobiological system that facilitates goal-directed behavior in response toward incentive and reward, which may contribute to personal achievement in reality (Gray, 1990). Hence, it is necessary to comprehensively understand the role of BAS sensitivity in influencing both maladaptive and adaptive aspects of functioning in BD.

Given that people high in BAS sensitivity are more prone to experiencing positive affect and show strong desire and persistence in goal-directed behavior (Carver and White, 1994), the psychological variables (e.g. positive affect, ambition, drive) previously discussed as relevant to creativity can also be viewed as being closely tied to normal BAS function. Furthermore, studies suggest that the link between BD and creativity is related not to the disorder per se but to a certain affective temperament, which is a continuous individual difference of which the extreme may correspond to affective pathology (Akiskal and Akiskal, 2005, Johnson et al., 2012d, Schuldberg, 2001). Therefore, there is ample possibility that high BAS sensitivity observed in BD may also contribute to creativity as well as mood pathology. But, to the best of our knowledge, there is no empirical study that examined the link between BD and creativity from BAS sensitivity perspective.

Last but not least, it should be worthwhile to mention that creativity is a multifaceted construct without consensus definition (Johnson et al., 2012d). Creativity can be defined as the ability to invent a novel solution (Runco, 2004) or the ability to produce something new, original and useful (Feist, 1998). Various distinctions can be made such as creative process versus product and everyday versus eminent creativity (Barron and Harrington, 1981, Ivcevic and Mayer, 2009, Rhodes, 1987). As a result, measurement of creativity is a complicated matter as well. So far, lifetime creative achievement has been regarded as the most valid and objective measure (Johnson et al., 2012d, Taylor et al., 2015); however, this approach has a limitation in that creativity may or may not be expressed into creative outcomes depending on multiple factors including certain circumstances or motivation. Also, variables associated with the creative process rather than the product may have implications for explaining subjective and internal-working aspects of creativity. Furthermore, as previously noted, it is acknowledged that expressions of creativity may manifest in non-eminent, non-artistic areas. Therefore, studying creative ability in daily life will supplement valuable information in the existing literature (Richards, 1993).

The main objective of this study was to explore the relationship between hypomania risk, BAS sensitivity and creativity. Specifically, we expected that BAS sensitivity would be associated with creativity as well as hypomania risk and (hypo)manic symptoms. Next, to rule out the possibility that the association between BAS sensitivity and creativity is due to the third variable, positive affect, we tested if BAS sensitivity in addition to hypomania risk would be an incrementally significant predictor of creativity, when positive affect was controlled for. Finally, we examined if BAS sensitivity mediated the relationship between hypomania risk and creativity to further explore the relationship.