Do Neurodegenerative Diseases Affect Creativity? Divergent Thinking in Frontotemporal Dementia and Parkinson’s Disease

Creativity is considered to be one of the most important characteristics that humans possess. It emerges from fundamental cognitive operations and the activation of specific brain regions. In several neurological disorders, such as frontotemporal dementia (FTD) and Parkinson’s disease (PD), creativity plays an important role in diagnosis and rehabilitation strategies. This study examined the link between creativity and pathology in a sample of neurological patients (idiopathic PD, n = 17; FTD, n = 11 with behavioural or semantic variants), and 15 healthy subjects (Mini Mental State Examination score ≥ 20; age range, 45 to 85 years) using the Divergent Thinking Test. The FTD group exhibited lower scores than the PD and control groups. Furthermore, PD patients performed significantly better on the single DTT factor, originality, than controls.

These results are discussed in relation to neurological mechanisms that may influence creative strategies in dementia. Finally, it has been proposed creativity therapy as a cognitive rehabilitation approach, which may help patients enhance and maintain cognitive functions, reduce the severity of emotional disorders, and promote social interactions.     

Neuropsychological Differences Between Frontotemporal Dementia and Alzheimer's Disease: A Review

This paper surveys the similarities and differences between frontotemporal dementia (FTD) and Alzheimer's disease (AD). The review covers findings primarily from neuropsychological studies on memory, language, attention/executive function, and visuospatial abilities. However, neuropsychiatric and neuroimaging data are also briefly discussed. Distinguishing features of both FTD and AD are described in order to present a comprehensive clinical picture of these dementing diseases, which is essential for the process of differential diagnosis. The cause of specific cognitive deficits is also considered. Our comprehensive review of the empirical literature reveals that AD is characterized by early memory loss and visuospatial problems, while among the main features of FTD are behavioral abnormalities and executive dysfunctions.     

The Early Neuropsychological and Behavioral Characteristics of Frontotemporal Dementia

Frontotemporal lobar degeneration (FTLD) represent a constellation of disorders that may be overlooked or misdiagnosed, despite being fairly common presenile neurodegenerative diseases. Although the cognitive disorder can be difficult to document, particularly early in the dementia course, neuropsychological evaluation can assist in the diagnosis. Neuropsychologists are in an excellent position to draw from related disciplines like personality theory and social psychology to better assess the types of changes that characterize the prodromal and early phases of the disease. This review summarizes the current state of the field in the diagnosis of FTLD and discusses the emerging role of neuropsychology in elucidating the brain organization of complex processes including empathy, behavioral control and inhibition, reward systems, appetitive behaviors, emotional regulation, and goal-orientation. As this review underscores, frontotemporal dementia remains a powerful model for studying brain–behavior relationships.     

Divergent thinking in Alzheimer's and frontotemporal dementia

Twenty-three patients with mild dementia of the Alzheimer's type (DAT) or frontotemporal type (DFT) and age- and education-matched control subjects were administered tests of complex fluency involving divergent thinking and tests of letter, category, and figural fluency. The tests of complex fluency discriminated the dementia patients from control subjects more strongly than did the other fluency tests. The results suggest that divergent thinking as assessed by complex fluency tests is a cognitive domain that is impaired early in the course of dementia. The sensitivity of complex fluency tests compared to that of letter, category, and figural fluency tests may be related to greater demands for conceptualization in relating stimulus attributes to function and greater demands for flexible thinking during self-directed search processes.     

Divergent Thinking and Age-Related Changes

Aging can affect cognition in different ways. The extent to which aging affects divergent thinking is unclear. In this study, younger and older adults were compared at the performance on the Torrance Test of Creative Thinking in visual and verbal form. Results showed that older adults can think divergently as younger participants, although they produce fewer visual ideas. This finding involves implications for active aging, given that also older adults can be still capable to produce original ideas and improve living conditions surrounding them.     

The Cerebellum in Frontotemporal Dementia: a Meta-Analysis of Neuroimaging Studies

Neuropsychology Review - Frontotemporal dementia (FTD) is a neurodegenerative brain disorder primarily affecting the frontal and/or temporal lobes. Three main subtypes have been recognized:...     

Flexibility and Originality in Children's Divergent Thinking

Previous research on the ideational process indicates that original ideas increase in frequency as an examinee works through an open-ended task. In the present investigation, ideational flexibility was evaluated to determine if ideas also become more varied and diverse. Additionally, the relationship of intelligence (IQ) with order effects of both originality and flexibility was investigated. Tests of verbal and figural divergent thinking were administered to 80 intermediate school children. The midpoint of each individual's ideational set was found, and the flexibility and originality scores of each half of the set were compared. Results indicated that flexibility and originality scores were higher in the second half than the first half of the ideational set, but there were significant differences between high- and low-originality subjects and differences between the verbal and the figural tests. The order effect was unrelated to the IQ scores of the subjects. Suggestions are made to integrate ideational flexibility into existing theories of divergent ideation.     

Primary Process Thinking,Divergent Thinking,and Coping in Children

The relationships among primary process thinking, divergent thinking, and coping were investigated in fifth-grade children. Specifically, it was hypothesized from psychodynamic theory that access to and integration of primary process thinking would be positively related to divergent thinking and that both integration of primary process and divergent thinking would be predictive of coping ability. The Rorschach (Holt's scoring system) and Alternate Uses Test (spontaneous flexibility score) were administered to 53 fifth-grade children. Zeitlin's Coping Inventory, a teacher's rating scale, was the coping measure. Results confirmed the hypotheses for boys in that the percentage of primary process and the Adaptive Regression score on the Rorschach were significantly related to divergent thinking, r(27) = .33, p < .05 and r(27) = .34, p < .05, respectively. Divergent thinking was significantly related to teachers' ratings of coping ability for boys, r(27) = .58, p < .01. There were no significant relationships among the variables for girls. These sex differences in the pattern of correlations are consistent with previous findings.     

Disrupted Face Processing in Frontotemporal Dementia: A Review of the Clinical and Neuroanatomical Evidence

Faces play an integral role in day-to-day functioning, particularly for social interactions where dynamic and rapid processing of information is vital. Analysis of faces allows an individual to ascertain a wide range of information including deciphering mood and identity, with these assessments directing an individual’s subsequent response and behaviours. The prominent social and emotional deficits observed in frontotemporal dementia (FTD), a younger-onset dementia syndrome, may in part reflect a breakdown of the face processing network. Different subtypes of FTD present with divergent patterns of atrophy, although damage is predominantly confined to the frontal and temporal lobes. Specific predictions regarding the role of frontal and temporal regions in face processing have been proposed in the model outlined by Haxby et al. Trends in Cognitive Sciences, 4(6), 223–233 (2000). This model presents a parsimonious method by which to understand face processing in FTD while concurrently allowing assessment of the predictive value and applicability of such a model. By applying the Haxby model to the existing FTD literature, this review presents both direct and indirect evidence of a breakdown in key elements of the face processing network. The type and degree of breakdown appears to differ as a function of FTD subtype and associated brain atrophy. The evidence presented in this review and its relationship with predictions of the Haxby model provides impetus and direction for future research investigating face processing in FTD.     

Disturbance of Emotion Processing in Frontotemporal Dementia: A Synthesis of Cognitive and Neuroimaging Findings

Accurate processing of emotional information is a critical component of appropriate social interactions and interpersonal relationships. Disturbance of emotion processing is present in frontotemporal dementia (FTD) and is a clinical feature in two of the three subtypes: behavioural-variant FTD and semantic dementia. Emotion processing in progressive nonfluent aphasia, the third FTD subtype, is thought to be mostly preserved, although current evidence is scant. This paper reviews the literature on emotion recognition, reactivity and expression in FTD subtypes, although most studies focus on emotion recognition. The relationship between patterns of emotion processing deficits and patterns of neural atrophy are considered, by integrating evidence from recent neuroimaging studies. The review findings are discussed in the context of three contemporary theories of emotion processing: the limbic system model, the right hemisphere model and a multimodal system of emotion. Results across subtypes of FTD are most consistent with the multimodal system model, and support the presence of somewhat dissociable neural correlates for basic emotions, with strongest evidence for the emotions anger and sadness. Poor emotion processing is evident in all three subtypes, although deficits are more widespread than what would be predicted based on studies in healthy cohorts. Studies that include behavioural and imaging data are limited. Future investigations combining these approaches will help improve the understanding of the neural network underlying emotion processing. Presently, longitudinal investigations of emotion processing in FTD are lacking, and studies investigating emotion processing over time are critical to understand the clinical manifestations of disease progression in FTD.     

Convergent Thinking Moderates the Relationship between Divergent Thinking and Scientific Creativity

Creativity plays an important role in human society as well as in individual development, and creativity in the domain of science is a specific form. A body of research had demonstrated the role of divergent thinking in creativity. The role of convergent thinking had also been recognized, but more empirical evidence was needed. To investigate the interaction between convergent and divergent thinking on adolescent scientific creativity, the current study tested 588 high school students. The results showed that convergent thinking interacted with fluency/flexibility of divergent thinking on scientific creativity. In particular, divergent thinking predicted creativity in those high in convergent thinking. Findings suggested a threshold-setting effect of convergent thinking, which meant only when convergent thinking capacity reached a certain level, divergent thinking could play a role in scientific creativity. Implications for future research and educational practice were discussed.     

Benefits of Incubation on Divergent Thinking

Studies on whether fixation cues provided in the first episode of divergent thinking tasks influence creative outcomes after incubation, as they do for convergent problem-solving tasks, remain limited. This research examined the beneficial effects of incubation using the delayed- and immediate-incubation paradigms. Participants in Experiment 1 were either provided or not provided fixation cues during the first episode of a new type of divergent-thinking task, similar to creating titles in plot stories. The results indicated that fixation cues moderated people’s creative outcomes after incubation. Going through incubation did not improve the participants’ creativity in the second episode for strong fixation cues. By contrast, an incubation period led to the generation of more divergent items in the second episode compared to the first episode for less strong fixation cues, and this led to the performance matching the condition without fixation cues. The results from Experiment 2 suggested that immediate incubation downsized the influence of fixation cues. Therefore, if people want to promote their creativity through a period of incubation, the outcomes may still depend on the conditions of environments in which the creative works are executed.     

Strategy Induction Enhances Creativity in Figural Divergent Thinking

Instructional effects in creative‐thinking tasks are important to understand in order to promote creative performance of individuals. In divergent‐thinking tasks, for example, instructional and strategic enhancement effects have been extensively studied for verbal tasks. However, while studies on instructional enhancement effects on creative drawing tasks exist, it is surprising that strategy enhancement in figural divergent thinking is still underresearched. In this study, we used a strategy manipulation approach to reassess the role of executive strategy implementation and the moderating role of an indicator of fluid intelligence, figural analogical reasoning, in two types of figural divergent‐thinking tasks (abstract vs. concrete). The sample comprised N = 75 high‐school students. Importantly, we found strategic enhancement effects by combining strategy instructions with a prompt to “be creative.” This combined instruction was contrasted with a standard instruction, and main effects were found for overall, concrete, and abstract creativity. Moreover, we found in a regression analysis a main effect for figural analogical reasoning on overall creativity and creativity for only the concrete object tasks. An expected interaction effect of instruction and figural analogical reasoning was not found. As another addition, the role of current motivation in figural divergent thinking was explored.     

Developmental Trends in the Evaluative and Divergent Thinking of Children

The purpose of this study was to investigate divergent thinking and evaluative skill as important processes in the development of creative thinking in elementary schoolchildren. Children from the 3rd, 4th, and 5th grades (N = 117) received divergent thinking tasks and measures of evaluative accuracy. The latter indicated how well they liked various ideas (i.e., their preferences) and the degree to which the children believed those ideas to be original. Results indicated that the accuracy of their originality judgments increased significantly with age, as did the preference for appropriate ideas. Unlike previous research, evaluative scores were not related to divergent thinking test scores. Also somewhat surprising, given earlier research, was the lack of a "4th-grade slump." In fact, there was a significant peak, rather than slump, in the divergent thinking of 4th-grade children, at least in the raw fluency scores. When fluency ratio scores were compared, there were still some incidents of a 4th-grade peak, but there was also a significant decline with grade in the proportions of 1 index of highly appropriate ideas. Although a relation was not found between evaluative skill and divergent thinking raw fluency scores, an increasing preference for appropriate square ideas was found to contribute significantly to the prediction of decreases in the proportion of high-quality round ideas given. Possible explanations are given to account for this unexpected finding, including differences in interpersonal and intrapersonal evaluative skills, and the distinction between the ability to accurately identify original or appropriate ideas and choosing to selectively express such ideas.     

Effects of Marijuana Use on Divergent Thinking

This research sought to evaluate the effect of marijuana use on creativity as defined by the term divergent thinking. Another objective was to verify if there was a difference in the creativity of regular users (60 participants) and that of novice users of marijuana (60 participants) under 3 experimental conditions: without marijuana, with placebo, and with marijuana. The 4 divergent thinking factors (fluency, flexibility, originality, and elaboration) were measured by the Torrance Tests of Creative Thinking (Form A, Figural scale). The results showed that the use of marijuana had no positive effects on divergent thinking (creativity) in novice users and reduced it in regular users.     

Word List Generation Performancein Alzheimer's Disease and Vascular Dementia

Word list generation (WLG) was examined among clinical samples of individuals with Alzheimer's disease (AD) (n = 73) or ischemic vascular dementia (IVD) (n = 85), equivalent in age, education, current and estimated premorbid intellectual functioning, and proportion of men and women. The AD group performed significantly better than did the IVD group on lexical WLG, and a trend was observed indicating superior performance among the IVD group on categorical WLG. Within-groups, comparisons of group means, and profile analyses of individual performance patterns all indicated that persons with AD demonstrated a lexical > categorical pattern significantly more often than did IVD participants. The absolute difference in average performance between the AD and IVD groups on lexical and categorical WLG was small; the findings, however, generally support the clinical utility of the lexical > categorical WLG pattern in the differential diagnosis of AD and IVD. The patterns of performance support the presence of relative impairment in semantic processing among the individuals with AD and global deficits in retrieval and processing speed in individuals with IVD.     

Improving The Measurement of Divergent Thinking Attitudes in Organizations

Three new improved scales measuring three independent divergent thinking attitudes were developed in field research with managers and were labeled “Valuing New Ideas,” “Belief that Creativity is Not for Only a Select Few,” and “Not Feeling Too Busy for New Ideas.” These three scales represent an improvement over three scales initially identified by Basadur and Hausdorf (1996). Two studies were done. The first was a reliability study in which higher internal consistencies and improved understanding and labeling were achieved. The second was a field experiment in which preliminary evidence of external validity of the three scales was established. The scales effectively measured the changes in these attitudes that were expected after training. Opportunities for future research are identified.     

Theory of Mind and the Origin of Divergent Thinking

The development of a “theory of mind” may not only be important for understanding the minds of others but also for using one's own mind. To investigate this supposition, 40 children between the ages of three and four were given false-belief and creativity tasks. The numbers of appropriate and of original responses in the creativity test were found to correlate positively with performance on false-belief tasks. This association was robust, as it continued to be strong and significant even when age and verbal intelligence were partialled out. The results support the hypothesis that the metarepresentational skills involved in theory of mind also affect the way children can access and scan their own mental repertoire beyond the areas of currently activated content (i.e. divergent thinking). With the advent of theory of mind a basic cognitive shift takes place in human development, and possibly took place in cognitive evolution.     

Preference for Complexity and Asymmetry Contributes to Elaboration in Divergent Thinking

The study continues the exploration of the contribution of creative perception to creative potential. Creative potential was operationalized as divergent thinking and measured by the Abbreviated Torrance Test for Adults. Creative perception was operationalized as a preference for complexity and asymmetry and was assessed by a standard Barron-Welsh Art Scale. Sixty-five undergraduate college students participated in the study. Preference for complexity and asymmetry was found to make a measurable contribution to the elaboration trait of divergent thinking. This finding suggests that in addition to the process, product, person, place, persuasion, and potential perspectives, creativity construct can be evaluated from the standpoint of creative perception.