Giftedness and ADHD

Giftedness is (actually) a technical term and refers to people with an IQ of 130 and above (2.1 to 2.28% of all people). An IQ of 140 and higher occurs in 0.7% of all people, an IQ of 145 and higher in 0.1%.
However, by giftedness this article does not mean the narrow definition term, but rather people in general with an IQ that is well above the average of 100.

Significantly reduced intelligence is associated with an increased risk of ADHD. This applies not only to an IQ below 70, but also to an IQ of 70 to 85.¹

Even though we know many gifted people who suffer from ADHD, our following presentation does not intend to equate ADHD and giftedness, nor to justify one with the other. However, while dealing with the topics of ADHD, giftedness and high sensitivity (according to Aron) or heightened sensitivity, we encountered so many parallels and points of contact that we could not help but wonder whether these could be helpful in the search for an explanation of ADHD.

• 1. ADHD more common in gifted individuals?
• 2. Intelligence and IQ in ADHD
  • 2.1. Definition of intelligence
  • 2.2. IQ measurements in ADHD
    • 2.1.1. Questions about IQ testing procedures when comparing ADHD sufferers and non-affected individuals
      • A. Were the ADHD sufferers tested with medication and were they optimally adjusted?
      • B. Were the ADHD sufferers tested unmedicated?
      • C. Was no attention paid to medication?
    • 2.1.2. Conclusions for IQ testing procedures when comparing ADHD sufferers and non-affected individuals
  • 2.3. Influence of ADHD subtype on IQ?
  • 2.4. Influence of comorbidities on IQ measurement
  • 2.5. Influence of learning ability on IQ
  • 2.6. Common genes of ADHD and IQ
  • 2.7. Intelligence deviance as a relevant factor for ADHD?
  • 2.8. Speculation: Do stress and increased sensitivity train intelligence?
• 3. Giftedness and mental disorders
  • 3.1. Common genetic roots of intelligence and mental disorders
  • 3.2. Common environmental causes of intelligence and mental disorders
• 4. Delayed cortex maturation in ADHD as in giftedness
• 5. Similar traits of gifted people and ADHD sufferers
  • 5.1. Convergent traits of giftedness and ADHD
  • 5.2. Non-matching traits of giftedness and ADHD
    • 5.2.1. Specific traits of ADHD
    • 5.2.2. Specific traits of gifted people
  • 5.3. No change of positive traits by ADHD medication
• 6. Differential diagnosis required
• 7. Giftedness and coping skills
• 8. ADHD testing through intelligence testing?
• 9. More about ADHD and giftedness:

1. ADHD more common in gifted individuals?¶

Several sources claim that ADHD sufferers do not have a higher IQ than non-affected individuals.² Some report just below average to normally distributed intelligence with 10% affected with an IQ of 120³, others report 5 to 6% highly gifted among ADHD sufferers⁴ in the verbal IQ range, which would be well above average.

A more recent study shows a massively above-average occurrence of ADHD symptoms in adults with an IQ of 130 and above and in 7.7 % of children with an IQ of 135 and above, which is almost three times more frequent than in the control group with 2.8 %.⁵ A survey of the Baden-Württembergische Landesverband Hochbegabung e.V. in 2002 among 252 highly gifted members of the association between 5 and 30 years of age included a rate of ADHD-I of 4 % (of which 80 % were boys) and of ADHD-HI of 4.8 % (of which 83 % were boys), thus 8.8 % ADHD. Limiting the survey to children with an IQ of 130 or more resulted in an ADHD rate of 6.6%.⁶ The result indicates an existing relationship, although the restriction to club members implies a limitation in interpretability, since people who have no problems at all with an issue that affects them are generally less likely to have a reason to join a club. This study also reports many studies on IQ and ADHD that confirm a correlation.
These studies may be a reflection of the increased rate of ADHD in people with lowered IQs, making ADHD less likely in those with intermediate IQs.

One study determined an average IQ of 107.88 from 511 ADHD sufferers. Whether the subjects were tested with or without medication was (as is usually the case) not reported.⁷
In a lecture, Barkley cited an IQ reduced by 7 to 10 IQ points in ADHD and reasoned that the same genes as those for giftedness were involved.⁸ Another study also found decreased IQ scores in ADHD.⁹ The lowest IQ values were found in persistent ADHD, and the (relatively) highest in late-onset ADHD. This study also did not differ according to medication status.

A fascinating similarity of giftedness and ADHD from a neurological perspective is reported by Eckerle.¹⁰

Even if a correlation between HB and ADHD should one day be proven, it should at best be possible to deduce from this - against the background that ADHD and marked underachievement also correlate - that particularly high and particularly low IQs are equally associated with an increased risk of ADHD.

2. Intelligence and IQ in ADHD¶

2.1. Definition of intelligence¶

Intelligence is not a scientifically fixed measure, but a - quite differently - defined term.
According to Newton and McGrew’s definition, general intelligence includes eight broad components:¹¹

• Fluid thinking (abstract thinking ability)
• Crystalline general knowledge
• Visuo-spatial ability
• Long-term memory
• Auditory processing
• Information processing speed
• Short-term memory
• Quantitative knowledge

as well as additional skills such as psychomotor skills¹²

Gardner distinguishes eight independent intelligences in his “Theory of Multiple Intelligences” model:

• Linguistic
• Musical
• Logical-mathematical
• Spatial (which distinguishes architects, for example)
• Physical-kinesthetic (common among athletes and dancers)
• Natural history
• Interpersonal intelligence (facilitates work with fellow human beings)
• Intrapersonal (ability to self-reflect)

Common portions of working memory and short-term memory correlate with intelligence.¹³
The efficiency of working memory is a crucial factor for the measure of intelligence.
Highly gifted people thus automate their thinking performance. Highly gifted people do not simply think more than normally gifted people, but they use their brain more efficiently. The more efficient use occurs, among other things, by automating processes that normal gifted people bring about with active thinking (working through individual thinking steps in the frontal cortex) and outsourcing these automated thinking processes to the hindbrain cortex.¹⁴

Automation is not something that only highly gifted people can do.

The hindbrain cortex is also the center of visual processing. It is therefore not so wrong when people who have internalized a thing very much and have achieved an intuitive access to it say: “I see it”.

2.2. IQ measurements in ADHD¶

Among other things, working memory is impaired in ADHD sufferers. Intelligence tests usually also measure working memory.
Optimal treatment, whether successful neurofeedback or medication with stimulants, relieves the burden of this burden on the IQ reduced by ADHD symptoms (especially the massive impairment of working memory) - the working memory impairment is reduced.
The ADHD burden on IQ can be as high as 20 IQ points in individual cases. On average, it could be around 10 IQ points.

Of 19 participants with ADHD-HI according to DSM III-R, 12 responded very well to neurofeedback training in which beta was trained up and theta was trained down (40 sessions). The other 7 showed smaller improvements. In the responders, IQ improved by 10 points at the same time as symptomatology (from 112 to 122).¹⁸ Other sources report a difference of 20 IQ points between acute and inapparent (medicated) symptom states.¹⁹

The statement “ADHD has nothing to do with giftedness”, in the sense of “giftedness and ADHD do not correlate” or “the IQ of ADHD sufferers and non-affected persons is the same”, can therefore not be correct (in this global form), since ADHD obviously has an influence on examination and test results, which - like IQ tests - depend on the usable IQ.

2.1.1. Questions about IQ testing procedures when comparing ADHD sufferers and non-affected individuals¶

An important question is:
Were the ADHD sufferers whose IQ was compared with that of non-affected persons tested with or without medication? Very few studies provide information about this, which already gives rise to considerable doubts about the reliability of conclusions about the IQ of the affected persons.

A. Were the ADHD sufferers tested with medication and were they optimally adjusted?¶

If the IQ of only medicated ADHD sufferers and the average of non-affected persons is the same, the IQ results of unmedicated ADHD sufferers should be significantly (about 10 IQ points) below the average of non-affected persons, because the impaired working memory (short-term memory) in unmedicated ADHD sufferers impairs IQ. However, such test results are not known.
Another argument against this assumption is that in this case a reduced IQ would be a recognizable symptom of (untreated) ADHD and would therefore have found its way into the diagnosis. This is also not reported.
Moreover, a comparative test with only medicated ADHD sufferers would be unusual enough to have been reported.

B. Were the ADHD sufferers tested unmedicated?¶

Then the following possibilities arise:

Possibility 1:

The evaluations of the IQ tests were carried out by excluding the share of working memory. Then, however, the statement “The IQ of ADHD patients and non-affected persons is the same” would be wrong and would have to be restricted with “if one excludes the working memory”. So far, we have not found such a restriction anywhere.

Possibility 2:

Other brain areas of ADHD sufferers can compensate for the below-average working memory. However, then the other brain areas of ADHD sufferers would function better on average than those of non-affected persons. This would be nothing more than a partially higher aptitude that (coincidentally?) is just as high that the IQ impairment is compensated by the burdened working memory.
This seems very unlikely. Moreover, such a result would be so surprising that it would have been the subject of reports with some probability.

C. Was no attention paid to medication?¶

Such tests would be useless due to the presented influence of the impaired working memory in ADHD on IQ.
Since the above alternatives to the influence of medication were not mentioned in most studies, we suspect this variant.

2.1.2. Conclusions for IQ testing procedures when comparing ADHD sufferers and non-affected individuals¶

For IQ testing of ADHD sufferers, we believe it follows:

For a comparison of the IQ average of ADHD sufferers with that of non-affected persons:

• The IQ submeasurements for working memory must be evaluated separately.
• When comparing ADHD sufferers / non-affected persons, only optimally medicated persons may be tested for the IQ tests of ADHD sufferers (medically optimally adjusted medication and taking the medication during the test).
• Since medication can usually only alleviate ADHD symptoms, but not completely eliminate them, even this would only bring about true comparability to a limited extent.
• It would at least be interesting to see whether the respective test results would change significantly if, for IQ matching of the subjects, IQ was matched once from unaffected to optimally medicated affected and once from unaffected to unmedicated affected.

For the treatment of ADHD sufferers:

• Successful treatment makes the intelligence that is actually present and impaired by the ADHD symptoms (partially) available again.
  Of 19 participants with ADHD-HI according to DSM III-R, 12 responded very well to neurofeedback training in which beta was trained up and theta was trained down (40 sessions). The other 7 showed smaller improvements. In the responders, IQ improved by 10 points (from 112 to 122) in addition to symptomatology.¹⁸

2.3. Influence of ADHD subtype on IQ?¶

According to a (single) study, the IQ of the entire ADHD group was reduced by 15 points, and for ADHD-C it was considerably lower than for the predominantly inattentive (ADHD-I) or the predominantly hyperactive/impulsive ADHD-HI subtype. Only for the predominantly hyperactive/impulsive ADHD-HI subtype was IQ comparable to the control group.²³ However, even the abstract of the article contradicts the reported values.
Our impression does not coincide with this.

2.4. Influence of comorbidities on IQ measurement¶

Further, it should be noted that partial performance disorders often occur as comorbidities in ADHD, including:

• Reading and spelling disability (dyslexia)
• Dysgraphia
• Dyscalculia

Their effects may have an influence on the measurement results in the linguistic or mathematical area. This could result in a value in the measurement of the overall IQ that could be too low in view of the abilities for abstraction and analytical thinking.²⁴
For a clean comparison of the IQ of ADHD sufferers with non-affected persons, such comorbidities would have to be excluded.
⇒ Partial Achievement Disorders in the article Comorbidity

2.5. Influence of learning ability on IQ¶

Although IQ is fundamentally genetically predisposed, this disposition includes a mean deviation of 21 IQ points as a random dispersion measure. This can be eliminated with a suitably high number of subjects (n).
In contrast, what cannot be eliminated from IQ tests of ADHD sufferers is that IQ in school-aged children continues to be significantly

• From the social environment and
• From the ability to learn

is influenced.
Children adopted by socially advantaged parents from a socially disadvantaged family had only 17% of their children remain in school until the 6th grade and developed an IQ 14 points higher than their biological siblings who grew up in the socially disadvantaged family of origin, 66% of whom remained in school until the 6th grade….²⁵ This experience is consistent with other findings in this regard.

ADHD sufferers symptomatically suffer from reduced attention and concentration abilities. It is plausible that children who are less able to learn for psychological reasons also suffer limitations in IQ development (independent of the genetic disposition to intelligence).

However, these facts are not easily reconciled with the statement that the IQ of ADHD sufferers does not differ from that of non-affected persons.

2.6. Common genes of ADHD and IQ¶

One study reports more than 30 genes with a correlation between ADHD and IQ.²⁶

2.7. Intelligence deviance as a relevant factor for ADHD?¶

The finding that the overall average IQ of ADHD sufferers is the same as that of nonaffected individuals does not necessarily mean that intelligence may not be a significant influencing variable in relation to ADHD.
In the case of schizophrenia, it is known that normal gifted persons are affected less frequently, whereas highly gifted and less gifted persons are affected more frequently than average. The overall average of those affected may again correspond to the overall average (100) - yet IQ is a significant factor.
Schizophrenia is also highly dependent on dopamine levels. The positive symptoms result from a too high dopamine level, the negative symptoms from a too low dopamine level. The negative symptoms show certain parallels to ADHD symptoms.

About such distributions in ADHD, we currently know of no other professional publication except for the studies in²⁷ cited by Simchen¹⁵ that indicate different “IQ types” in ADHD.

It is conceivable that a greater deviation in IQ, both upward and downward, represents a stressor in its own right insofar as this “being different” makes it more difficult to belong to groups. That being an outsider can represent a stressor is plausible. That is why a differential diagnosis of ADHD for unrecognized giftedness is common.

ADHD is also a valid construct in the context of high intelligence. ADHD and IQ are negatively correlated on almost all phenotypic and cognitive constructs. Therefore, IQ should always be considered as a potential moderator in ADHD studies.²⁸

2.8. Speculation: Do stress and increased sensitivity train intelligence?¶

Rats that grow up in “enriched environments” develop a thicker cortex. Derived from this, it would be conceivable that the increased sensitivity correlating with ADHD as well as with giftedness, which we perceive as corresponding to an “enriched perception”, leads to a thicker cortex (which at the same time develops later).

The effect of enriched environments seems to be age-dependent. It is true that positive effects are already evident in childhood. However, the greatest benefit was observed in middle adolescence. Enriched environments resulted in improved selective and auditory sustained attention, increased exploratory and food-gathering behavior, and a significant decrease in corticosterone levels and reduced anxiety levels.³¹
Middle adolescence is also the period in which there is the greatest vulnerability to the “second hit” in terms of the development of mental disorders in adulthood. This is supported by the findings of Heim and Binder, according to which stress in adolescence can lead to a potentiation of stress in early childhood.³²

Since it is known from giftedness research that IQ can change by 10 points within 10 years and, moreover, we seem to encounter the combination of stress sensitivity and special giftedness with unnatural frequency, we have developed the hypothesis that stress has its own mechanism of action that promotes IQ.
This may explain why the character traits attributed to ADHD sufferers as positive traits in the ADHD literature and the traits attributed to gifted individuals in the giftedness literature have such surprising similarities.
A correspondence to this hypothesis could result from the fact that mild stress leads to a slight increase of dopamine and norepinephrine levels in the PFC (but not directly to an increased IQ.). Only severe stress increases the levels in such a way that the PFC is “switched off” and behavioral control is transferred to other brain areas.
More frequent mild stress could thus increase cognitive performance. This could have an influence on IQ in certain constellations.

3. Giftedness and mental disorders¶

3.1. Common genetic roots of intelligence and mental disorders¶

Intelligence has a genetic component. Not everyone who inherits such genes is or becomes highly gifted. And you don’t have to have exactly these genes or those genes to be highly gifted - at best, it increases the chance. People who have been given genes favorable for giftedness also need an (early childhood) environment that enables the manifestation, the actual formation of this genetic disposition.

Up to this point, the emergence of giftedness is no different from the emergence of mental disorders: Gene disposition x environment = manifestation.
However, the link between giftedness and mental disorders, at least to certain mental disorders, goes further.
There are genes that modify the formula gene x environment = manifestation - the formula is then rather gene x environment² = manifestation.
We call these genes “chance-risk genes”. More accurately, it should be called chance-risk gene polymorphisms, because 99% of people’s genes are the same, but they all differ in various subtypes (polymorphisms). In the interest of readability, we have therefore shortened the expression somewhat.

We currently know 6 risk-reward genes. The most important are

• COMT: Met158Met
• DRD4: 7R
• 5HTTPR: short

We suspect that these gene variants are the basis for increased sensitivity and thus vulnerability. If carriers of these genes are particularly promoted, they develop better than other people. If carriers of these genes are neglected or mistreated, they develop worse than other people. Those affected are sometimes referred to (in a rather esoteric-sounding way) as orchid children.³³³⁴

Chance-risk genes could also be described as genes that react particularly intensively to both positive and negative environmental influences. A more detailed description of how opportunity-risk genes work and references to them can be found at ⇒ How ADHD develops: genes + environment. For an in-depth account of how COMT Met-158-Met influences dopamine balance to produce greater mental performance and concomitant stress vulnerability, see ⇒ The neurological cause of attentional symptoms, section Dopamine depletion in the PFC by COMT rather than by DAT

Just as a special support of carriers of chance-risk-genes often leads to special achievements like giftedness, neglect or maltreatment (which in its severity would not hurt people without these genes = resilience) leads to particularly adverse consequences in carriers of these genes - thus also to more frequent mental disorders.
Examples include ADHD and borderline.

Against this background, it no longer seems inconclusive to us that genes that have such intense effects on the psyche can cause typical character traits similar to those attributed to gifted individuals and ADHD sufferers.

3.2. Common environmental causes of intelligence and mental disorders¶

Newborn Brown Norway rats, known for their long and healthy lifespan, were separated from their mother for a single 24-hour period on day 3 of life. At 30 months of age, they differed significantly from the siblings remaining with the mother:
The learning ability in animals that had been separated from their mothers for 24 hours two and a half years earlier was either particularly good or particularly poor, but hardly average. In contrast, among their siblings not separated from the mother, the majority were mediocre learners and only some were good or poor learners (normal distribution).³⁷

4. Delayed cortex maturation in ADHD as in giftedness¶

Highly gifted people differ from normally gifted people by a clearly delayed maturation of the cortex thickness. This delayed development of cortex thickness is impressively similar to that of ADHD patients.¹⁰³⁸

The thinner the cortex, the greater the inattention symptoms in ADHD.³⁹
Further research confirms that the reduced volume in various brain areas observed in children with ADHD does not persist in adulthood.⁴⁰ This is consistent with the finding that only a later maturation of brain volume maxima occurs.

From the fact that the amount of norepinephrine metabolites (NE breakdown products) in urine normalizes in ADHD sufferers with and further after puberty, in parallel with the decrease of (child-typical) ADHD-HI symptoms, it is concluded that there is a brain maturation delay in ADHD.⁴¹
Such a “brain maturation delay” is also found more frequently than average in carriers of the DRD4 7 allele polymorphism.⁴² Increased sensitivity is associated with the DRD4-7 polymorphism as a risk/opportunity gene. See more at ⇒ How ADHD develops: genes or genes + environment
Increased sensitivity, in turn, correlated very strongly with giftedness, according to our earlier perceptions, although this is not covered by the current data we are aware of.

As a result, the described facts strengthen the assumption of neurological similarities between highly gifted and ADHD sufferers.

5. Similar traits of gifted people and ADHD sufferers¶

In addition to the unpleasant symptoms, the ADHD literature unanimously names a very typical bouquet of positive (character) traits of ADHD sufferers.
It is interesting to note that the literature on giftedness also identifies specific traits in gifted individuals. These positive traits mentioned in the literature on ADHD on the one hand and giftedness on the other hand show a degree of correspondence that can no longer be explained by coincidence.
Unfortunately, this correspondence is rarely addressed in the literature.²⁷.

We have therefore started to collect a detailed overview of the matching and differing traits including the respective sources. However, the statements about traits in ADHD as in giftedness are largely based on the subjective impression of the authors. Not all traits have been investigated by studies.

A helpful summary on the positive traits of ADHD with quite a few references can be found at ADHSpedia.⁴⁵

5.1. Convergent traits of giftedness and ADHD¶

• Strong sense of justice
  • For ADHD ^{46 47 48 45 4950}
    • Sense of social fairness⁵¹
  • In autism spectrum disorders (ASD), the sense of justice seems to be even more pronounced⁵²
  • For giftedness⁴⁴
• Sensitive
  • For ADHD⁵³
  • For giftedness⁵⁴
• Much compassion for others
  • For ADHD⁴⁶⁴⁵
    • Empathy possibly more of a strength of ADHD-I than of ADHD
  • For giftedness
    • Empathy⁵⁵
    • Sees so many possible alternative interpretations that appropriate social response is made difficult⁵⁶
• Helpful
  • For ADHD⁴⁶⁴⁵
• Caring
  • For ADHD⁴⁶
• Good observation skills
• Sharpness and clarity
• Quick comprehension
  • For ADHD⁵⁷⁴⁶
  • For giftedness⁴⁴
• Curiosity
  • For ADHD⁵⁸⁴⁶⁴⁵
  • For giftedness
    • Constantly asking why⁵⁹
• Are explorers, as such willing to take risks
  • For ADHD⁴⁶
• Diversity of interests
  • For giftedness⁴⁴
• Open-mindedness
• Openly approaching others
  • One study found only a very slight increase in openness in ADHD overall, with the increase more likely to occur in those with attention and inhibition problems and slightly decreased in those with increased delay discounting and atypical working memory/verbal fluency.⁶⁰
• Enthusiastic, passionate
  • For ADHD⁴⁶
  • For giftedness⁶¹
• Creativity
  • Creative
    • For ADHD^{57466250636451}
    • For giftedness⁴⁴; also as divergent thinking⁶⁵
  • Original problem solving
    • For ADHD⁴⁶⁶²
    • With giftedness: more divergent thinking ⁶⁶
  • Can make connections well
    • For ADHD⁴⁶
    • With giftedness: more divergent thinking ⁶⁶
  • Be able to look at things from different perspectives
    • For the highly gifted:⁶⁷
      This can go to stressful extremes even with giftedness:
      • Too many aspects in the head at the same time, so that this confuses and burdens⁶⁷
      • Always have to look at all sides, to the point of complicating the simple things⁵⁹
  • Resourceful
    • For ADHD⁴⁶⁶²
    • Imaginative
      • For ADHD⁶⁸⁶³
  • Inventiveness⁵¹
• Aversion to monotonous tasks
  • For giftedness⁶⁶
    • Monotonous activities with a lot of constant repetition (memorizing vocabulary, learning notes, learning to write) seem not only boring to gifted people, but contradictory to their way of thinking⁶⁹
• Prolix, digressive
  • For giftedness⁶⁷
    • Easily digress from topic
    • Become too detailed
• Decision problems
  • For giftedness:
    • Some think about the pros and cons until discussion is over⁶⁷
    • Always have to look at all sides, to the point of being unable to make decisions⁵⁹
    • Too many aspects at the same time in the head, so that this confuses and burdens⁶⁷
  • In ADHD: typical pattern, especially in ADHD-I subtype
• Ambition
  • For ADHD⁴⁶
• Perfectionism
  • For giftedness⁴⁴
• Agile, nimble, flexible⁶⁸⁴⁶
• Spontaneous
  • For ADHD⁴⁶⁵¹
• Intuition
• Playful until old age
  • For ADHD⁴⁶
• Can do many things at the same time
  • For ADHD⁴⁶
• Often pronounced love of animals and nature
• Often amazing knowledge / skills in areas of great interest
• Ability to hyperfocus (for special interest)
  • In ADHD: phenomenon of hyperfocus
    • Unmedicated ADHD sufferers spent more time studying than non-affected people and less time playing computer and video games or playing with others, according to one study.⁷⁰
  • For giftedness
    • Up to task switching problems⁷¹
• More intense perception
  • For giftedness⁷²⁴⁴
    • Noise sensitivity⁶⁵
    • Light sensitive⁶⁵
    • Odor-sensitive⁶⁵
    • Touch sensitive⁶⁵
    • Sensitive to pain⁷³
    • Emotional⁷⁴
• More intense feeling
  • For giftedness⁷²⁷⁵⁴⁴
• Intense emotions
  • For giftedness⁷²⁷⁶
    • Films can be extremely emotionally involving⁷¹⁷⁷⁴⁴
  • Correlate with
    • Creativity⁷⁸ and
    • Ability to structure other people
      • For ADHD⁷⁹
• Constantly under power
  • For giftedness⁷¹
  • For ADHD
    • Inexhaustible energy⁶⁸
  • In ADHD-HI (less in ADHD-I)
    • Core symptom due to inability to recover / lack of HPA axis shutdown
• Aversion to small talk
  • For giftedness⁸⁰
• Great relief when meeting people of the same kind
  • For giftedness: Mensa e.V.
  • For ADHD: self-help groups
  • For ADHD⁸¹
  • Preference for solitary/retreat/individual activities

In highly gifted people, the literature also knows typical disadvantageous character traits. If one is not inclined to regard the coincidence of positive traits as a coincidence, the negative traits, which also occur in parallel in giftedness and ADHD, could give a clue to the cause of these traits.

Highly gifted people are said to have communication behaviors that “go one step toward Asperger’s.”⁸²

For highly creative people, the following character traits are named as common in the literature:

• Difficult social behavior⁸³⁸⁴⁸⁵
• Socially harsh behaviour^{8384 85}
  • E.g. by expressing perceived motives of others, which are not perceived by others and may also not be conscious to the affected persons⁸⁶
• Repellent/rough/groggy⁸⁷⁸⁴
• High psychotic personality scores⁸⁸⁸⁴
• Stronger negative affects⁸⁹⁸⁴
• Greater physiological stress⁸⁹⁸⁴
• More self-oriented perfectionism⁸⁹

The enumeration mentioned so far arouses strong associations to ADHD traits according to our impression. However, a match is at least questionable for:

• More irrational beliefs⁸⁹

Conspicuousness for the social environment, which often coincide in ADHD and giftedness:

• Feeling of being isolated
• Highly gifted: emotionally but at age-typical level, intellectually very developed
• ADHD: emotional development delayed compared to intellectual development
• Constant critical questioning of authorities
• Very individualistic
• Tendency to want to determine situations alone

However, we consider these factors to be a consequence of being different in each case rather than a congruent cause.

Abnormalities in relation to work behavior and interests

• Strong immersion in specific problems (HB: specific interests, ADHD: hyperfocus)
• Perfectionist demands
• Boredom and even refusal to work on routine tasks

Conspicuousness in kindergarten and school

• Boredom (HB: even more common, ADHD when inactive)
• Disturbing other children to get attention (class clown)
• Outsider position, the child feels misunderstood

5.2. Non-matching traits of giftedness and ADHD¶

5.2.1. Specific traits of ADHD¶

The following traits of ADHD are not reported as typical in gifted individuals.

• Great toughness / endurance
  • For ADHD⁴⁶
    • Physical fitness and enjoyment of movement⁵¹
  • In our opinion, however, only in the case of high intrinsic interest or as a result of the treatment effect of endurance sports in ADHD
• Warm-hearted
• Little resentment⁵⁰
• Risk appetite
  • For ADHD⁷⁹
• Intense emotions correlate with good memory, since what is experienced is better remembered in the presence of intense emotion; however, working memory is impaired in ADHD. We know nothing about impairments of long-term memory.
• Love for physical work
  • In our opinion, symptomatic at best as a typical stress reduction reaction in ADHD
• Need for harmony⁵⁰
• Sense of situation comedy⁵¹
• Prickly charm⁵¹

In ADHD, changes in the personality traits of the Big 5 are reported:

• Neuroticism (significantly elevated)
• Conscientiousness (significantly reduced)
• Compatibility (reduced)
• Extraversion (reduced)
• Openness to experience, on the other hand, has hardly changed.

See more at ⇒ Personality traits changed In the article ⇒ Total list of ADHD symptoms according to manifestations in the chapter ⇒ Symptoms.

5.2.2. Specific traits of gifted people¶

The following traits of gifted individuals are not mentioned as typical in ADHD.^9091929394

• Abnormalities related to learning and thinking

  • High level of detailed knowledge and very good understanding of interrelationships⁴⁴
  • Unusually pronounced Vocabulary and linguistic expression⁴⁴
  • Early reading
  • (Early) interest in books that are well above the age level
  • Preference for independent work, high goals
  • Intrinsic motivation style⁴⁴

• Conspicuousness in kindergarten and school

  • No interest in age-appropriate activities, or in the subject matter of the grade level

• Salient features for the social environment

  • Hardly any interest in age-typical activities
  • Preference for verbal rather than physical confrontations
  • Choice significantly older friends

5.3. No change of positive traits by ADHD medication¶

ADHD medications, especially methylphenidate, do not alter (positive) traits.

There is evidence that the personality profiles of ADHD sufferers change with long-term medication.⁹⁵ However, the development under medication (methylphenidate) changed in the 81 % MPH responders in almost all measured dimensions away from the (unfavorable, associated with personality disorders) extremes towards the more balanced design (which is less associated with personality disorders).⁹⁶
The changes consistently demonstrate a change in the direction away from a more unstable, toward a more stable personality.

ADHD sufferers consistently report that they notice no change in their personality when given the appropriate dosage. The typical statement is that the medication makes them much more themselves. Other perceptions arise with overdose or when non-affected individuals take ADHD medications.

Stimulants, however, dampen the limbic system. Stimulants can therefore be associated with impaired emotionality, especially in overdose. Barkley explained in a presentation,⁹⁷ that stimulants can dampen emotions by inhibiting the limbic system, which is not affected in ADHD per se. The higher the dosage, the more the limbic system (including the amygdala) is inhibited, he said. This naturally reduces affect. An individually too high stimulant dosage, especially an overdose, can therefore lead to impaired emotional experience, which occurs in about 20% of patients treated with stimulants.
In this context, Barkley refers to the increasingly frequent use of combination medication (stimulants and atomoxetine or stimulants and guanfacine) for this reason, in order to accumulate the respective positive effects and to spread and thus reduce the side effects, which are usually located in different areas. Atomoxetine, unlike stimulants, does not affect the limbic system and therefore does not affect emotional sensation. Atomoxetine activates the ACC and frontal lobe, directly affecting executive functions. Stimulants improve attention cognition, executive functions, and working memory. They are less useful for improving emotion regulation.

6. Differential diagnosis required¶

The fact that a differential diagnosis for unrecognized giftedness is necessary when ADHD is suspected does not reveal any neuro(physio)logical or biological connection between ADHD and giftedness. The necessity of differential diagnostics results solely from the fact that unrecognized gifted people (especially with individually limited social abilities) often live an outsider’s existence just like ADHD sufferers and feel that they do not really belong anywhere. Such an outsider position can cause massive social stress. This stress can be misinterpreted as ADHD symptomatology, which should therefore be ruled out by means of differential diagnostics.
⇒ ADHD symptoms are stress symptoms

Typical forms of expression include:

• Being an outsider, which is sometimes attempted to compensate with class clown or other roles
• The feeling of not belonging
• Self-esteem problems together with the resulting comorbidities from depression to social phobias

The hypothesis that highly gifted people might not have ADHD is definitely incorrect. We know a relevant number of highly and extremely gifted people who have a clear ADHD-HI or ADHD-I diagnosis.

In unrecognized gifted individuals (especially children), ADHD-like symptoms are attributed to problems with the social environment.⁹⁸

Feeling like an outsider and not belonging can lead to a lowered sense of Self-esteem lead.⁹⁹
Decreased self-esteem creates psychological stress.¹⁰⁰

In the case of unrecognized gifted individuals, underchallenge can lead to boredom and - depending on the predisposition - to dreaming oneself away into an inner world (ADHD-I confusability) or to disrupting lessons, e.g. in order to get attention (ADHD-HI confusability). In addition, (over-) adjustment phenomena can occur when the affected person places the “blame” on themselves.¹⁰⁰ This, in turn, can result in them intentionally working slowly or making mistakes, and thus neither being recognized as highly gifted nor expressing their frustration to the outside world. A constant underchallenge and the resulting lack of motivation can lead to a complete refusal to perform.¹⁰¹
See also: Psychic saturation.

7. Giftedness and coping skills¶

The specialist literature on giftedness agrees that gifted people have an above-average coping ability as a result of their special abilities. Coping are coping strategies to defuse or circumvent impairments or deficits (regardless of their nature or cause) through appropriate behavior. Coping strategies do not correct ADHD. Coping merely leads to the individual being better able to cope with the symptoms or understand how to better avoid situations in which he or she would suffer from the symptoms.¹⁰²

A distinction must be made between the severity and the consequences of ADHD. While one study of ADHD patients with an IQ of 120 or more found no differences in ADHD severity except for slightly lower cognitive impairment¹⁰³, another study concluded that high intelligence predicts less severe ADHD effects in the future.¹⁰⁴ Another study found an even massively more frequent occurrence of ADHD in highly gifted individuals.¹⁰⁵

8. ADHD testing through intelligence testing?¶

It would be conceivable, at least theoretically, to determine the impairment caused by ADHD by appropriate intelligence tests.

Intelligence tests usually also measure working memory. For the ADHD differential diagnosis of (non-) existing giftedness, only IQ tests that separately output the working memory values are therefore suitable for determining the ADHD indication of impaired working memory. The affected person must not have taken any medication for this.

Repeating the IQ test while taking medication after dosage adjustment by a physician should show a significant difference in the working memory area in ADHD sufferers. This would be a strong indication for ADHD.

9. More about ADHD and giftedness:¶

• Wiki
  • http://www.adhspedia.de/wiki/Hochbegabung_and_ADHD
• Forum
  • http://www.adhs-anderswelt.de/index.php/board,31.0.html
• Other sources
  • <http://www.eigen-sinn.homepage.t-online.de/merkmale.htm&amp;gt
  • http://www.adhs.info/fuer-paedagogen/allgemein-diagnostik/untersuchungsgegenstand/differentialdiagnostik.html
  • http://www.praxis-drbachmann.de/media/Bachmann_ADHD_Giftedness_06.pdf
• Intelligence test online (with naturally limited validity)
  • https://www.test-iq.org
  • <https://www.mein-wahres-ich.de/wissen/iq-test.html&amp;gt
  • <https://www.psychomeda.de/online-tests/iq-test.html&amp;gt