The electrical discharge of neurons associated with seizure activity stimulates a marked rise in cerebral metabolic activity. Estimates from animal experiments indicate that energy utilization during seizures increases by more than 200", while tissue adenosine triphosphate (ATP) levels remain at more than 95" of control, even during prolonged status epilepticus. The brain generally withstands the metabolic challenge of seizures quite well because enhanced cerebral blood flow delivers additional oxygen and glucose. Mild to moderate degrees of hypoxemia that commonly accompany seizures are usually harmless. However, severe seizures and status epilepticus can sometimes produce an imbalance between metabolic demands and cerebral perfusion, especially if severe hypotension or hypoglycemia is present. A marked increase in glutamate release, which occurs during a prolonged seizure, is likely to result in the activation of all types of glutamate receptors. Although kainic acid produces seizures in the immature brain, it produces little cytotoxicity.

As everyone knows, true creativity comes from simple formulas and the memorization of data. This chapter focuses on divergent thinking tests, which are still the most common way that creativity is measured. Guilford derived the core ideas behind divergent thinking as well as many popular measures. The people who score the Torrance Tests are specifically trained to distinguish responses that are truly original from those that are just bizarre. There are other tests that measure creativity, but most are either a variation on divergent thinking or use some type of raters. For example, the Evaluation of Potential Creativity (EPOC) has begun to be used in some studies and may be promising, but is still largely rooted in a mix of divergent thinking scoring and raters. Another test is the Finke Creative Invention Task, which is clever but also requires raters for scoring.

The Big Five, which this chapter discusses in more detail, are extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience. Each of these five factors represents a continuum of behavior, traits, and inclinations. There are some popular personality measures that use different theories, such as Eysenck’s Personality Questionnaire, which looks at extraversion and neuroticism as well as psychoticism. The personality factor most associated with creativity is openness to experience. Indeed, one way that researchers study creativity is by giving creative personality tests. Being open to new experiences may also help creative people be more productive. King found that people who were creative and high on openness to experience were more likely to report creative accomplishments. DeYoung and S. B. Kaufman, of course, are not the only people to blend or split different factors of personality to present new models. Fürst, Ghisletta, and Lubart suggest three factors: plasticity, divergence, and convergence.

This chapter explores three ’classic’ studies of creativity and mental illness. The first is Jamison whose focus is on the connection between bipolar disorder and creativity. The second is Andreasen, who used structured interviews to analyze 30 creative writers, 30 matched controls, and first-degree relatives of each group. The writers had a higher rate of mental illness, with a particular tendency toward bipolar and other affective disorders. The third major work is Ludwig, who utilized the historiometric technique. All three studies have come under serious criticism. Many of the studies of Big-C creators are historiometric, akin to Ludwig’s work. Some such studies claim that eminent creators show higher rates of mental illness. A much more common approach is to look at everyday people and give them measures of creativity and mental health. Typically, researchers look at what are called subclinical disorders—in other words, they’re not clinically significant.

One school admissions area that already uses creativity is gifted admissions—which students are chosen to enter gifted classes, programs, or after-school activities. Both education and business play great lip service to creativity. Puccio and Cabra review the literature on creativity and organizations and do a nice job of highlighting how every couple of years, a new report from industry emphasizes the importance of creativity. It is important to note that there is a large inconsistency between gender differences on creativity tests and actual creative accomplishment. Although gender differences on creativity tests are minor or nonexistent, differences in real-world creative accomplishment are large and significant. This chapter shows how creativity can play a role in admissions and hiring. Hiring measures tend to have better validity, even the general mental ability (GMA) measures; even if minorities score lower, the accuracy of prediction is consistent by ethnicity.

Creative people are also often seen as being outsiders and eccentric. Sen and Sharma’s examination of creativity beliefs in India tested beliefs about the Four P’s and found that creativity was more likely to be described as a holistic essence of an individual, and less likely to be focused on the product or process. Romo and Alfonso studied Spanish painters and found that one of the implicit theories that the painters held about creativity involved the role of psychological disorders. Plucker and Dana found that past histories of alcohol, marijuana, and tobacco usage were not correlated with creative achievements; familial drug and alcohol use also was not significantly associated with creative accomplishments or creative personality attributes. Humphrey, McKay, Primi, and Kaufman did find that illegal drug use predicted self-reported creative behaviors even when openness to experience was controlled.

Depression is sometimes referred to as the common cold of psy-chopathology. Consistent with this aphorism, epidemiological studies demonstrate that depressive disorders are indeed rather common across the life span. Given the importance of the social relationships and context to understanding depression, it seems likely that culturally informed and diverse research will yield important findings about those critical components of human cognition, emotion, and social relationships that underlie risk for depression, as well as those that serve to aid in recovery from these disorders. Most researchers believe it is unlikely there is a direct effect of hormones on depression, but rather that they indirectly increase risk via any one of several mechanisms, including: the effects of hormones on brain development, the development of secondary gender characteristics that are generated by these hormones, or the hormonal changes that occur during the pubertal transition may interact with life events and the social context.

Depressive disorders are characterized by etiological heterogeneity, which means that many diverse causal factors or causal pathways can lead to the same clinical outcomes. Women are at higher risk for depressive episodes beginning at early adolescence and then throughout the life span. Unipolar depressive disorders can onset at any point in the life span, but are most prevalent in late adolescence through early to mid-adulthood. Bipolar disorder (BD)s generally onset before mid-adulthood; new cases are rare thereafter. More severe cases of unipolar and bipolar disorders are characterized by a chronic/recurrent course. Both unipolar and bipolar disorders are commonly comorbid with other forms of psychopathology; overall severity and poorer outcome over time is associated with comorbidity. If gender differences are of interest, the effects of potential etiological factors are measured in persons of both genders and their associations with depressive disorders are statistically compared across genders.

Recent advancements in molecular genetics have expanded our understanding of the etiology of many neurological diseases and neurodevelopmental abnormalities. Having a comprehensive understanding of genetics is essential in treating patients with metabolic epilepsies. Genetic counseling has been defined as a process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. Some of the components of a genetic counseling interaction include interpretation of family and medical histories to assess the chance of disease occurrence or recurrence; education about inheritance, testing, management, prevention, resources, and research; and counseling to promote informed choices and adaptation to the risk or condition. The genetic counselor may also educate patients and their families about the underlying genetics of their epilepsy and the relevance of a genetic cause of epilepsy for family members, including recurrence risk, reproductive options and the possible teratogenic effect of antiepileptic drugs.