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"Living Beyond Limits": Neurogenic Influences of Overexcitabilities on the

Mental Health of the Highly Gifted

Article in ASEAN Journal of Psychiatry · April 2024

DOI: 10.54615/2231-7805.47349

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

Research Article

“LIVING BEYOND LIMITS”: NEUROGENIC INFLUENCES

OF OVEREXCITABILITIES ON THE MENTAL HEALTH OF
THE HIGHLY GIFTED

Leon Alker#

Department of Clinical Neuropsychology, St. Franziskus-Hospital Winterberg, Germany

Abstract

This study introduced the concepts of the inability to deal with or channel overexcitabilities
to expand the giftedness research. Giftedness refers to outstanding levels of competence and
aptitude in one or several domains. Based on neurogenic theories of sensory modulation
and integration, it was hypothesized that gifted individuals (1) exhibit stronger
overexcitabilities and sensitivities than average-intelligent individuals, (2) that these
deteriorate their mental health and induce mental illness, (3) and (4) the inability to deal/
channel mediates the relation between overexcitabilities and mental health and illness. The
design of the study was cross-sectional and descriptive (N=450). Highly gifted individuals
(n=300) were recruited from Mensa and non-gifted college students (n=150) were recruited
from the University of Groningen. The first and second hypotheses were tested using two
and four independent T-tests, respectively. Four mediation analyses were conducted to test
the mediational effects. The bootstrap sample was elevated to 5,000 to apply the analyses
with more confidence. All hypotheses were supported. The mediational analyses were highly
significant with medium to strong effect sizes. This study concludes that in the highly gifted
the inability to deal with or channel overexcitabilities can explain varying levels of mental
health and illness and is a major indicator in determining the influence of overexcitabilities
on mental health and illness. Whether gifted individuals thrive in their lives may largely
depend on their ability to channel overexcitabilities into success and innovation. As existing
therapeutic practice - more often than not - fails the complexity of the gifted client, this thesis
recommends interventions based on the Theory of Positive Disintegration to meet the needs
of highly gifted individuals. ASEAN Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

Keywords: Neuroscience, Intellectual Giftedness, Emotional Regulation, Neuropsychology,

Intelligence Research

Introduction – Opus Magnum another man’s, and all his brain more sensitive and
quickened to that which his senses reveal to him in
“The creative instinct is, in its final analysis and in such abundance that actuality overflows into
its simplest terms, an enormous extra vitality, a imagination. It is a process proceeding from
super-energy, born inexplicably in an individual, a within. It is the heightened activity of every cell of
vitality great beyond all the needs of his own living his being, which sweeps not only himself, but all
- an energy which no single life can consume. This human life about him, or in him, in his dreams, into
energy consumes itself then in creating more life, the circle of its activity” - Pearl S. Buck.
in the form of music, painting, writing, or whatever
its most natural medium of expression. Nor can the Rationale
individuals keep himself from this process,
Although intellectual giftedness is no guarantee for
because only in its full function is he relieved of
success or happiness, it has been associated with
the burden of his extra and peculiar energy - an
the highest human achievements and has been,
energy at once physical and mental, so that all his
more so than any other measurable human
senses are more alert and more profound than

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

trait, established as the strongest predictor for the brain intelligence resides” and is influential in
occupational, educational, social and economic that it (1) explains most of the current neuroimaging
outcomes [1-4]. While this relation towards studies and in that it (2) highlights the critical role
success is apparent, the relation between of rapid sensory processing and receptivity in
giftedness and mental health continues to be giftedness, which were associated with sensory
a task of intricated and complex matters and discomfort, strong emotional response sand mental
remains rather unclear [5-7]. Karpinski et al. point illness. Based on 37 neuroimaging studies, Haier
out that overexcitabilities, or sensitivities, often proposed that the occipital and temporal lobe are
accompany intellectual giftedness and may cause the first regions to receive visual and auditory
mental illnesses such as severe depression [8]. information, respectively [15-19]. The information
Depression has been designated as the ‘leading travels then from visual and auditory cortices to
cause of disability around the world’, signifying parietal regions where it is elaborated and
the relevance to investigate the role of integrated [17]. Finally, the information is
overexcitabilities in giftedness [9]. The current transferred to frontal cortices and used to analyze
thesis assumed that gifted individuals exhibiting hypothetical action outcomes [19]. The anterior
strong overexcitabilities are prone towards mental cingulate cortex is hereby critical for decision-
illness rather than mental health compared to those making, error recognition and the responses [17].
with weak overexcitabilities. It was further More white matter tracks in this system result in
presumed that the inability to process rapid processing speed and high IQ, representing
overexcitabilities acts as a mediator of this there by the critical convergence between parietal
relation, which in this case would be decisive in sensory association cortices and frontal lobes
identifying gifted persons at risk for mental illness [16,17,19].
and consequential negative life outcomes.
The Columbus Group (1991) promoted a new
Cognitive-emotional characteristics of intellectu- definition of giftedness to account for the different
ally gifted individuals sensory processing and the thereof different
perceptual experience of gifted individuals, stating
The American Psychological Association (APA) that “the uniqueness of the gifted renders them
defines intelligence as the extent to which particularly vulnerable and requires modifications
“individuals differ from one another in their ability in parenting, teaching and counselling in order for
to understand complex ideas, to adapt effectively them to develop optimally”. These needs seem to
to the environment, to learn from experience, be pronounced in gifted children, as they are
and to engage in various forms of reasoning, to more aware of unspoken messages in interpersonal
overcome obstacles by taking thought” [10]. relationships and as they experience emotions
Although there are currently no widely accepted such as joy, boredom and sadness to a
definitions of giftedness, “outstanding potential in heightened degree [20]. Non-promotion or neglect
any area recognized by performance” or of the demands has been associated with a
“outstanding ability to deal with complexity” negative overall life trajectory [5]. Specifically,
appear to be the hallmarks of giftedness recurrent gifted individuals who have not been identified or
in different definitions. Prevalence estimates, as nurtured and promoted at an early stage, suffer
indicated by an Intelligence Quotient (IQ) of 130 significantly more from low self-esteem, fear of
or above, range from one to two percent, as failure, depression, and a variety of other negative
proposed by Turkman, Henry and McCoach et al., mental health impacts [5]. These needs might be
respectively [11-13]. Research for more than 100 further pronounced as the brain maturation of
years provides conclusive evidence that a general the highly gifted differs compared to average-
factor of intelligence, or g, exists, which strongly intelligent individuals, and may thus play a critical
correlates with all domains of cognitive tests such role in the asynchronous development frequently
as processing speed, reasoning, memory, observed in gifted children and adolescents, which
executive functioning and spatial ability [14,15]. was negatively associated with mental health [6].
Factor g has been used to delineate structural and
functional brain differences of individuals with Mental health of the highly gifted
varying levels of intelligence [16].
The relation between intellectual giftedness and
The Parieto-Frontal Integration Theory (P-FIT), mental health and illness occupies an ambivalent
promulgated by Jung and Haier, was deemed as the position in science. There has been some evidence
“best available answer to the question of where in that intellectually gifted individuals are physically

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

and mentally healthier than their peers. Two of the overexcitabilities, sensual overexcitabilities may
most renowned studies about the relation between act as catharsis of emotional tension that manifests
intellectual giftedness and mental illness are the themselves in sensual expressions. Heightened
“Marburger Hochbegabtenprojekt” and the sensual overexcitabilities may result in overeating
“Termites” study [21,22]. Both studies are or excessive sexual stimulation.
longitudinal, and the latter, dating back to 1921, has
been acknowledged as the longest study about the Psychomotor overexcitabilities: A function of
relation between intellectual giftedness and mental energy surplus that manifest itself in increased
health and illness [23]. Both studies, continuing to pace of speech, restlessness, aggressive behavior,
measure gifted individuals at a whole life span, delinquency, sports and the urge to act. Expressions
concluded that gifted individuals are healthier in of psychomotor overexcitabilities can be either
psychological and physical terms. The results have pure manifestations of an energy surplus or may
been unchanged since then and the relation result from the inner emotional tensions.
“ingenuity and madness” has been declared as a
myth [23]. However, more recent evidence points Imaginational overexcitabilities: Increased
ability to associate pictures, images and sensations,
to a more critical direction, as there are substantial
conflicting studies in the literature regarding the which is related to ingenuity, creativity and a
association of IQ, especially high verbal ability, richness of ideas that manifest it in usage of
and mental disorders such as depression, anxiety images and metaphors in linguistic expressions or
disorders, bipolar disorder, ADHD, and autism in clear and distinct visualizations. Emotional
spectrum disorders [7,15,24-27]. tensions may herein translate into vivid dreams,
nightmares and a blending of imagination and
Overexcitabilities and high sensitivity truth, and a fear of the unknown. In extreme forms
individuals may live in a phantasy world and may
Overexcitabilities were defined in different ways, exhibit a preference for poetry.
such as “enhanced and intensified mental activity
distinguished by characteristic forms of Intellectual overexcitabilities: Contrary to the
expressions which are above common and first three overexcitabilities, there is no transfer of
average” or as “multifaceted lens through which to emotional tension on intellectual activities of
view the intensities of gifted” acting as a “mode of any kind. This, however, does not mean that
understanding and responding to the world”. intellectual and emotional processes of high
Piechowski adds that “giftedness is not a matter of intensity do not accompany each other. Intellectual
degree but a different quality of experiencing”. overexcitabilities manifest themselves in a strong
The terms overexcitabilities and sensitivity are thirst of knowledge and a deep curiosity about
commonly defined as equivalent to each other scientific thinking and matter. Individuals with
(Lind, 2000), in that both refer to (1) “the higher- intellectual overexcitabilities like it to deal with
than-average responsiveness to stimuli”, the (2) and to solve theoretical problems.
corresponding reactions that are “over and above
Emotional overexcitabilities: A function of
average in intensity, duration, and frequency”, and
emotional experiences, especially with regard to
(3) the resulting ease of overstimulation [28-34].
relationships yielding a strong bond and deeper
If there is a difference between the two, this seems
connection with persons, locations and living
to be rather in Dabrowski’s approach to divide the
objects. Intense feelings and emotional expressions
overexcitabilities into several dimensions, as
are only relevant for development insofar they
illustrated in the following, to understand its
relate to the experience of relationships.
psychological and behavioral consequences,
including coping strategies, on an individual’s life Different types of overexcitabilities, as cited in
better. Incrementally, the essential role of Preckel et al. [37].
overexcitabilities in the emergency of mental
health disorders has become acknowledged Role of overexcitabilities
[7,35,36].
Gere found that gifted individuals with strong
Sensual overexcitabilities: A function of sensitivities exhibit severe sensory processing
heightened experience of sensual pleasures that is problems and explained this by theories of sensory
expressed via increased desire for luxury, aesthetics, modulation and integration [35]. Karpinski et al.
comfort, fashion and superficial relationships with built upon this finding and framed the Hyper Brain-
peers, promiscuity etc. As in psychomotor Hyper Body framework, suggesting that highly

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

gifted individuals with strong overexcitabilities gifted individuals cannot respond to stimuli
are several times more likely to suffer from mood appropriately due to their inability to modulate
disorders, such as depression and bipolar disorder, sensory input [35]. Sensory modulation refers to
ADHD, generalized and specific anxiety disorders, the process of the brain to regulate itself, in that
obsessive compulsive disorder, allergies, asthma, the Central Nervous System (CNS) changes the
auto-immune diseases, neuro-inflammation and responsiveness and excitability of neuronal
autism spectrum disorders compared to their peers circuits to adjust to changing external conditions
[7]. This relation could be explained by the [51,52]. Sensory modulation relies on habituation
mediation of overexcitabilities. Overexcitabilities and excitatory sensitization [35]. Habituation
may act as a protective resource against the emerges when the CNS recognizes a stimulus as
development of mental illness, which can, familiar or repetitive and leads to neural inhibition.
contrary, equally well predispose the gifted ones Without habituation, an individual would be
towards psychological disorders. Gere noted that continually distracted by new stimuli, which
heightened sensitivity might be seen as double- is thus decisive in mediating incoming stimuli
edged sword, which is a highly tuned measure of to focus on specific tasks while attending to the
receiving information being a distractor when this surrounding. Excitatory sensitization enhances
ability to integrate information is not functioning attention and immediate response to a stimulus
optimally. Correspondingly, it has been noted that [35]. The process of sensory modulation transducts
the same abilities and awareness that inspire gifted then energy from the environment into signals,
individuals to create potentially drives the same making thus an appropriate response possible [35].
into deep depression and to withdrawal [7,38-42]. Modulation may refer to behavioral or
physiological adjustments as response to sensory
Nevertheless, processing difficulties, as suggested stimulation [53]. This process can be unstable
by Gere, were neither considered nor included in gifted individuals since their neurological
in or other studies [7,35]. Therefore, the exact threshold towards stimuli is very low [35].
underlying mechanisms of overexcitabilities in
the emergency of mental illness remain unclear. Theories of Sensory Integration: Sensory
Sensory modulation provides a neurogenic Integration Theories refer to the interactive
account of overexcitabilities in the highly gifted, relationship between neurological threshold, and
whereas sensory integration offers insights into the physiological, behavioral, and emotional response
consequential impact on the mental health and as a consequence of atypical modulation abilities
illness. It has been found that processing problems [35,53]. Sensory modulation is necessary for the
(i.e., sensory modulation and integration) reduce brain and body to maintain homeostasis by
resilience, which predisposes them towards mental modulating to new and ongoing stimuli.
illness and impairs their mental health [43- 48]. Modulation inability was associated with psycho-
Resilience, which was defined as “dynamic physiological disruptions of parasympathetic and
process encompassing positive adaption within the sympathetic reactions [35,53,54]. Even typical and
context of significant adversity”, acts as protective benign sensory stimuli may thus be experienced as
resource that can “modify, ameliorate, or alter a unpleasant, painful, irritating and stressful,
person’s response to some environmental hazard” resulting in an inability to respond appropriately to
that predisposes a maladaptive outcome stimuli, such as defensive behaviors and social
[47,49,50]. Although it is disputed whether gifted withdrawal [55-58]. Atypical modulation may
individuals are more resilient than their peers, it hence lead to social and emotional maladjustment
has been found that gifted individuals with strong and psychological distress, thereby increasing the
sensitivities tend to be less resilient [46-48]. vulnerability towards mental illness by reducing
resilience, which in turn disturbs the physiological
Neurogenic account of overexcitabilities homeostasis and further the ability of gifted
individuals to deal with adversity [35,44-46].
The neurogenic account of overexcitabilities
provides insights into the underlying neurological Relevance and aim
mechanisms that contribute to heightened
sensitivity and responsiveness in individuals who All currently available therapies to combat mental
exhibit these traits. illness are merely palliative and none is curative
[58]. Furthermore, mental health is regularly but
Theories of Sensory Modulation: Sensory inconsistently conceptualized and measured in
Modulation Theories suggest that highly research [59]. Most measurements

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

focus on mental illness instead of mental health, gifted individuals to fulfill their potential and (3)
running thereby the risk of missing to identify to reduce or prevent mental illness. Particularly, it
individuals with low or high levels on the other, was shown that those who flourish are happier and
which, therefore, may account for the prevailing live a more satisfied, fulfilled, and meaningful life
discrepant findings of giftedness, mental health in terms of self-actualization [60,63].
and illness. As a result, the current thesis includes
Current research
both mental health, encompassing psychological,
emotional, and social well-being, and mental Based on the literature review, several assumptions
illness [60]. This approach allows to categorise can be made regarding the relationship between
individuals according to the Dual Continua Model, overexcitabilities, the inability to process or to
along the dimensions flourishing, struggling, channel overexcitabilities, and mental health and
floundering and languishing. An individual is illness. The corresponding research question of
flourishing in the absence of mental illness and this thesis is: Does the inability to deal with or
high levels of positive functioning (i.e., mental to channel overexcitabilities (i.e., the presence of
health) in terms of social, emotional and processing problems) mediate the relation between
psychological well- being [61]. The absence of overexcitabilities, mental health, and illness in
mental illness but low levels of positive gifted individuals? Gifted individuals exhibit
functioning is considered as languishing and stronger overexcitabilities than their peers and
struggling are those with high levels of positive processing problems of the same, which impairs
functioning in presence of mental illness [61]. resilience, which in turn disturbs the physiological
Floundering refers to a mental crisis with low homeostasis and the ability of gifted individuals to
positive functioning and high mental illness. deal with adversity, thereby predisposing them
towards mental illness [7,35,45,46,48]. Mental
Research indicates that sensory integration as an
health encompasses the dimensions of social,
intervention may help gifted individuals to process
emotional, and psychological well-being, which
sensory input in an appropriate way [62].
are all detrimentally affected by sensory
Especially gifted children with an asynchronous
processing problems, especially since even neutral
development may benefit from resources gained
and benign cues might be interpreted as malign.
from sensory integration, as the emotional and
Impaired mental health, in turn, increases mental
social consequences might be pervasive and
illness [35,60,63]. Correspondingly, the following
debilitating [62]. The current research aims to help
hypotheses have been deduced.
in this regard as the establishment of the inability
to deal with/to channel overexcitabilities (thereby H1: Intellectually gifted individuals exhibit
highlighting its role in mental health and illness) stronger (internal as well as external)
would prove its significance in determining the overexcitabilities compared to average-intelligent
mental health status of the gifted. Contrary, the individuals.
ability to channel overexcitabilities (i.e., absent
processing problems), may be defined as “freeing of H2: Intellectually gifted individuals with strong
overexcitabilities from its negative consequences overexcitabilities exhibit a poorer mental health
in that it allows an individual to use its capacities status than their peers.
in the promotion of mental health in a manner that
enables the individual to flourish and strive in his H3: The inability of intellectually gifted
or her life.” This may allow future research to (1) individuals to deal with overexcitabilities mediates
delineate the exact nature of processing problems the relation between strong overexcitabilities and
of highly gifted individuals, to (2) help mental health (Figure 1).

Figure 1. Conceptual relationship between overexcitabilities, the inability to deal with

overexcitabilities, and mental illness and health.
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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

H4: The inability of intellectually gifted 6=every day).

individuals to deal with overexcitabilities mediates
the relation between strong overexcitabilities and BSI: The Brief Symptom Inventory (BSI) is a self-
mental illness (Figure 1). reported questionnaire used to identify clinically
relevant psychological symptoms in adolescents
Materials and Methods and adults [66]. Five scales, each containing 5-
7 items, were included in this study: The
Participants Somatization, Depression, Anxiety, Hostility and
Interpersonal Sensitivity scale. A General Severity
This study was approved by the Ethics Committee Index (GSI), illustrating mental illness, was
of the University of Groningen and incorporated a computed based on these scales. Alpha coefficients
control sample of n=150 psychology students from for the used BSI symptom scales exhibit satisfying
the University of Groningen and an international degrees of internal consistency [67]. Convergent
sample of n=300 intellectually gifted individuals validity was established by inter correlations with
from Mensa Germany. This was accomplished for clinical rating scales. Participants could rate the
both groups via Qualtrics, where individuals could extent to which they agree to statements such as
register for participation. The research head of “Feeling that you are watched or talked about by
Mensa sent an e-mail to its members who were others” on a 5-point Likert scale (1=not at all to
directed to Qualtrics. The control sample was 5=extremely).
recruited via Subject Online Need Access (SONA)
first-year practicum. Non-completion of the Dual continua model
questionnaire resulted in exclusion from the
The BSI and the MHC-SF were used to determine
analyses (n=49). As indicated in Appendix A,
the mental health status of individuals, which is
students who indicated to suffer substantially from
composed of a combination of mental health and
study-induced symptoms of mental illness due to
illness. The mental health status encompasses the
stress (n=49) were excluded from the analysis. A
four categories of flourishing, languishing,
screening for giftedness showed that roughly one-
floundering, or struggling [60]. High scores on the
third of the students believed to be gifted, which
GSI of the BSI indicate high levels of mental
is, given the low prevalence of giftedness,
illness (Figure 2). High scores on the MHC-SF are
statistically impossible and seems thus to be
based on the scores on the three subscales
exemplarily of the Dunning-Kruger effect - the
emotional, psychological, and social well-being,
tendency of psychology students to inaccurately
thereby displaying mental health. Emotional well-
assess their intellectual capacities [64]. As
being indicates overall happiness, interest in life
illustrated in Appendix B, the final dataset included
and general satisfaction with life. Psychological
a sample of n=352, of whom were n=255 gifted
functioning indicates high levels of self-
individuals and n=98 students from the University
acceptance, positive relations with others, personal
of Groningen, the latter being young, less
growth, autonomy, and purpose in life, and finally,
educated, and more likely to be female.
an individual exhibits high social well-being if he
Mental health and illness or she scores high on social contribution, social
integration, social actualization, social acceptance,
MHC-SF: The Mental Health Continuum- Short and social coherence.
Form (MHC-SF) is a 14-itemself-administered
questionnaire used to measure social, Overexcitabilities, sensitivity, and its processing
psychological, and emotional well-being problems
exhibiting a high internal consistency and
OEQ-II: The Overexcitability Questionnaire-
moderate test-retest reliability [65]. The three-
Two (OEQ-II) is a 32-item self-administered
factorial structure of the MHC-SF has been
questionnaire measuring the nature and degree
confirmed as the three subscales correlated well
of over-excitability [68,69]. Preckel, Schneider,
with the respective aspects of well-being and
and Holling indicated a Cronbach’s Alpha of
functioning, establishing convergent validity.
0.86 (psychomotor), 0.89 (sensual), 0.85
Mental health could be differentiated from mental
(imaginational), 0.89 (intellectual), and 0.84
illness, showing discriminant validity. Participants
(emotional) for the five different sub-dimensions
could rate how much they agree with statements
[37]. The validity of the OEQ-II was established
such as “That our society is becoming a better place
[2,70]. Participants could rate how much they
for people” on a 6-point Likert scale (1=never to

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

agree to statements such as “I have strong feelings could rate the extent of their agreement on
of joy, anger, excitement, and despair” on a 5-point a 5-point Likert-scale (1=does not apply to
Likert-scale (1=not at all like me to 5=very much 5=applies completely. Furthermore, the SV-12
like me). The following example items illustrate measures the sensitivity towards outer perception,
the different types of overexcitabilities: the sensitivity towards inner perception, empathic
sensitivity, emotional sensitivity, and openness. In
the following, an example for each of the translated
sensitivity subscales was illustrated:

• Sensitivity towards outer perception: “I notice

many subtleties in my environment.”

• Sensitivity towards inner perception: “I have

a rich, complex inner life.”

• Empathic sensitivity: “I feel the mood quickly

when I come into a room with people.”

• Emotional sensitivity: “Feelings play an

Figure 2. Schematic representation of the dual
important role in my decisions.” Openness: “I
continua model. Flourishing refers to a state of
am curious and always want to try new
complete mental health, struggling to high
things.” Processing problems: “I am often
functioning despite the presence of mental
overwhelmed by my feelings”.
illness and languishing to a state of incomplete
mental health. In the last category, floundering Procedure
describes a condition of both mental illness and
impaired mental health. The data collection period encompassed ten days.
It started on the 15th of October and was closed on
the 25th of October. To collect the necessary data
• Sensual: “The varieties of sound and colour
the four questionnaires as illustrated above were
are delightful.”
transformed into online questionnaires by using
• Psychomotor: “I love to be in motion.” the survey website Qualtrics. To contact
participants of the control group, the link to the
• Imaginational: “I like today dream.” survey was published on Sona-Systems, a platform
where researchers can gather a convenience-based
• Intellectual: “I like to play with ideas and try sample consisting mainly of first-year students in
to think about how to put them to use.” need of European Credit Transfer System (ECTS)
points. To contact intellectually gifted individuals,
• Emotional: “I have strong feelings of joy, the link was sent to members of Mensa Germany,
anger, excitement, and despair.” the German branch of the worldwide leading
association for intellectual giftedness. Participants
SV-12: The Clinical Inventory for the Assessment were transferred to the website of the questionnaire
of Sensitivity and Corresponding Processing
by clicking on the provided link. During the
Problem (SV-12) is a 30-item self-administered
first part of the questionnaire, participants were
German questionnaire measuring sensitivity and
informed about the topic of the study and were
its processing problems [71]. Cronbach’s Alpha
asked for their informed consent. Afterwards, the
range from 0.84 to 0.77 for the Sensitivity and
participants completed the four questionnaires.
Processing problems scales, respectively.
After completion of all questionnaires, participants
Convergent validity was established by a two-
have been asked if their want to be informed about
factorial solution of both constructs. The SV-
the results of this study and were offered an option
12 was translated, as illustrated in Appendix C, in
to fill in their e-mail address. Finally, they were
English for the purpose of the current study. An
thanked for participation and informed about the
example of the Sensitivity scale would be “I notice
opportunity to contact the researcher in case of any
many subtleties in my environment” and an
questions or in case of any remarks about the study.
example of the Processing problems scale would
be “I often feel that I need more time to process
certain impressions or experiences”. Participants

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

The dimensions and subscales of the final survey were formulated as follows:
created for the purposes of the current study were
based on the literature review and a pilot study. • Trick question 1: “In order to ensure that you
The final survey, including in this study included are reading the content of this study carefully,
variables and subscales, is depicted in Table 1. we ask you to answer this statement with
“applies most often”.
In order to warrant a high data quality, trick
questions have been incorporated into the survey • Trick question 2: “To ensure the data quality
to identify non-credible responses. Three of such of this study, please enter a numeric one”.
questions were spread throughout the multiple
scales of the survey. The three trick questions • Trick question 3: “Please select the choice
“Not at all like me”.

Table 1. An overview of all in the current study included variables and different sub scales.

Questionnaires Number of items Variable Subscales and measures

MHC-SF 12 Mental health Emotional WB

Psychological WB

Social WB

BSI 28 Mental illness Somatisation

Depression
Anxiety

Hostility

Interpersonal

Sensitivity

OEQ-II 32 Overexcitabilities Sensual

Psychomotor

Imaginational

Intellectual

Emotional

SV-12-1 16 Sensitivity Outer/Inner

Empathetic

Emotional

Openness
SV-12-2 14 The inability to deal with/ Processing
channel overexcitabilities
Problems

Note: WB refers to well-being; SV-12-1 refers to the sensitivity a subscale of the SV-12; SV-12-2 refers to
the processing problems subscale of the SV-12.

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

Design and analysis MHC-SF were considered as mentally healthy and

categorized on the right part (flourishing or
This study had a descriptive and cross-sectional struggling) of the model.
design. SPSS 24.0 has been used to analyze the
data. First, a screening for study-related stress was The third and fourth hypothesis whether the
used to filter stress-induced influences on mental inability to channel overexcitabilities (SV- 12-
health and a screening for intellectual giftedness 2) mediates the relation between strong
for the control group was used to eliminate overexcitabilities and mental health and illness has
potential biases that might have impacted the been evaluated by conducting four mediation
results of the current study. Secondly, the trick analyses. Both hypotheses were tested by
questions were correlated with the variables of the analyzing the indirect effect of the inability to deal
study to evaluate non-reliable responses. Third, with overexcitabilities on this relation by using
descriptive statistics were computed including the The MEDIATE file developed by Hayes and
means, standard deviations, kurtosis, skewness Preacher (2014). Bootstrapping was chosen to test
and Cronbach’s Alpha of all variables. Fourth, the mediation hypotheses because it is more
a Kolmogorov-Smirnov test was used to test for effective than the Baron and Kenny approach and
normal distribution. Depending on the normal as it works with comparably low sample sizes
distribution of the data, Spearman or Pearson by selecting randomly a large sample from the
correlations were employed. Effect sizes of R2 original sample, which increases the statistical
have been set at 0.01 (small), 0.09 (medium) and power [72,73]. The MEDIATE file does not
0.25 (large) according to the recommendation of assume the traditional assumptions of the Baron
the Cambridge University (n.d.) and Cohen (1988) and Kenny causal steps approach, such as a
in determining the magnitude of the observed significant relation between x and y.
effects.
In order to check for reverse causal effects, x was
The first hypothesis if gifted individual’s exhibit interchanged with m, and effect sizes between
stronger overexcitabilities has been tested by these and the initial models were compared. It was
conducting a T-test between the scores for the scales assumed that effect sizes for the proposed models
of Overexcitabilities and (OEQ-II) sensitivity (SV- are substantially larger compared to the reverse
12-1) between gifted individuals and average- causal effect models, although the reverse causal
intelligent individuals in the control group. The effect models might be significant likewise because
second hypothesis whether gifted individuals with as noted, processing problems. The indirect effects
strong overexcitabilities exhibit a poorer mental have been computed in the sample of highly gifted
health status than their peers was tested by individuals to identify mediation effects.
conducting two independent T-tests comparing Overexcitabilities and Sensitivity have been used
strong versus weak overexcitabilities for each for both analyses as separate independent variables,
group. High versus low Overexcitabilities (OEQ- thereby yielding in total four different mediation
II) were divided by a median split of the overall analyses, as Figure 3 illustrates. The indirect effect
sample. The means were subsequently applied of the inability to channel overexcitabilities
to the Dual Continua Model to evaluate whether between overexcitabilities and sensitivity as the
gifted individuals with strong overexcitabilities independent variables and mental health as the
exhibit a poorer mental health status than their dependent variable was analyzed by calculating
peers. the non-standardized indirect effects for each of
5,000 bootstrapped samples. A corresponding 95%
In order to categorize the participants in the Dual Confidence Interval (CI) was computed by
Continua Model, cut-off scores for values of determining the indirect effects at the 2.5th and the
mental health and illness were used (Appendix D). 95.5th percentile. An indirect effect of the inability
Westerhof and Keyes prescribe mean values of 0.7 to deal with/channel overexcitabilities could be
(corresponding to a 1.7 on a 1-5 Likert- Scale) and confirmed if the CI did not include the number zero
above on the BSI as a possible mental illness, [74]. With a bootstrap sampling of 5,000, it is
precluding categorization of flourishing and possible to circumvent power problems and to
languishing [60]. Those who scored 4 (6-point apply the mediational analyses with more
Likert-Scale) on average or above on the confidence.

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

Figure 3. The four mediation models were tested in this thesis.

Results Hypothesis testing

Descriptive analyses Hypothesis 1: The first hypothesis if intellectually

gifted individual’s exhibit stronger
The descriptive analyses as well as the zero- order overexcitabilities has been tested by conducting
correlations for all in the study included variables a T-test between the scores for the scales of
are illustrated in Appendix E, for the overall overexcitabilities and sensitivity between gifted
sample, the Mensa group and the student group and the student group. Gifted individuals exhibited
from the University of Groningen group, stronger overexcitabilities (M=3.56, SD=0.48)
respectively. than students (M=3.28, SD=0.56), ((t (350) =
0.851, p<0.001, R2=0.063)) and scored marginally
Table 1 illustrates the difference between the significantly higher on the sensitivity questionnaire
giftedness group and the student group. Mental (M=3.60, SD=0.53) than students (M=3.48,
health scores were non-normally distributed, with SD=0.56), ((t (348) = 0.922, p=0.053, R2=0.011)).
a left skewness of -0.39 (SE=0.13) and kurtosis of
-0.16 (SE=0.26). Mental illness scores were non- Finally, intellectually gifted individuals exhibited
normally distributed, with a right skewness of 1.13 stronger outer overexcitabilities (M=3.99,
(SE=0.13) and kurtosis of 1.12 (SE=0.26). SD=3.64), compared to the control group
Participant scores on overexcitabilities were (M=3.64, SD=3.64), (t (249) = 3.782, p<0.001,
normally distributed, with skewness of 0.00 R2=0.039), as well as inner overexcitabilities
(SE=0.13) and kurtosis of-0.51 (SE=0.26). (M=3.01, SD=.74), than the control group
Consistently, sensitivity scores were normally (M=2.83), (t (350) = 2.005, p=0.046, R2=0.012).
distributed, with a skewness of 0.83 (SE=0.13) and The hypothesis was thus supported. Means for the
kurtosis of -0.22 (SE=0.26). Finally, the inability individual subscales, corrected for multiple
to deal with overexcitabilities was normally testing, are depicted in Table 2. Appendix G shows
distributed, with scores exhibiting a skewness of a comparison of the overexcitability subscales with
-0.02 (SE=0.13) and kurtosis of -0.41 (SE=0.26). the norm population.
Cronbach’s Alpha for the overall survey and the
questionnaires used indicated a good to excellent Hypothesis 2: The second hypothesis if gifted
internal consistency, as shown Appendix F. A individuals with strong overexcitabilities exhibit a
composite score of the items, as measured by the poorer mental health status than their peers was
Kolmogorov-Smirnov test, showed no significant evaluated by conducting four independent T-
deviation from a normal distribution (D (350) = comparing strong versus weak overexcitabilities
0.038, p=0.20) and usage of Pearson correlation and sensitivities, divided according to a median
seemed thus warranted. In order to identify non- split of the overall sample. Table 3 displays the
credible responses as a potential confounder, trick frequencies for both groups regarding strong
questions were correlated with all the variables versus weak overexcitabilities and strong versus
included in this study. The correlations were weak sensitivities. Strong overexcitabilities and
insignificant. strong sensitivities were primarily found in the

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 “Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

giftedness group, whereas the average intelligent The results, including the confidence interval and
individuals scored lower on both overexcitabilities effect size for each of the four models, are depicted
and sensitivities. in Table 5. All four mediation models were highly
significant with effect sizes ranging from medium
Table 4 illustrates the results of the four to large. Both mediational hypotheses, as shown in
independent T-tests. Highly gifted individuals with the following, were supported.
strong overexcitabilities and sensitivities tended to
exhibit more symptoms of mental illness, but there The four mediation models
was no such difference regarding mental health.
No differences were found for strong versus weak Model 1 and 2: The relationship between
overexcitabilities and sensitivities regarding overexcitabilities, sensitivity and mental illness
mental health and illness in average intelligent was mediated by the inability to channel
individuals. As Figure 4 illustrates, the hypothesis overexcitabilities. As Figure 6 illustrates, the
that overexcitabilities are primarily associated standardized regression coefficients between
with a low mental health status of gifted overexcitabilities, sensitivity and mental illness
individuals was thus confirmed. were significant, as was the coefficient between the
inability to channel overexcitabilities and mental
Gifted individuals with strong overexcitabilities illness. The bootstrapped standardized indirect
were most likely to be categorized as floundering effects did not include zero in either models (Model
(complete mental illness), whereas those with 1: β=0.62; (0.12; 0.29)) (Model 2: β=0.65 (0.16;
weak ones were most likely to be categorized as 0.33)) and was thus significant.
being languishing (incomplete mental health).
Students were, irrespective of strength of Model 3 and 4: The relation between
overexcitabilities, most likely to be categorized as overexcitabilities, sensitivity and mental health
struggling (incomplete mental illness). The was mediated by the inability to channel
frequencies are depicted in Figure 5. Almost every overexcitabilities. As Figure 6 illustrates, the
second gifted individual (42.6%) who was unable standardized regression coefficient between
to channel overexcitabilities was categorized as overexcitabilities and mental health was significant,
floundering (complete mental illness) compared but not the coefficient between sensitivity and
to one quarter (28.0%) of the overall giftedness mental health. The coefficient between the inability
sample. to channel overexcitabilities and mental health was
significant. The bootstrapped standardized indirect
Hypothesis 3 and Hypothesis 4: Overexcitabilities effects did not include zero (Model 3: β=0.43; (-
and Sensitivity were used for both analyses as 0.38, -0.15)) (Model 4: β=0.44; (-0.44,
independent variables to test the hypothesis that -0.18)). The indirect effect was thus significant in
the inability to channel overexcitabilities mediates both models.
its relationship with mental health and mental
illness, respectively. Four mediations analyses
have been conducted with the Mensa sample.
Reverse causal effect models displayed much
lower effect sizes than the proposed models and
were thus deemed as an unlikely solution.

Table 2. Differences between gifted individuals and average-intelligent individuals.

Characteristic Total Highly gifted Average intelligent P-value

Mental health (M, SD) 3.91 (0.86) 3.84 (0.92) 4.10 (0.64) 0.011a*
Emotional well-being 4.43 (1.03) 4.36 (1.09) 4.60 (0.82) 0.053b*
Psychological well-being 4.04 (1.05) 4.15 (1.05) 3.74 (1.0) 0.001b*
Social well-being 3.45 (1.15) 3.14 (1.12 4.22 (0.81) <0.001b**
Mental illness (M, SD) 1.70 (0.59) 1.66 (0.49) 1.80 (0.52) 0.017a*
Somatisation 1.24 (0.25) 1.21 (0.40) 1.35 (0.47) 0.008b*
Depression 1.77 (0.76) 1.71 (0.73) 1.93 (0.79) 0.017b*
Anxiety 1.72 (0.61) 1.66 (0.58) 1.86(0.65) 0.006b*
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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

Hostility 1.67 (0.63) 1.68 (0.61) 1.64 (0.68) 0.498b

Interpersonal Sensitivity 2.02 (0.83) 1.96 (0.83) 2.18 (0.81) 0.027b*
Overexcitabilities (M, SD) 3.48 (0.50) 3.56 (0.48) 3.28 (0.50) <0.001a**
Sensual OEs 3.54 (0.77) 3.62 (0.73) 3.32 (0.84) 0.001b*
Psychomotor OEs 3.21 (0.79) 3.22 (0.77) 3.17 (0.83) 0.537b
Imaginational OEs 2.97 (.87) 3.06 (0.84) 2.72 (0.90) 0.001b*
Intellectual OEs 4.16 (0.63) 4.38 (0.48) 3.60 (0.63) <0.001b**
Emotional OEs 3.44 (0.79) 3.41 (0.84) 3.51 (0.63) 0.262b
Sensitivity(M,SD) 3.50 (0.54) 3.35 (0.50) 3.26 (0.52) 0.053a
Outer Sensitivity 3.89 (0.78) 3.99 (0.77) 3.64 (0.75) <0.001b**
Inner Sensitivity 2.96 (0.76) 3.01 (0.74) 2.83 (0.80) 0.046b*
Empathetic Sensitivity 3.67 (0.77) 3.69 (0.77) 3.62 (0.76) 0.582b
Emotional Sensitivity 3.18 (0.93) 3.04 (0.92) 3.56 (0.85) <0.001b**
Openness 4.04 (0.72) 4.15 (0.67) 3.75 (0.77) <0.001b**
Inability to channel/deal with 3.03 (0.75) 3.10 (0.78) 2.87 (0.65) 0.012a*
Overexcitabilities (M, SD)
Note: a= Independent samples t-test; b= ANOVA; OEs= overexcitabilities; Mean values are indicated in the
corresponding range to enhance interpretability; ANOVA tests were added to correct for multiple testing;
*P<0.05; **p<0.001.

Table 3. Comparison of strong and weak overexcitabilities and sensitivity between the two groups.

Highly gifted individuals Average intelligent individuals

Overexcitabilities Sensitivity Overexcitabilities Sensitivity
Strong (%) 148 (58.3%) 138 (53.5%) 32 (32.7%) 57 (39.8%)
Weak (%) 106 (41.7%) 118 (46.4%) 66 (67.3%) 39 (58.2%)
Note: Frequencies were computed by a median split of the overall sample.

Table 4. Differences between weak and strong overexcitabilities and sensitivities on mental health
and illness.

Highly gifted individuals Average intelligent individuals

Mental illness Mental health Mental illness Mental health
(M, SD) (M, SD) (M, SD) (M, SD)
Overexcitabilities strong 1.77 (0.53) 3.91 (0.92) 1.77 (0.45) 4.23 (0.75)
weak 1.50(0.38) 3.73 (0.91) 1.86 (0.64) 4.03 (0.58)
P-value <.001 0.132 0.504 0.147
Sensitivities strong 1.76 (0.52) 3.91 (0.90) 1.88 (0.56) 4.16 (0.72)
weak 1.54 (0.43) 3.75 (0.94) 1.76 (0.49) 4.05 (0.60)
P-value <0.001 0.159 0.259 0.397
Note: Mental health and illness scores based on strong and weak overexcitabilities, displayed for both
groups.

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

Figure 4. Gifted individuals and students with strong versus weak overexcitabilities and an inability
to deal with/channel overexcitabilities as categorized in the dual continua model. Cut-off scores are
depicted in Appendix D. Note: 1 = Highly gifted individuals with strong overexcitabilities; 2 = Highly
gifted individuals with weak overexcitabilities; 3 = Highly gifted individuals who are unable to
channel/deal with overexcitabilities; 4 = Students with strong overexcitabilities; 5 = Students with
strong overexcitabilities; 6 = Students who are unable to channel/deal with overexcitabilities.

Figure 5. Frequency of flourishing, struggling, languishing and floundering based on (1)

overexcitabilities (left side), (2) group (upper right side) and (3) and the Inability to channel
overexcitabilities (lower right side). Note: ( ) Flourishing; ( ) Languishing; ( ) Floundering; ( )
Struggling.

Table 5. Confidence intervals and effect sizes for the four mediational models.

Model Independent Mediator variable Dependent variable Confidence Intervals (CI) R2

variable
1 Overexcitabilities Inability to channel Mental Illness (β=0.62**; (0.12, 0.29)) 0.42
overexcitabilities
2 Sensitivity Inability to channel Mental Illness (β=0.65**; (0.16, 0.33)) 0.41
overexcitabilities
3 Overexcitabilities Inability to channel Mental Health (β=0.43**;(-0.38, -0.15)) 0.18
overexcitabilities

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“Living beyond limits”: Neurogenic Influences of Overexcitabilities on the Mental Health of the Highly Gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

4 Sensitivity Inability to channel Mental Health (β=0.44**; (-0.44, -0.18)) 0.17

overexcitabilities
Note: *p<0.05; **p<0.001; Appendix H shows testing with normal instead of strong overexcitabilities.

Figure 6. Results of the four Preacher and Hayes mediational analyses.

Discussion Hypothesis 1

The primary purpose of the current research was to In line with the first hypothesis, highly gifted
obtain a better understanding of sensitivity and individuals exhibited, on average, stronger
overexcitabilities and its influence on the mental overexcitabilities and (inner and outer) sensitivities
health and illness of highly gifted individuals. compared to average-intelligent individuals.
Intellectual giftedness is praised as being the When looking at the frequencies of overall
strongest predictor for positive outcomes, such as overexcitabilities and sensitivities, the majority of
income levels and educational success. However, gifted individuals were primarily found to be highly
little is known regarding the difficulties encountered overexcitable (58.3%) and sensitive (53.5%),
by this group. Specifically, those who are highly while highly overexcitable (32.7%) and sensitive
gifted demonstrate overexcitabilities in various (39.8%) individuals constituted only the minority
domains that predispose them to psychological in the control group. Except for psychomotor and
disorders and elevated sensory responses [7,35]. emotional overexcitabilities, gifted individuals
Based on the Parieto-Frontal Integration Theory were more likely to display sensual, imagination
(P-FIT) by Jung and Haier, Karpinski et al.’s and intellectual overexcitabilities. This is
Hyper Brain-Hyper Body framework and Gere’s congruent with the meta-analysis conducted by
Theory of Sensory Modulation and Integration, Winkler and Voight who found that highly gifted
four hypotheses were proposed: (1) Gifted individuals were likely to display stronger overall
individuals exhibit stronger overexcitabilities than overexcitabilities and to reach higher mean values
average-intelligent individuals, (2) gifted for the subscales of intellectual, imaginational, and
individuals with strong overexcitabilities exhibit a sensual overexcitabilities [75]. However, the study
poorer mental health status than their peers and reported also higher mean values of emotional
(3) as well as (4) that the inability to deal with overexcitabilities, which was not supported by the
overexcitabilities mediates the relation between current research.
strong overexcitabilities, mental illness and mental
A potential explanation for the difference between
health [7,16]. All hypotheses were supported. All
the findings of the current research and the meta-
mediation models reached medium to large effect
analysis by Winkler and Voight regarding
sizes and suggest that sensitivity and
emotional overexcitabilities is that the control
overexcitabilities are highly similar constructs.
group consisted of a selective sample of psychology
Finally, factor analyses yielded support for one
students [75]. E.g., it was found that psychology
underlying factor as the most likely solution.

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“Living beyond limits”: Neurogenic influences of overexcitabilities on the mental health of the highly gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

students possess unique emotional characteristics planning, concentration, avid reading, thirst for
which may decrease the comparability with highly knowledge, curiosity, keen observation, search for
gifted individuals regarding emotional understanding and truth, the forming of new
overexcitabilities [76,77]. concepts, passion for precision, tenacity in
problem-solving and reflective thought, such as
In order to increase the external validity of this love of theory and analyses, thinking about
thesis, mean values of the normal population of the thought, preoccupation with logic, introspection
individual overexcitability subscales by Rost et al. without judgement, critical thinking and intuitive
were used to compare gifted individuals and and conceptual integration [28,80].
students with respect to the normal population
(Appendix G) [21]. Piechowski promulgated that Hypothesis 2
at least one domain of overexcitability must be
prevalent to support Dabrowski’s notion that Mental health: Heightened sensitivity is assumed
overexcitabilities are prevalent in highly gifted to influence the sensory experience to such an
individuals [78]. In the current thesis, 87.8% and extent that typical and benign sensory inputs are
61.8% of the giftedness sample scored more than experienced as unpleasant, subsequently resulting
one standard deviation higher on the intellectual in defensive responses and withdrawal. Gere
and sensual overexcitability subscale compared to argued that this amplified reaction towards
the normal population, respectively, whereas this incoming stimuli leads to sensory discomfort and
was the case for none of the subscales for the subsequent peculiarity in emotional and behavioral
student population. The results are in line with response, increasing thereby psychosocial and
Alias, Rahman, Majid and Yassin who reported emotional problems and reducing the mental
that 88% of gifted children of their study had at health [35]. Contrary to Gere and Bar-Shality et al.,
least one type of overexcitabilities [79]. this thesis found no overall discernable effect of
varying levels of overexcitabilities on mental
The heightened scores of gifted individuals on health in average intelligent and highly gifted
the sensual overexcitability subscale, the outer individuals [35,44].
sensitivity subscale and on the inability to
channel/deal with overexcitabilities are consistent However, it was found that highly gifted
with previous research. That is, the P-FIT individuals scored lower on mental health than
predicted [16,17], based on the convergence and average intelligent individuals. Although highly
increased white matter tracks between parietal gifted individuals scored lower on mental health, it
association cortices and frontal lobes, that gifted could be discarded that this difference resulted
individuals exhibit a rapid sensory processing, from diverging levels of overexcitabilities because
which may lead to sensory discomfort and highly gifted individuals with strong versus weak
emotional response [18]. Sensual overexcitabilities scored equally low on mental
overexcitabilities allow an individual to have a far health, which was supported by the insignificant
more expansive experience, to perceive reality in correlation between overexcitabilities in gifted
greater depth [80] as manifested in heightened individuals and their mental health. Another more
awareness of all senses of sight, touch, taste and likely explanation accounting for the reduced
hearing [80,81]. This may lead to ease of mental health of gifted individuals was proposed
overstimulation and sensory discomfort and thus by Glaw et al., who argued that highly gifted
aligns with the overall theme of this thesis and the individuals exhibit low levels of positive mental
enhanced outer perception of gifted individuals health because they find it hard to find meaning in
[80]. life, which is critical for successful human
functioning, happiness, well-being, psychosocial
The heightened scores of highly gifted individuals health and a positive development [82-87].
on the inner sensitivity and intellectual and
imaginational overexcitability subscales are Mental illness: Average intelligent individuals
presumed to result from the enhanced brain exhibited more symptoms of mental illness
connectivity, as predicted by the P-FIT [18]. compared to highly gifted individuals. However,
Further, high scores on these scales were after closer inspection, it was revealed that the
associated with typical characteristics of the Likert scale of the official German version of the
highly gifted, such as an increased activity of BSI differs from the English version [66]. The
the mind, an increased capacities for sustained differences are displayed in Appendix I. Although
intellectual effort, detailed visual recall, detailed

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“Living beyond limits”: Neurogenic influences of overexcitabilities on the mental health of the highly gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

not noticed directly by the author, the same bias can being, quality of life, relationships, meaningful
be found in the validation of the German version. purpose and engagement (University of Alabama,
From the gifted individuals, 96.8% completed the 2013). Contrary, strong overexcitabilities in gifted
German version of the survey, which was only the individuals were associated with low positive
case for 22.4% of the average-intelligent functioning and emotional well-being [68].
individuals. The differences in mental illness In conclusion, the mental health of gifted
between both groups might thus be attributable to individuals was lower than that of average-
the differences between the two language scales. intelligent individuals and was not associated with
their level of overexcitability. Mental illness,
Highly gifted individuals with strong
overexcitabilities scored higher on mental illness however, is more prominent in gifted individuals
with higher levels of overexcitabilities. While
than those with weak overexcitabilities. This
finding is important to note because it indicates, as stronger levels of overexcitabilities appeared to
have a detrimental outcome in gifted individuals,
a priori hypothesized, that strong overexcitabilities
this trend was reversed in average intelligent
and sensitivities predispose especially gifted
individuals. That is, stronger overexcitabilities
individuals towards mental illness. The Columbus
were (1) not related to mental illness symptoms in
Group (1991) noted that the intensities of gifted
individuals interact with the heightened cognitive average intelligent individuals but were (2)
positively related to mental health levels of
capacity, making them thus especially vulnerable.
average intelligent individuals, indicating thus an
Roedell asserted that this vulnerability will
incremental growth of mental health for them for
increase with intellectual advancement [88]. The
stronger levels of overexcitability.
Hyper Brain-Hyper Body framework promulgated
Correspondingly, stronger overexcitabilities were
further that there is a nonlinear relationship
between intelligence and mental illness that is associated with a better mental health status in
average intelligent individuals and with a worse in
caused by overexcitabilities [7]. While the
difference between gifted individuals and average gifted individuals.
intelligent individuals regarding mental illness Hypothesis 3 and 4
thus likely stems from the differing Likert-scales
of the BSI and the lower scale response of gifted The current research hypothesized - other than the
individuals, this thesis can support the notion, in Hyper Body-Hyper Brain framework - that the
line with and the Columbus Group (1991), that mental health and illness of gifted individuals is
overexcitabilities specific to gifted individuals put more the result of extent of processing problems
these particularly at risk for mental illness [7]. (i.e., sensory modulation and integration), in
combination with overexcitabilities, than of
Dual continua model: In line with the second overexcitabilities alone [7]. Indeed, it was found that
hypothesis, highly gifted individuals with strong the inability to deal with/channel overexcitabilities -
overexcitabilities exhibited thus the poorest mental or equivalently processing problems - mediated the
health status (floundering: high mental illness, low relation between strong overexcitabilities, mental
mental health), followed by those with weak ones health and illness. All regression coefficients were
(languishing: low mental illness, low mental in the hypothesized direction. As expected, both
health) and average intelligent individuals with strong overexcitabilities and stronger inability to
strong and weak overexcitabilities (Struggling: channel/deal with overexcitabilities were thus
High mental illness, high mental health). When associated with higher levels of mental illness and
considering the frequencies of those who are lower levels of mental health in gifted individuals,
flourishing or floundering when categorized in respectively.
the Dual Continua Model, it was found that gifted
individuals with strong overexcitabilities were less The results are consistent with previous literature.
likely to flourish (37.84%) compared to average That is, the heightened sensitivity towards light,
intelligent individuals with strong sound, smell or texture (or in Dabrowski’s terms,
overexcitabilities (46.88%). Reversely, gifted strong overexcitabilities) can be either associated
individuals with strong overexcitabilities were more with Sensory Integration Dysfunction as a source
likely to be categorized as floundering (33.11%) of mental illness such as ADHD, depression,
compared to average intelligent individuals with bipolar disorder, anxiety disorder and ASD or
strong overexcitabilities (21.88%). Strong may act as a capacity and predictor for a life full of
overexcitabilities in average intelligent individuals passion, success, engagement, self-fulfillment and
were thus associated with higher levels of well- innovation [31,89,90]. In

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“Living beyond limits”: Neurogenic influences of overexcitabilities on the mental health of the highly gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

the first case, Hinterberger et al. suggested that in the recent past is, however, that sensitivities and
processing problems may result in mental illness processing problems are strongly related, but
and impairments, such as mental overload, stress, clearly distinct constructs [71]. For now, it is too
anxiety disorders [71]. This finding aligns well early and beyond the scope of this thesis to make
with Gere’s conception of processing problem as a further statements regarding the relationship
predictor for emotional disturbances in gifted between overexcitabilities, sensitivity, and
individuals and the positive correlation between processing problems other than stating that all
processing problems and mental illness found in three constructs often accompany each other at
the current research [35]. In the second case, least in the current study for gifted individuals.
strong overexcitabilities may be even conducive to
the mental health. Strengths

That is, the ability of a highly gifted individual This thesis enjoyed several strengths, such as
to channel overexcitabilities in such a way that this reliable confirmation that participants fell in highly
individual is not overstimulated, may be giftedness range (to be admitted at Mensa,
conducive to that individual’s mental health participants must score two standard deviations
because overexcitabilities are not inherently a above the mean on an IQ test and the tests are
defect and can even feed, empower, enrich and administered by a psychologist). Karpinski et al.
amplify an individual’s potential towards success argued that Mensa participants from any country
and innovation [89,90]. E.g., Konrad found are representative of those with high cognitive
recently that highly sensitive individuals were abilities [7]. The findings of this study can be thus
only vulnerable to develop a mental illness when assumed to be a reasonable proxy for those who are
they exhibited concurrently processing problems highly gifted. Furthermore, Karpinski et al. argue
[91]. Tentative support for this theory can be that most studies examining the relation between
provided by the current research - at least for the IQ and mental disorders include only standard
average intelligent individuals - as they scored deviation above or below the mean, falling short of
lower on problems and seemed to even benefit incorporating individuals with a very superior
from strong overexcitabilities. intelligence (130 and above or at or above the 98th
percentile) [7]. Most studies report an increased
Overexcitabilities, sensitivity, processing prob- risk for negative mental health outcomes in
lems lower IQ and a reduced risk for each increase in
standard deviation, assuming thus a linear trend
During the literature review, it became not clear continuing upwards [7]. This is relevant to note
how overexcitabilities and sensitivity are related to since without including individuals scoring in
each other. Dabrowski and Piechoswki use both uppermost intelligence percentiles (at least two
terms frequently interchangeably for each other, standard deviations above the mean or higher) -
making it thus hard to differentiate both concepts as this study did - results with respect to mental
from each other [32,33,81,92]. Usually, health cannot be generalized to gifted individuals
overexcitabilities are described as a “lens through as most researchers fall short in discovering
which to view the gifted” and this trend continues curvilinear relationships. A further major strength
in contemporary giftedness research (e.g., see of the current study is that a mental health and
Wageningen University, n.d.). Sensitivity - or the illness were separated, which made it possible to
highly sensitivity person, is not reserved for highly employ a multidimensional measurement of the
gifted individuals and has been introduced to a mental health status. This approach is innovative
broader audience by Aron and Aron [27,34]. The because the traditional approach of scientific studies
validation of all four mediation models for both to focus exclusively on mental health or illness has
overexcitabilities and sensitivities, and the factor become obsolete as there is increasingly more
analyses that yielded one underlying factor as the evidence that mental health and illness are two
most likely solution, indicate that both constructs related, but distinct dimensions [60]. Specifically,
are highly similar. This would suggest that the it was found that both groups exhibited similar
terms sensitivity and overexcitabilities may be frequencies with respect to those who are
used interchangeable - at least in the future, but for flourishing and floundering (the other two
now, more research is required to either demarcate categories cannot be effectively compared as there
both constructs or to conclude that both constructs is no consensus whether struggling or languishing
have essentially the same underlying factor or is worse: which drastically changed when strong
overlap to a large extent. What has been shown overexcitabilities was taken into consideration
[60]). In this way, this
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“Living beyond limits”: Neurogenic influences of overexcitabilities on the mental health of the highly gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

thesis provides a (1) valuable explanation under Finally, another limitation seems to apply to
which circumstances highly gifted individuals positive psychological approaches (of which the
may be flourishing or floundering and (2) a viable Dual Continua Model is part of) in general as
mechanism (i.e., the inability to channel or to deal that there seems to be no standard in calculating
with overexcitabilities) which can reconcile the the four categories of flourishing, languishing,
dispute in science over the contribution of struggling and floundering. E.g., while Teng et al.
giftedness on an individual’s mental health status. relied on principles of exclusion, others rely on
Further strengths include the usage of validated cut-off scores [59,63]. This study followed the
questionnaires, the large sample size employed approach by Westerhof and Keyes to preclude
and finally the statistical power, which was even individuals with a BSI score of 1.7 (in the paper
enhanced by the bootstrapping procedure. 0.7 because of their Likert scale) from flourishing
and languishing [60]. Finally, there are currently
Limitations no existing measures of the ability to deal with/
channel overexcitabilities. Correspondingly, any
Several limitations should be beard in mind before indirect inferences in this regard are drawn based
strong conclusions may be drawn. Some on low levels of the inability to deal with/channel
limitations regard the external validity of the overexcitabilities and replications with the direct
findings. Firstly, hypothesis 2 was evaluated by measure are needed to establish its significance in
considering results of the gifted and student gifted individuals. Despite these limitations, this
sample separately because participants who took thesis provides a valuable extension for giftedness
the German version of the BSI, irrespective of the research.
group, scored significantly lower compared to the
English version (Appendix I). Correspondingly, Clinical implications
the results must be replicated in the future with a
corrected BSI scale. Although it was later shown, Since as many as 35% of highly gifted individuals
in line with the hypothesis, that giftedness with experience symptoms of sensory processing
strong overexcitabilities was associated with the disorder, the most extreme form of processing
poorest outcome (floundering), it can be assumed problems, this thesis highlights the paramount role
that the difference between this group and the interventions can potentially provide to improve
others would be even larger. Secondly, the control the mental health status of highly gifted individuals
group encompassed a homogenous group of [95]. The low effect sizes of therapies based on
psychology students, which did not match the sensory processing problems may be owed to the
Mensa sample regarding age, sex, education and fact that they do not acknowledge the universal and
language, limiting thus the comparability between prevailing impact that sensitivity and
both groups. Similarly, it has become increasingly overexcitabilities have on all life domains of many
acknowledged that college students suffer from highly gifted individuals, as “Effective counseling
high levels of anxiety and depression [93,94]. For for the gifted requires a therapeutic orientation that
this reason, students with study-induced mental strives to help a client integrate all aspects of his
illnesses were excluded from the analyses, which being”. Although sensory desensitization or a
may limit comparability with the Mensa sample as sensory diet may prove to be effective and may
they were not screened for stress- induced streamline the self-education process of gifted
disorders. Future studies may match individuals, a combination with therapeutic
characteristics of both groups more carefully. approaches based on the needs of highly gifted
Thirdly, nine participants failed one or more of the individuals, such as those emphasizing the
trick questions whose responses were not deleted prevailing and ubiquitous role of overexcitabilities
as the advantages (greater effect size, greater in the developmental path of gifted individuals,
number of participants, otherwise consistent seem to be most promising in helping them to deal
responses, confirmation of honest responding of with/channel overexcitabilities [62].
all participants and insignificant correlation
between trick questions and the other variables) of Future intervention-based research may show
retaining them were, after careful weighting and whether approaches based on the Theory of
inspection of each case, estimated to be greater Positive Disintegration (TOPD) (although not
than the disadvantages. Thus, it cannot be assured explicitly discussed in the text, some approaches
that all responses were completely credible. proved to be highly effective in applied contexts
[96]). Several single case studies (for an excerpt:
Shavinina) already provided evidence for TOPD

18
“Living beyond limits”: Neurogenic influences of overexcitabilities on the mental health of the highly gifted ASEAN
Journal of Psychiatry, Vol. 25 (3) March, 2024; 1-23.

therapeutic approaches for all life domains of strong overexcitabilities on the mental health and
gifted individuals [97]. Therapeutic approaches illness of highly gifted individuals.
based on the TOPD treat overexcitabilities
indirectly. That is, overexcitabilities are not Acknowledgements
regarded as maladaptive, but as elementally to the
higher development and personal growth of For Elisabeth Gesina Diek.
highly gifted individuals. One strategy is to teach
gifted individuals to embrace the profound Thank you for all and everything.
emotional intensity, the depth and imaginal
qualities resulting from sensory sensitivity as Thank you for your last words.
a necessary part of deeper understanding and to
For all you did for other people.
regard overexcitabilities not as a weakness, but as
a strength that needs to be fostered [98]. Gifted You are my inspiration.
individuals are encouraged to activate and express
inner impulses, insights and drives in their most In hope you are well, wherever you are.
natural form of expression, such as art. In this way,
gifted individuals learn to channel - rather than to Utmost thanks to Yvonne Groen, who supervised
suppress - overexcitabilities in an adaptive form this project.
that fosters personal growth and mental health.
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Corresponding author: Leon Alker, Department of Clinical Neuropsychology, St. Franziskus-Hospital

Winterberg, Winterberg, Germany

E-mail: leonalkergnp@gmail.com

Received: 15 March 2024, Manuscript No. AJOPY-24-129669; Editor assigned: 18 March 2024, PreQC
No. AJOPY-24-129669 (PQ); Reviewed: 01 April 2024, QC No AJOPY-24-129669; Revised: 08 April
2024, Manuscript No. AJOPY-24-129669 (R); Published: 18 April 2024, DOI: 10.54615/2231-7805.47349.

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