1239649

research-article2024
GCQXXX10.1177/00169862241239649Gifted Child QuarterlyAykutlu et al.

Feature Article

Gifted Child Quarterly

Gifted Children and Psychiatric Disorders:

2024, Vol. 68(3) 226­–237
© 2024 National Association for
Gifted Children
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Their Peers? DOI: 10.1177/00169862241239649

https://doi.org/10.1177/00169862241239649
journals.sagepub.com/home/gcq

Hasan Cem Aykutlu1 , Fatih Dereli1 , Bahadır Turan2 ,

Tuğba Türk Kurtça1 , and Onur Burak Dursun3

Abstract
This study examined the prevalence and correlates of psychopathology in gifted children (GC) and explored whether
giftedness confers protection or risk for mental health problems. We used a comparative design to analyze a population-
based sample of 100 GC and 100 controls matched by age and sex in Turkey. We assessed psychiatric diagnoses with the
Development and Well-Being Assessment (DAWBA), a valid diagnostic tool for child and adolescent mental health, and
measured resilience and temperament with standardized scales. GC and controls did not differ significantly in the frequency
of psychiatric disorders. However, GC showed lower resilience and higher negative reactivity and activity than controls.
Negative reactivity was a significant predictor of psychopathology in GC. Sex did not moderate the effects of giftedness
on mental health outcomes, resilience, or temperament. Our findings suggest that GC may have increased vulnerability to
stress and reduced coping skills. We highlight the need to identify and support GCs who experience mental health problems
and face psychological challenges. Our results emphasize the importance of early intervention and prevention to enhance
resilience and well-being in this population. Future research should investigate the underlying mechanisms and develop
tailored strategies to support the mental health and well-being of GC.

Keywords
case study, logistic regression, children, gifted, mental health, resilience

Gifted children (GC) are those who demonstrate exceptional GCs are twice-exceptional, possessing both giftedness and a
abilities or potential in various fields, such as general intel- neurodevelopmental disorder (Foley-Nicpon et al., 2010),
lectual skills, specific academic aptitudes, creative or pro- presenting unique challenges and potentially amplifying
ductive thinking, leadership ability, and visual and performing socioemotional struggles. Regardless of the cause, GCs often
arts, as compared with their peers. According to the Marland experience isolation, misunderstanding, and boredom in
Report, these children are often quick learners with broad school (Košir et al., 2015; Reis & Renzulli, 2004; Smith,
knowledge and heightened curiosity, and their advanced 2017; Vialle et al., 2007), leading them to encounter more
thinking abilities are believed to increase their emotional and socioemotional problems and seek clinical assistance for
sensory sensitivity (Marland, 1972). However, the most school-related issues (Guénolé et al., 2013).
commonly used definitions of giftedness emphasize intelli- Several studies have shown that GC may experience
gence and academic ability as the main criteria (Cassidy & socioemotional difficulties. While some studies have found
Hossler, 1992; Rinn et al., 2022). internalization problems such as anxiety, introversion, social
Despite possessing high potential, some gifted children withdrawal, low self-esteem, and extreme perfectionism to be
(GCs) struggle to express their talents due to socioemotional associated with GC, others have also indicated a link between
difficulties (Jellinek et al., 2009). These challenges might externalization problems, including emotional dysregulation,
stem from heightened sensitivity, perception, and hyper-
excitability (Reis & Renzulli, 2004). Asynchronous develop- 1
Trakya University, Edirne, Turkey
ment, where abilities in certain areas outpace others, could 2
Karadeniz Technical University, Trabzon, Turkey
exacerbate these disparities, leading to increased socioemo- 3
Saglik Bilimleri University, Istanbul, Turkey
tional struggles compared with peers (Silverman, 1997). Corresponding Author:
However, environmental factors like unsupportive learning Hasan Cem Aykutlu, Department of Child and Adolescent Psychiatry,
environments or lack of peer connections can also play a sig- Trakya University, Edirne 22030, Turkey.
nificant role (Mueller & Winsor, 2018). Furthermore, some Email: [email protected]
Aykutlu et al. 227

hyperactivity, irritability, and aggression (Tasca et al., 2022). giftedness, diverse and unreliable assessment tools for psy-
A study assessing GC who sought treatment at a psychiatric chopathology, and inadequate control for confounding vari-
clinic discovered that these children exhibited internalization ables (Francis et al., 2016; Martin et al., 2009; Tasca et al.,
problems, and those with advanced IQ scores displayed a 2022; Tourreix et al., 2023).
higher frequency of behavioral problems (Guénolé et al., To address these limitations, we conducted a community-
2013). Another study that compared GC without psychiatric based study using a valid and reliable psychiatric assessment
disorders to their peers also discovered that GC showed tool to screen for psychiatric disorders in GC and their non-
higher levels of inattention, lower social functionality, and gifted peers. We also measured temperament characteristics
worse physical health (Eren et al., 2018). In a 2020 study, and resilience to explore psychological differences between
Kermarrec et al. showed that children with high IQ scores had the two groups. Thus, this study aims to answer three research
more anxiety disorders than their peers. However, there was questions:
no statistically significant difference between groups based
on anxiety scale scores self-reported by children. A 2022 Research Question 1: Are there differences in the rates
study found that GC had a significantly higher risk of sleep of psychiatric disorders between GC and their peers?
problems (4.67 times) and maladaptive behavior (14.12 Research Question 2: How do resilience and tempera-
times) than their peers (Bastien et al., 2022). ment in GC differ from those of their peers?
Several studies have challenged the prevailing assumption Research Question 3: Which psychological traits are
linking giftedness to socioemotional difficulties. These studies correlated with psychiatric diagnoses in GC?
have found that GC exhibit stronger personality traits and
lower psychological distress than their non-gifted peers, sug-
gesting that giftedness may not inherently compromise an Method
individual’s socioemotional well-being (Cornell et al., 1995;
Research Model
Sierra et al., 2015). For instance, high IQ has been correlated
with improved regulation of behavior, cognition, and emo- This research was designed as a correlational study, which is
tions, as well as enhanced outcomes across various domains one of the quantitative research types. Correlational research
such as academics, education, vocational pursuits, physical examines the relationship between two or more variables
health, and mental well-being (Plomin & Deary, 2014). In a without intervening in any way. This examination may give
population-based study encompassing 2,221 participants, the researcher an idea that there may be a cause-and-effect
Rommelse et al. (2017) observed that 39 children with high relationship, but it cannot be interpreted as a definite cause-
IQs (>130) exhibited fewer symptoms associated with effect relationship between variables (Gall et al., 2007).
Attention Deficit Hyperactivity Disorder (ADHD), along with
fewer externalizing and internalizing problems when com- Sample Size
pared with their peers. In addition, in a prospective cohort
study tracking 1,207 children from ages 5 to 11, Cook et al. We examined studies included in meta-analyses that investi-
(2020) noted that children with high IQs (>120) experienced gated the association between high IQ and psychiatric disor-
fewer mental health challenges than their peers at all assessed ders to estimate the effect size for our power analysis (Francis
time points. Furthermore, previous cross-sectional investiga- et al., 2016; Martin et al., 2009). The effect sizes of these
tions have demonstrated that GC share a psychological profile studies varied widely, ranging from -1.37 to 0.02. Therefore,
comparable to that of their non-gifted counterparts (Kanlı, we adopted a conservative estimate of small effect size
2013; Morawska & Sanders, 2008). Three systematic reviews (<0.20) to suit the requirements of our study (Cohen, 2013).
have focused on this subject and have highlighted that children We calculated the average effect size from the studies ana-
with high IQ exhibit similar or fewer socioemotional and lyzed by Francis et al. (2016) as 0.15. Then, we used
behavioral difficulties when compared with their peers G*Power 3.1 software to determine the required sample size
(Francis et al., 2016; Martin et al., 2009; Tourreix et al., 2023). for a chi-square test with an effect size of 0.15, a power of
The mental health of GC remains a controversial topic. 0.80, and a significance level of 0.05 (Faul et al., 2007). The
Although GCs are often assumed to have superior intelli- computed sample size was 350 participants (175 per group).
gence, creativity, and achievement, the evidence for their
psychological well-being is inconclusive. A recent system- Participants
atic review reported that the current literature is insufficient
to determine whether giftedness is a protective or a risk fac- Participant Recruitment. Although our initial plan was to enroll
tor for psychopathologies (Tasca et al., 2022). Moreover, 175 participants in each group, our study faced low compli-
previous research on GC’s mental health has produced ance rates, with only 52.1% for the gifted group and 35.7%
inconsistent and inconclusive findings, partly due to method- for the control group. Most dropouts occurred during the
ological issues, such as small and biased samples (e.g., clini- Development and Well-Being Assessment (DAWBA) assess-
cal vs. population), using only IQ scores to diagnose ment, as parents had to attend online meetings to complete it.
228 Gifted Child Quarterly 68(3)

These meetings were held to explain the use of DAWBA techniques for diagnosing childhood and adolescent mental
online and complete the assessment in a single session to pre- disorders based on ICD-10 and DSM-IV. It was originally
vent changes over time. Also, completing DAWBA may take developed for a nationwide epidemiological study that was
up to 90 min due to its inclusion of both closed-ended and used in planning the organization of child and adolescent
open-ended questions, both of which are crucial for assessing mental health services in the United Kingdom, with a sample
psychiatric disorders. of more than 10,000 children (Goodman et al., 2000). It is
Due to enrollment difficulties, the study consisted of 100 now one of the most widely used diagnostic interviews in
intellectually gifted students (aged 9-12) from the Edirne child and adolescent psychiatry, with proven reliable validity
Science and Art Center (SAC). To achieve a controlled com- and reliability.
parison, we formed a control group comprising 100 students The DAWBA scale collects information from various
who were matched on age and gender. The students were sources, including parents, teenagers over the age of 11, and
selected from schools in the central district of Edirne to address teachers, who can complete the scales online. The assess-
potential socioeconomic differences with the gifted participants. ment covers many areas of psychopathology, including anxi-
The students in the control group were not enrolled in the SAC ety disorders, depression, ADHD, autism, eating disorders,
program. Both participant groups were conveniently selected and tics. The tool evaluates the impact and impairment of
and provided voluntary consent for participation in the study. symptoms. Experienced clinicians use a structured interview
These children and their families were given scales to fill to make a diagnosis, which involves a combination of closed
out online. Parents completed the DAWBA and School Age questions to address diagnostic criteria and open-ended
Temperament Inventory (SATI). Children completed the questions to allow informants to describe the problem in
Child and Youth Resilience Measure-12 (CYRM-12). The their own words. An accredited child psychiatrist conducts
workflow of the study is presented in Figure 1. the evaluation. A Turkish validity and reliability study of the
DAWBA scale was conducted by Dursun et al. (2012).
Assessment of Giftedness. The SAC Student Identification In our study, the DAWBA was assessed by two indepen-
Guidelines describe the process of identifying gifted primary dent child and adolescent psychiatrists (B.T. and O.B.D) who
school (first, second, and third grades) students in the fields were blinded to the clinical diagnosis, except for the first
of general intellectual ability, music, and artistic talent. The author (H.C.A). The inter-evaluator correlation of two physi-
process consists of three stages: nomination, group screen- cians was tested against the data obtained from 20 patients
ing, and individual assessment. In the first stage, classroom who were given the DAWBA for other reasons previously,
teachers nominate up to 20% of their students in each grade and the correlation between the evaluators was found to be
level for a talent area. In the second stage, nominated stu- strong (κ value = .89).
dents take a tablet-based test that measures their abilities in
similarity (e.g., obtaining the pair of tomato and tomato paste Child and Youth Resilience Measure-12 (CYRM-12). Child and
from the pair of olive and olive oil by analogy), coding (e.g., Youth Resilience Measure-12 (CYRM) is a self-report ques-
sorting or matching according to a certain rule formed from tionnaire that was originally designed by Michael Ungar to
letters, words or shapes), matrix (e.g., completing the cell assess resilience in children and adolescents. It assesses pro-
left blank by discovering the common features of the shapes tective factors that contribute to resilience, including per-
or objects in the boxes), short-term memory, perception (e.g., sonal attributes, supportive relationships, and contextual
completing the visual integrity in mind by taking into account factors. The CYRM consists of 28 items, with responses on a
the view of the cube from different directions), and number 5-point Likert-type scale ranging from 1 (not at all true) to 5
sequence recall (Ministry of National Education [MEB], (very true). The CYRM has been shown to have good psy-
2016). In the third stage, candidates who applied for musical chometric properties and has been used in diverse cultural
and artistic talent undergo performance evaluations by min- and linguistic contexts (Ungar & Liebenberg, 2011). Lieben-
istry-appointed commissions, while candidates who applied berg et al. (2013) created a brief form of the CYRM with 12
for general intellectual ability take one of the following IQ items to assess resilience in children and adolescents. In Tur-
tests: the Wechsler Intelligence Scale for Children-Revised, key, Arslan (2015) conducted a validity and reliability study
the Wechsler Nonverbal Scale of Ability, or the Anadolu-Sak of the CYRM-12. In our study, the internal consistency reli-
Intelligence Scale. Candidates who score above 130 on the ability of the CYRM-12 was assessed using Cronbach’s α,
IQ tests are classified as gifted in general intellectual ability, with a value of 0.79, indicating good reliability.
and those who pass the performance evaluations are classi-
fied as gifted in music and artistic talent (MEB, 2022). School Age Temperament Inventory. School Age Temperament
Inventory is a parent-report questionnaire that was devel-
oped by McClowry (1995) to evaluate the four temperament
Scales
dimensions: negative reactivity, task persistence, approach/
The Development and Well-Being Assessment (DAWBA). withdrawal, and activity. Negative reactivity measures how
DAWBA is a suite of interview, questionnaire, and rating often the child expresses negative emotions, task persistence
Aykutlu et al. 229

Figure 1. The Flowchart of Participant Recruitment.

evaluates their self-directedness, approach/withdrawal SATI was made by Eremsoy (2007). The internal consistency
assesses their response to new situations, and activity mea- reliability of the scale was assessed using Cronbach’s alpha,
sures their level of motor activity. Higher scores suggest with values of .90 for Negative Reactivity, .89 for Task Per-
higher levels of each domain. The questionnaire consists of sistence, .82 for Approach/Withdrawal, and .77 for Activity
38 items, with responses on a 5-point Likert-type scale rang- in our study. These values indicate good reliability of the
ing from 1 (never) to 5 (always). The Turkish adaptation of scale.
230 Gifted Child Quarterly 68(3)

Table 1. Sociodemographic Characteristics of Control and Gifted Group.

Variable Control Gifted Total χ2 df p

Age (Year) 10.6 ± 0.9 10.4 ± 0.9 10.5 ± 0.9 t= 1.16 197 .258a
Sex Girl 51 (51%) 50 (50%) 101 (50.8%) 0.02 1 .888b
Boy 49 (49%) 50 (50%) 99 (49.2%)
Family income Low 39 (39%) 17 (17%) 56 (28%) 12.01 2 .002b
Medium 35 (35%) 47 (47%) 82 (41%)
High 26 (26%) 36 (36%) 62 (31%)
Mother’s age 18-44 86 (86%) 82 (82%) 168 (84%) 0.36 1 .562b
>45 14 (14%) 18 (18%) 32 (16%)
Father’s age 18-44 66 (66%) 63 (63%) 129 (64.5%) 0.20 1 .658b
>45 34 (34%) 37 (37%) 71 (35.5%)
Mother’s education Elementary 53 (53%) 30 (30%) 83 (41.5%) 10.90 1 .001b
High 47 (47%) 70 (70%) 117 (58.5%)
Father’s education Elementary 51 (51%) 26 (26%) 77 (38.5%) 13.20 1 <.001b
High 49 (49%) 74 (74%) 123 (61.5%)

Note. Mean ± Standard deviation,

a
Student’s t-test.
b
Pearson chi-square was used for statistical analysis.

Ethical Approval (16%), and music (3%). Only a small number of children
exhibited abilities in two areas, where 5% showed talent in
The Ethics Committee of Trakya University Faculty of general intellectual ability and visual arts, and 1% displayed
Medicine approved the study as ethical on March 15th, 2021 talent in general intellectual ability and music.
(with reference number 2021/118). The study was also While 64% of the GC and 15% of the control group
granted permission to be conducted in the participating reported attending public schools, the majority of the control
schools based on the Ministry of National Education’s decree group (84%) did not disclose their school type. The remain-
on June 23rd, 2021 (with reference number 26921416). The ing GC (36%) and control group (1%) were enrolled in pri-
study’s objective was stated in the questionnaires, and we vate schools. The distribution of grade levels among the GC
obtained parental consent to ensure data confidentiality. was as follows: fifth grade (38%), fourth grade (32%), sixth
grade (17%), seventh grade (8%), and third grade (5%). The
distribution of grades in the control group was as follows:
Statistical Analysis
fifth grade (43%), sixth grade (38%), fourth grade (11%),
The normality assumption was assessed using the Shapiro- and third grade (8%), respectively.
Wilk test. An independent samples t-test was used to com- Age (10.44 vs. 10.59, p = .258) and sex (female 50% vs.
pare two independent groups, while chi-square tests were 51%, p = .888) were similar between GC and the control
used to examine the relationship between categorical vari- group. However, in GC, mother (high 70% vs. 47%, p =
ables. Descriptive statistics, such as mean and standard devi- .001) and father education level (high 74% vs. 49%, p <
ation, were reported for quantitative variables, while .001) and family income level (high 36% vs. 26%, p = .002)
frequency and percentage were reported for qualitative vari- were higher than the control group (see Table 1).
ables. Multiple comparisons were controlled using the There was no statistically significant difference in the fre-
Bonferroni correction. Logistic regression analysis was used quency of psychiatric disorders between the GC and control
to investigate the effects of gifted children’s sex, parental groups (22% vs. 13%, p = .158). The three most common
education, socioeconomic level, temperament, and resilience psychiatric diagnoses in GC and control groups were spe-
scores on the diagnosis of psychopathology. A significance cific phobia, ADHD, and generalized anxiety disorder (see
level of 0.05 was used for all statistical analyses. Table 2). However, GC had higher negative reactivity (t =
−3.786, p < .001) and activity (t = −2.670, p = .008) scores,
while the control group had higher psychological resilience
Results scores (t = 2.097, p = .037; see Table 3).
We recruited 200 students between the ages of 9 and 12, There were no significant differences between sexes in
comprising 100 gifted and 100 control children. The major- terms of psychiatric diagnosis (26% vs. 18%, p = .365),
ity of GC displayed skills in general intellectual ability as resilience (54.3 vs. 52.7, p = .125), or temperament scores
their primary area of talent (75%), followed by visual arts among GC (negative reactivity, p = .125; task persistence,
Aykutlu et al. 231

Table 2. Psychiatric Diagnoses of Control and Gifted Groups.

Psychiatric Disorders Control, n (%) Gifted, n (%) χ2 df p Effect size Power

a
Any Disorder No 69 (69.0%) 57 (57.0%) 3.69 2 .158 0.14 0.40
SPD 18 (18.0%) 21 (21.0%)
Yes 13 (13.0%) 22 (22.0%)
Specific Phobia No 90 (90.0%) 82 (82.0%) 3.17 2 .205a 0.13 0.36
SPD 7 (7.0%) 10 (10.0%)
Yes 3 (3.0%) 8 (8.0%)
Generalized Anxiety Disorder No 97 (98.0%) 95 (95.0%) 1.08 2 .856b 0.07 0.13
SPD 1 (1.0%) 3 (3.0%)
Yes 2 (2.0%) 2 (5.0%)
Obsessive-Compulsive Disorder No 97 (98.0%) 96 (96.0%) 1.35 2 .714b 0.08 0.16
SPD 1 (1.0%) 3 (3.0%)
Yes 2 (2.0 %) 1 (1.0%)
Separation Anxiety Disorder No 96 (96.0%) 97 (98.0%) 0.51 2 1.000b 0.05 0.09
SPD 3 (3.0%) 2 (2.0%)
Yes 1 (1.0%) 1 (1.0%)
Other Specified Anxiety Disorder No 98 (98.0%) 97 (97.0%) 0.66 2 1.000b 0.06 0.10
SPD 1 (1.0%) 2 (2.0%)
Yes 1 (1.0%) 1 (1.0%)
Social Anxiety Disorder No 96 (96.0%) 99 (99.0%) 1.92 2 .369b 0.10 0.22
SPD 3 (3.0%) 1 (1.0%)
Yes 1 (1.0%) 0 (0.0%)
Posttraumatic Stress Disorder No 98 (98.0%) 100 (100.0%) 4.08 2 .121b 0.14 0.41
SPD 1 (1.0%) 0 (0.0%)
Yes 1 (1.0%) 0 (0.0%)
Major Depressive Disorder No 97 (97.0%) 92 (92.0%) 4.04 2 .151b 0.14 0.41
SPD 3 (3.0%) 4 (4.0%)
Yes 0 (0,0%) 4 (4.0%)
Attention-Deficit/ Hyperactivity No 91 (91.0%) 92 (92.0%) 4.56 2 .126b 0.15 0.46
Disorder SPD 7 (7.0%) 2 (2.0%)
Yes 2 (2,0%) 6 (6.0%)
Oppositional Defiant Disorder No 95 (95.0%) 97 (97.0%) 1.73 2 .604b 0.09 0.19
SPD 3 (3.0%) 3 (3.0%)
Yes 2 (2,0%) 0 (0.0%)
Tic disorders No 94 (94.0%) 84 (84.0%) 5.77 2 .058b 0.17 0.57
SPD 6 (6.0%) 12 (12.0%)
Tourette’s Disorder Yes 0 (0.0%) 2 (2.0%)
Other Specified Yes 0 (0.0%) 2 (2.0%)
Tic Disorder
Eating disorder No 96 (96.0%) 92 (92.0%) 2.37 2 .432b 0.11 0.26
SPD 4 (4.0%) 6 (6.0%)
Binge-Eating Disorder Yes 0 (0.0%) 1 (1.0%)
Unspecified Eating Disorder Yes 0 (0.0%) 1 (1,0%)
Autism No 99 (99.0%) 100 (100.0%) 1 1.000b
SPD 1 (1.0%) 0 (0.0%)

Note. SPD: Subthreshold Psychiatric Disorder,

a
Pearson chi-square,
b
Fisher exact test for rxc contingency tables used for statistical analysis.

p = .412; approach/withdrawal, p = .083; activity, p = parents, psychological resilience, negative reactivity, task
.114; see Table 4). persistence, approach/withdrawal, and activity scores as pre-
To identify the factors that predict psychiatric diagnosis in dictors. Using the Forward Likelihood Ratio method, we
GC, we conducted a regression analysis that included age, found a significant positive correlation between negative
sex, family income, age and education level of reactivity score and psychiatric diagnosis. The analysis
232 Gifted Child Quarterly 68(3)

Table 3. Resilience and Temperament Scores of Control and Gifted Groups.

Variable Control (n=100) Gifted (n=100) t p Effect size Power

Resilience 54.9 ± 4.5 53.5 ± 5.2 2.097 .037 0.288 0.96
Negative Reactivity 29.4 ± 9.4 34.8 ± 10.5 −3.786 <.001 0.542 1.00
Task Persistence 42.1 ± 8.8 40.1 ± 9.9 1.519 .130 0.213 0.77
Approach/Withdrawal 22.7 ± 6.9 23.4 ± 7.6 −0.640 .523 0.096 0.21
Activity 14 ± 4.7 16 ± 5.5 −2.670 .008 0.390 0.99

Note. Mean ± Standard deviation,

Student’s t-test used for statistical analysis.

Table 4. Sex Differences in Psychiatric Disorders, Resilience, and Temperament Among Gifted Children.

Variable Girl (n=50) Boy (n=50) t p Effect size Power

Resilience 54.3 ± 4.9 52.7 ± 5.4 1.546 .125a 0.310 0.80
Negative Reactivity 35.3 ± 10.3 34.2 ± 10.8 0.530 .597a 0.104 0.14
Task Persistence 40.9 ± 9.3 39.3 ± 10.6 0.824 .412a 0.160 0.28
Approach/Withdrawal 24.8 ± 7.9 22.8 ± 7.1 1.751 .083a 0.266 0.66
Activity 15.1 ± 5 16.8 ± 5.9 -1.597 .114a 0.311 0.80
Psychiatric disorder No 32 (64%) 25 (50%) χ2 df .365b 0.10 0.13
SPD 9 (18%) 12 (24%) 2.015 2
Yes 9 (18%) 13 (26%)
a
Student’s t-test,
b
Pearson chi-square was used for statistical analysis.

Table 5. Logistic Regression Analysis to Identify Predictive Factors of Psychopathology in Gifted Children.

95% C.I. for EXP(B)

Variable B S.E. Wald df Sig. Exp(B) Lower Upper

Negative Reactivity 0.081 0.028 8.596 1 0.003 1.085 1.027 1.145
Constant -4.276 1.111 14.806 1 <0.001 0.014

indicates that the logistic regression model is statistically negative reactivity emerged as a predictor of psychiatric dis-
significant, with χ2(1) = 10.24 and p = .010. The model orders among GC.
accounts for 15% of the variance in the diagnosis, as mea- Previous research has reported contradictory findings on
sured by Nagelkerke R2 (see Table 5). the psychopathology of GC compared with their peers.
Several systematic reviews have concluded that intellectu-
ally GC have similar or less psychopathology than their
Discussion
peers (Francis et al., 2016; Martin et al., 2009; Tourreix
Investigating psychopathology in GC, a topic that has been et al., 2023). However, Tasca et al. (2022) posit that the evi-
extensively discussed in the literature for many years, is cru- dence is insufficient to draw definitive conclusions. As all of
cial to determining whether giftedness is a protective or risk these reviews included studies that used scales to compare
factor. This knowledge, in turn, informs the development of psychopathology, they could not assess rates of psychiatric
educational and mental health interventions for this unique disorders, which is an important method of evaluating
population and deepens our understanding of the complex psychopathology.
interplay between giftedness and psychological well-being. Only two studies in the literature have compared psychi-
Our study revealed several noteworthy findings. While atric disorders between GC and their peers, focusing solely
we found no significant difference in the prevalence of psy- on anxiety disorders, but with significant methodological
chiatric disorders between GC and their non-gifted peers, our limitations (Kermarrec et al., 2020; Lacour & Zdanowicz,
analysis revealed that the gifted group had lower psychologi- 2019). Kermarrec et al. (2020) found that children with an IQ
cal resilience and higher negative reactivity and activity above 130 exhibited a greater prevalence of anxiety disor-
scores compared with their peers. Notably, increased ders, including generalized anxiety disorder, specific phobia,
Aykutlu et al. 233

and separation anxiety disorder, than those with an IQ below they exhibited similar levels of psychological distress and
130. However, their sample was gathered from clinical refer- subjective well-being as their peers. Valadez et al. (2020)
rals to a specialized child psychiatry unit. Seventy-eight per- examined the impacts of pandemic-related lockdowns on
cent of their high IQ group had school problems, which gifted youth and their non-gifted peers and found that emo-
included school failure and other psychiatric disorders. Thus, tional reactions and problems, both negative and positive,
the high frequency of psychopathology in their high IQ were comparable across both groups. In conclusion, the lit-
group may have led to biased comparisons with the control erature reveals conflicting outcomes regarding the socio-
group. Conversely, Lacour and Zdanowicz (2019) found that emotional problems of GC.
children with an IQ above 130 and below 130 have similar Gifted individuals may show higher than average respon-
rates of phobias. However, they only evaluated 35 teenagers siveness to stimuli, manifested by various types of excitabil-
(15 high IQ vs. 20 controls) in their study. ity, such as psychomotor, sensual, emotional, imaginative, or
Our study stands as a significant contribution to this field, intellectual (Reis & Renzulli, 2004). These excitabilities
being the first to compare a wide range of psychiatric disor- may lead to typical ADHD-like features, such as high levels
ders in GC with their peers. We did not find a significant of activity, low impulse control, frustration and boredom,
difference in the prevalence of psychiatric disorders between and poor attentional span (Budding & Chidekel, 2012). Our
gifted and non-gifted children. While our findings align with study found that high negative emotional reactivity signifi-
some prior research indicating that gifted children have com- cantly increases the likelihood of psychiatric diagnosis
parable rates of psychopathology to their peers (Kanlı, 2013; among GC. Based on our prior results regarding lower resil-
Morawska & Sanders, 2008), we must acknowledge that our ience and higher activity scores in GC, we argue that GC
study may lack the statistical power for broad generaliza- may be more vulnerable to stress and may experience diffi-
tions. Thus, further research with a larger sample size is culty in managing challenging situations. Therefore, early
essential to gain a more nuanced understanding of the rela- identification and counseling for GC with mental health con-
tionship between giftedness and psychiatric disorders in cerns could impede the onset of psychiatric disorders. Huang
children. et al. (2020) supported our hypothesis by showing that indi-
We also aimed to compare the psychological traits of GC vidual mindfulness and life skills training increased resil-
with their peers. We found that GC exhibit lower psychologi- ience and decreased emotional-behavioral problems in gifted
cal resilience, higher negative reactivity, and higher activity adolescents. However, further intervention studies are neces-
scores compared with their non-gifted peers. Researchers sary to clarify this hypothesis and to explore the potential
suggest that high-IQ individuals, similar to those with low mechanisms underlying the association between emotional
IQ, tend to have high activity levels, low impulse control, reactivity and psychiatric disorders in GC.
irritability, boredom, and poor attention skills (Lee & We found no significant differences in sex in terms of
Olenchak, 2015). These characteristics may impair their cog- psychiatric diagnosis and psychological characteristics
nitive processing speed and emotional regulation abilities among GC. This was consistent with our regression analysis,
(Tolan, 2017), as evidenced by recent studies. For instance, which revealed that sex did not play a significant role in pre-
Eren et al. (2018) reported that GC without psychiatric disor- dicting psychiatric diagnosis in GC. However, the literature
ders had more complaints of attention and hyperactivity presents mixed findings regarding the effect of sex on mental
symptoms than controls, according to the Strengths and health problems in GC. For example, Eren et al. (2018),
Difficulties Questionnaire. Casino-García et al. (2019) found that gifted boys have more depressive symptoms than
observed that GC experienced reduced subjective well-being girls, while Ogurlu et al. (2018), found that females had
and positive affect, along with elevated negative mood. higher depressive symptom scores, but there was no differ-
Lacour and Zdanowicz (2019) found that GC showed higher ence in other symptom domains. Other studies have reported
levels of irritability, negative affect, distractibility, and sepa- conflicting findings, with some suggesting that gifted girls
ration anxiety than their non-gifted peers. have more emotional problems than boys (Freeman, 1983;
However, several studies have also reported similar or Huang et al., 2020), while others report no significant differ-
fewer emotional and behavioral problems in GC compared ences (Cross et al., 2008; Richards et al., 2003). Overall, the
with their peers (Eklund et al., 2015; Fouladchang et al., literature suggests that there is no clear consensus on the
2010; França-Freitas et al., 2014; Rommelse et al., 2017; effect of sex on mental health problems in GC.
Valadez et al., 2020; Zeidner & Shani-Zinovich, 2011). For We found that families of GC had higher income and edu-
instance, Rommelse et al. (2017) found that high IQ scores cation levels compared with the control group. Our study
correlated with lower levels of hyperactivity-impulsivity findings are consistent with previous research that has
and behavioral problems, as reported by teachers. Zeidner reported higher socioeconomic status and educational levels
and Shani-Zinovich (2011) compared gifted high school stu- of families with GC compared with control groups (Cook
dents with their peers and found that gifted adolescents had et al., 2020; Rommelse et al., 2017). In addition, studies have
high scores in openness to innovation and low scores in neu- found that the education level of GC’s mothers tends to be
roticism as well as lower levels of state anxiety. Moreover, higher (Cook et al., 2020). Given that high family income
234 Gifted Child Quarterly 68(3)

and education levels are associated with a lower risk of men- skewed toward intellectual talent, complicating the process
tal health problems (Bot et al., 2011), it is crucial to pay close of making direct comparisons across diverse talent domains,
clinical attention to GC who are experiencing psychological as observed in our study. We suggest that future research
problems. should explore specific subdomains of giftedness to yield a
more detailed and nuanced understanding.
Despite these limitations, our study has several strengths
Study’s Strengths and Limitations
that should be highlighted. First, we used a valid and reli-
Our study has notable limitations that require careful consid- able diagnostic evaluation tool (DAWBA) to assess psy-
eration when interpreting the findings. First, the methodol- chiatric disorders in participants. Second, we included
ogy we employed for sample selection plays a pivotal role in broad talents in the determination of giftedness, which is
the generalizability of our results. We chose to use a conve- important given studies reporting more mental problems in
nience sampling approach, which, regrettably, constrained individuals with high creativity, an area of giftedness
our capacity to draw comprehensive conclusions. This (Chan, 2002; Kroesbergen et al., 2015). In addition, our
approach may have inadvertently led to a participation bias, study was conducted in a post-pandemic period, which
with families and children who had preexisting mental health enabled us to evaluate and compare the mental health of
concerns being more inclined to take part in the study. This children after a serious mental stressor, which adds value
potential bias could have influenced the generalizability of to our findings.
our findings. Furthermore, it is important to acknowledge the
possibility of undiagnosed cases of giftedness within our Study’s Contributions and Implications
control group, which may have influenced our comparative
analysis. Employing a stratified sampling approach for both Our study provides valuable insights into the intricate rela-
the study and control groups could have produced a more tionship between giftedness and psychopathology in chil-
balanced and representative sample, thereby enhancing the dren. In addition, it can serve as a guide for stakeholders
external validity of our findings. looking to support the mental health and overall well-being
Second, our study encountered limitations stemming from a of gifted individuals. Educators may find the study particu-
small sample size that was unexpectedly small due to low par- larly helpful in identifying signs of psychological problems
ticipation rates, particularly regarding the DAWBA assess- in gifted students and providing them with appropriate coun-
ment. This limitation was significantly influenced by the seling support. The study can assist clinicians in identifying
time-intensive process involved in conducting extensive psy- and diagnosing psychiatric disorders in GC and customizing
chiatric evaluations. Completing the parent module of the treatments to suit their specific requirements and strengths.
DAWBA for children at risk of psychiatric disorders can take Policymakers can benefit from this study by allocating
up to 1.5 hr, potentially deterring parental compliance. Our post resources and developing policies that meet GC’s mental
hoc power analysis revealed a large variation in values, from a health needs and guarantee access to quality education and
low of 0.21 for approach/withdrawal to a high of 1 for negative health care.
reactivity. Therefore, we recommend interpreting our findings
with caution and replicating them in future studies with larger Conclusion
samples. Nevertheless, collecting a large enough sample for in-
depth psychiatric diagnosis could be difficult and costly. Our study provides a comprehensive analysis of the psychiat-
Third, our study is limited by the accuracy of psychiatric ric disorders and characteristics of GC, utilizing a population-
diagnoses obtained only from the DAWBA parent module. based sample and a thorough assessment of psychiatric
Different sources of assessment, such as teachers’ and chil- symptoms. Despite the study’s limitations in statistical power,
dren’s report, could affect the diagnosis outcomes. For our findings suggest no significant disparities in psychiatric
instance, Kermarrec et al. (2020) reported that anxiety scores disorders between GC and non-gifted individuals. GC, how-
were similar between the high IQ and control groups when ever, exhibited reduced psychological resilience, heightened
they used reports from parents and children, but psychiatric negative reactivity, and elevated activity levels. Moreover, our
evaluations revealed higher rates of anxiety disorders in the study revealed a link between negative reactivity and increased
high IQ group. However, our plan to collect DAWBA reports susceptibility to psychiatric disorders in GC. These findings
from teachers and students was prevented by low parental necessitate further research to delve into the psychiatric disor-
participation. Future studies should use multiple sources of ders, potential risk and protective factors influencing psycho-
information to obtain a more comprehensive and accurate logical well-being in GC, and to develop tailored interventions
picture of the mental health of GC. addressing their unique emotional and behavioral needs.
Finally, we recognize that GC are frequently identified
based on their intellectual abilities, rather than talents in spe- Declaration of Conflicting Interests
cific areas such as art, creativity, or leadership. This often The author(s) declared no potential conflicts of interest with respect
leads to the formation of gifted samples that are heavily to the research, authorship, and/or publication of this article.
Aykutlu et al. 235

Funding among elementary school students in gifted programs. Journal

for the Education of the Gifted, 18(1), 4–19. https://doi.
The author(s) received no financial support for the research, author-
org/10.1177/016235329401800102
ship, and/or publication of this article.
Cross, T. L., Cassady, J. C., Dixon, F. A., & Adams, C. M. (2008).
The psychology of gifted adolescents as measured by the
Open Science Disclosure Statement MMPI-A. Gifted Child Quarterly, 52(4), 326–339. https://doi.
The data analyzed in this study are not available for purposes of org/10.1177/0016986208321810
reproducing the results. The code or protocol used to generate the Dursun, O. B., Güvenir, T., Aras, Ş., Ergin, Ç., Mutlu, C., Baydur,
findings reported in the article are not available for purposes of H., Özbek, A., Ozek, H., Alşen, S., Iscanli, L., Karaman, B.
reproducing the results or replicating the study. The newly created, İ., & Goodman, R. (2012). A new diagnostic approach for
unique materials used to conduct the research are not available for Turkish speaking populations DAWBA Turkish Version.
the purposes of reproducing the results or replicating the Epidemiology and Psychiatric Sciences, 22(3), 275–282.
procedure. https://doi.org/10.1017/s2045796012000479
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ORCID iDs emotional and behavioral risk among gifted and nongifted chil-
dren: A multi-gate, multi-informant approach. School Psychology
Hasan Cem Aykutlu https://orcid.org/0000-0002-4809-4857
Quarterly, 30(2), 197–211. https://doi.org/10.1037/spq0000080
Fatih Dereli https://orcid.org/0000-0002-4102-1997 Eremsoy, C. E. (2007). How do parental, familial, and child char-
Bahadır Turan https://orcid.org/0000-0003-1190-9589 acteristics differentiate conduct-disordered children with and
without psychopathic tendencies? [Master’s thesis]. Middle
Tuğba Türk Kurtça https://orcid.org/0000-0002-4361-3769
East Technical University.
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Aykutlu et al. 237

Valadez, M. L. D., López-Aymes, G., Ruvalcaba, N. A., Flores, Education.” His research interests include gifted and talented chil-
F., Ortíz, G., Rodríguez, C., & Borges, A. (2020). Emotions dren of early ages and creativity.
and reactions to the confinement by COVID-19 of children
Bahadır Turan, MD, is an associate professor of child and adoles-
and adolescents with high abilities and community samples:
cent psychiatry at Karadeniz Technical University in Turkey. He
A mixed methods research study. Frontiers in Psychology, 11,
specializes in parenting programs, neurodevelopmental disorders,
Article 585587. https://doi.org/10.3389/fpsyg.2020.585587
and dialectical behavior therapy for children and adolescents.
Vialle, W., Heaven, P. C. L., & Ciarrochi, J. (2007). On being
Currently, he is pursuing his PhD in interdisciplinary artificial intel-
gifted, but sad and misunderstood: Social, emotional, and aca-
ligence at Ankara University.
demic outcomes of gifted students in the Wollongong Youth
Study. Educational Research and Evaluation, 13(6), 569–586. Onur Burak Dursun, MD, is the Director of the Autism, Mental
https://doi.org/10.1080/13803610701786046 Special Needs, and Rare Diseases Department at the Ministry of
Zeidner, M., & Shani-Zinovich, I. (2011). Do academically gifted Health of the Republic of Turkey, as well as the Head of the
and nongifted students differ on the Big-Five and adap- Department of Child and Adolescent Psychiatry at the University of
tive status? Some recent data and conclusions. Personality Health Sciences. He attained the position of associate professor at
and Individual Differences, 51(5), 566–570. https://doi. Atatürk University and later became a professor at the University of
org/10.1016/j.paid.2011.05.007 Health Sciences. In addition, he has served as a scientific advisor at
the Commission on Down Syndrome, Autism, ADHD, and Other
Author Biographies Learning Difficulties at the Grand National Assembly of Turkey.
His areas of expertise include medical education and autism spec-
Hasan Cem Aykutlu, MD, is an assistant professor of child and
trum disorder.
adolescent psychiatry at Trakya University Faculty of Medicine in
Edirne, Türkiye. He is also a founding member of the Gifted Tugba Turk Kurtca is an academic and researcher in the field of
Research Department at the same university. His areas of interest psychology and education. She is a member of various committees
include neurodevelopmental disorders, group psychotherapies, and and working groups at her university, where she also serves as an
gifted children. academic advisor. She has published many articles in national and
international journals, covering topics such as trauma, resilience,
Fatih Dereli is an assistant professor in the Department of Early
bullying, procrastination, and well-being. She has also contributed
Childhood Education at the Trakya University, Türkiye. He is also
to a book chapter on family psychopathology. She is interested in
director of the Center for Research and Practice on Gifted and
cross-cultural studies and qualitative and quantitative methods.
Talented Education. He received his PhD from Hacettepe University
in 2019 with his doctoral thesis titled “Effectiveness of the Training Manuscript received: July 17, 2023; Final revision received:
Program for Nomination of Gifted Children in Early Childhood December 8, 2023; Accepted: December 18, 2023.