Letter to the Editor |
THE AUTHORS REPLY
1 Child Trends, 4301 Connecticut Avenue, NW, Washington, DC 20008
2 Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115
(e-mail: lmartin{at}childtrends.org)
We thank Dr. Voracek for his comments (1
) on our article (2) and agree with his position that suicide among highly intelligent persons is an important and often overlooked issue in research. We recently began a 3-year project designed to address what we, too, have considered a substantial gap in the literature: a lack of strong epidemiologic studies evaluating the mental health of gifted individuals over the life course. Interestingly, while some studies suggest that gifted children are prone to emotional and social difficulties (3), others find that gifted children are at least as well adjusted as their nongifted peers (4). Contributing to these contrasting results are varying definitions of "giftedness" and the use of small clinical or specialized study populations that are not readily generalizable to other gifted children or comparable to the general population (5).
Dr. Voracek's calculations of excess suicide among persons followed in the Terman Life Cycle Study of Children with High Ability (6) support the premise that at least some highly intelligent children do have serious difficulties adjusting to and coping with the issues in their lives. While the suicide mortality rate of 2.2 percent calculated by Dr. Voracek is substantially higher than the 0.5 percent reported for the general US population (1), it is important to note that the vast majority of the study population (97.8 percent) did not commit suicide. Therefore, to address the potentially higher rate of suicide among some gifted individuals, it is critical to identify factors that differentiate those who attempt suicide from those who do not. For example, there is great concern about gifted students with learning disabilities, often referred to as "twice exceptional" (7), whose learning needs are often not met through special education programs or programs designed for gifted children. There may also be other social, psychological, or biologic factors that put certain gifted children at particular risk for poor mental health outcomes.
Dr. Voracek argues that suicide may be an exception to the relation between intelligence and lowered mortality (1). Unfortunately, information on cause of death is not available in the public-use data files, so we are not able to test his hypothesis directly. Dr. Voracek's ecologic studies, however, provide some support for the hypothesis that intelligence quotient and suicide are positively related (8). If we take this hypothesis to be true, the inclusion of deaths by suicide in our outcome is, in effect, biasing our estimate of the relation between intelligence and mortality towards the null. This suggests that removing suicide from our outcomes would only strengthen the protective effects of intelligence quotient against mortality that we observed in our study (2). Further exploration of these issues is clearly warranted.
ACKNOWLEDGMENTS
Conflict of interest: none declared.
References
- Voracek M. Re: "Childhood cognitive performance and risk of mortality: a prospective cohort study of gifted individuals." (Letter). Am J Epidemiol 2006;163:1161–2.
[Free Full Text] - Martin LT, Kubzansky LD. Childhood cognitive performance and risk of mortality: a prospective cohort study of gifted individuals. Am J Epidemiol 2005;162:887–90.
[Abstract/Free Full Text] - Roedell W. Vulnerabilities of highly gifted children. Roeper Rev 1984;8:1–8.
- Galluci N, Middleton G, Kline A. Intellectually superior children and behavioral problems and competence. Roeper Rev 1999;22:18–21.
- Jackson P, Peterson J. Depressive disorder in highly gifted adolescents. J Secondary Gifted Educ 2003;14:175–86.
- Sears R. The Terman Gifted Children Study. In: Mednick S, Harway M, Finello K, eds. Handbook of longitudinal research. New York, NY: Preager Scientific, 1984:398–414.
- Nielson M. Gifted students with learning disabilities: recommendations for identification and programming. Exceptionality 2002;10:93–111.[CrossRef]
- Voracek M. National intelligence and suicide rate: an ecological study of 85 countries. Pers Individ Dif 2004;37:543–53.[CrossRef]
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