The SENG website (Supporting Emotional Needs of the Gifted, www.sengifted.org) has an article which may be of interest. Underachievement in Exceptionally Gifted Adolescents and Young Adults: A Psychiatrist’s View - See the archived article at: https://web.archive.org/web/20160420110520/http://www.sengifted.org/archives/articles/underachievement-in-exceptionally-gifted-adolescents-and-young-adults-a-psychiatrist%E2%80%99s-view

Some interesting points which jumped out at me in a quick skim of the article included: deliberate self harm (DSH) as related to maladaptive conflict resolution... a feeling of guilt for the unfair advantage of giftedness... mastering created obstacles as more gratifying than effortless success.

If I understood correctly, subjects are said to be in denial or only vaguely aware. Clearly there is suffering. Possibly healing the underlying feelings dissipates DSH...? That is to say, from reading this I did not get the impression that addressing the DSH directly was largely successful? Perhaps the DSH is a symptom of the underlying cause?