the challenges of a darwinian approach to psychological disorders

7/28/2019 The Challenges of a Darwinian Approach to Psychological Disorders

1/4

Evolutionary Psychology

www.epjournal.net 2012. 10(4): 727-730

Book Review

The Challenges of a Darwinian Approach to Psychological Disorders

A review of Peter R. Adriaens and Andreas De Block (Eds.), Maladapting Minds:Philosophy, Psychiatry, and Evolutionary Theory . Oxford University Press: New York,2011, 320 pp., US$69.95, ISBN #978-0-19-955866-7 (paperback).

Martin L. Lalumire, Department of Psychology, University of Lethbridge, Alberta, Canada. Email:[email protected] (Corresponding author).

Samantha J. Dawson, Department of Psychology, University of Lethbridge, Alberta, Canada.

It is worth wondering whether a Darwinian view of the mind and its problems is thenext step in the evolution of our understanding of mental disorders. After all, our views onthe etiology and treatment of psychological disorders have been revolutionized (and mostlyfor the better) many times in the past 150 years. Inefficacious and harmful treatments have

been, for the most part, abandoned for methods based on evidence gathered from carefulstudies, including randomized control studies. Conceptualizations involving humors, evilspirits, and cold mothers have been replaced by theories based on scientific evidenceinvolving genes, personality predispositions, and developmental factors. Notions of mentalillnesses as strictly personal events requiring intense one-on-one therapy have beenreplaced by contextual approaches involving precipitating factors and requiring systemicinterventions. Advances in pharmacological and cognitive-behavioral treatments,quantitative and molecular genetics, and neuroscience have transformed psychopathologyto a point that the grandfathers of abnormal psychologythe Freuds, Kraepelins, and Greyswould barely recognize it.

And yet, so much remains to be done. The genetic contribution to psychologicaldisorders is undeniable but nebulously complex. Efficacious treatments can be difficult toimplement outside of teaching hospitals, for various economic and professional guild reasons. Despite extensive research, some disorders remain highly resistant to treatment.

Neuroscience has difficulty incorporating the important notions of precipitating and contextual factors into its methodology. Adding to this, psychological disorders remainhighly stigmatized and misunderstood. Diagnoses are clouded by vigorous disagreementsabout what constitutes pathology, and diagnostic practices are mostly nothing but arelabeling of presenting problems. But, perhaps more importantly, there is no overarchingtheory of mental disorders.
mailto:[email protected]:[email protected]:[email protected]


2/4

The challenges of a Darwinian approach to psychological disorders

Evolutionary Psychology ISSN 1474-7049 Volume 10(4). 2012. -728-

In our Abnormal Psychology classroom, we typically begin one of the lectures byasking the question If it is true that at least 25% of people experience a serious mentaldisorder at some point in their lives, how can it be that evolution has left us with a mind

prone to such serious problems? This question has led to interesting discussions aboutwhether some of the disorders should be considered disorders in the first place, whether

there is a mismatch between our evolved minds and our current social and bioticenvironments, whether some of the disorders would have negatively affected our fitness inancestral environments, and whether some of the negative fitness effects resulting from adisordered mind have been balanced by positive effects, either in individuals themselves or their relatives. These are some of the questions that are addressed in Maladapting Minds .

The overarching question in Maladapting Minds is whether a Darwinian approachwill lead to the next revolution in our understanding of psychological disorders. And if so,what will the revolution look like? Will it be one in which Darwinian thinking simply

provides a better heuristic to think about the issues, or will it transform the field so that thetypes of questions asked and the solutions provided will be completely different from whatthey are today? The contributors vary in their opinions, some wondering if anything will

change, and others postulating that nothing will ever be the same. Geoffrey Miller, in hiscrafty Foreword, believes that evolutionary considerations have had little impact on psychiatry so far, and we agree. Despite promising beginnings, provided in large part bythe work of Nesse, Williams, and Hagen, little has changed. Perhaps reflecting how slowlythings change in medicine, evolution is now part of the curriculum in basic medicine, butnot in the psychiatry specialization.

This book provides an extremely thoughtful and balanced view on the big question(i.e., will evolution change psychiatry?) and on more applied questions (e.g., is there such athing as prepared fear that is related to certain phobias?). With the exception of perhaps onechapter, this volume was well conceived and a pleasure to read.

Adriaens and De Block, the editors of the book, provide an excellent introduction tothe main issues facing evolutionary approaches to mental illnesses, such as whether mentaldisorders are unique to humans, what are the best evolutionary models to consider (e.g.,adaptation, mismatch, trade-off, etc.), whether mental disorders are unique to (or morefrequent in) contemporary societies, and whether it is possible to arrive at a naturalistdefinition of pathology. They conclude with the suggestion that an interdisciplinaryawareness is necessary in order to pave the way for advances in how we conceptualize,diagnose, and treat psychological disorders.

Part 1 of the book deals with particular evolutionary hypotheses, such as whether there is a fear module that leads to particular phobias and whether imprinting can lead to

paraphilias. Faucher and Blanchette (Chapter 1) argue for flexibility rather than modularitywith regard to human fear mechanisms; they note that novel stimuli (e.g., a pen) can be justas readily detected and processed as evolutionarily relevant stimuli (e.g., a snake), castingdoubt on the current evolutionary models of phobias. Aronsson (Chapter 2) cogently arguesthat imprinting, a well-studied learning phenomenon, has not been considered as a possiblecontributor to paraphilias, such as fetishism, citing interesting studies on how mate choiceis affected by early exposure. Machery (Chapter 3) discusses the notion of dissociations that different brain functions can be studied separately from othersand whether the study


3/4



of developmental disorders can inform the study of normal functioning. Geerts and Brne (Chapter 4) argue, like Tinbergen (1963) did a long time ago (but that part is oftenforgotten), that a careful study of behavior and its proximate causes can inform ultimatequestions. They do so by applying ethological techniques to the study of depression (for example, demonstrating that depressed people often induce rejection in others, countering

some adaptationist hypotheses of depression).Part 2 of the book is about the tricky notion of mental disorders. Wakefield (Chapter 5) starts it off brilliantly with a defense of his notion of disorders as harmfuldysfunctions. Although Wakefields proposal is simple, its ramifications are complex and have resulted in much confusion. We have enjoyed reading Wakefields responses to criticsover the years, if only because of his systematic and thoughtful approach. Evenevolutionary psychologists are not immune to confusion about functions and dysfunctions.A colleague of ours gave a talk at an evolutionary psychology conference a few months agoabout psychopathy. He was presenting a test of a functional hypothesis for psychopathy,and an audience member questioned whether something as abhorrent and damaging as

psychopathy could ever be considered functional. Her point was (we think) that if

something as destructive as psychopathy could ever be considered not to be a disorder, thenthere must be something wrong with Wakefields notion of disorders. One wonders if weall forget, at one point or another, that evolution does not care about our happiness.

Nesse and Jackson (Chapter 6) discuss the making and the remaking of theDiagnostic and Statistical Manual of Mental Disorders, noting that psychiatry does notdistinguish between symptoms and diseases, nor does it even discriminate between

protective responses and diseases. They make a strong argument that diagnosis requires anidentification of causes. They produced our favourite sentence in the book: Living is asequence of episodes in which organisms attempt to reach goals and avoid losses (p. 185).

No poetry here, and certainly not uplifting, but it is hard to come up with a truer sentence of what it is all about.

Nettle (Chapter 7) provides a nice counterpoint to Nesse and Jackson. He wondersif it is in fact too hard to distinguish, in practice, between the normal and the abnormal,

between function and dysfunction. He makes an argument similar to one made many yearsago by Cosmides and Tooby (1999), that subjective distress is really what matters tocliniciansthe notion of treatable conditions. It doesnt matter whether a condition isfunctional or dysfunctional, or whether it falls in the realm of disease or not. What mattersis helping a suffering person. That is a fair point, but we believe a better understanding of dysfunction will serve as a good starting point to help fix what is broken.

Roe and Murphy (Chapter 8) close this section with a somewhat puzzling argument.They state that medicine does not care about evolved function, instead suggesting thatmedicine and psychiatry should be concerned with mechanistic (proximal) function only.They argue that we dont know much about reproductive success associated with manymental disorders, something that is clearly not true (and something that might not berelevant in the first place). They further write, We suggest that homeostasis, not survivalvalue, is what guides physiological answers to questions about causal explanations of

biological systems (p. 227). A thorough reading of Tinbergen (1963) might be beneficialhere.


4/4



Part 3 contains three very good chapters that did not fit nicely in the first two parts.Focquaert and Braeckman (Chapter 9) propose an evolutionary model of autism spectrumdisorder, suggesting that the sex difference in prevalence is the result of differentialselection pressures on empathy. Prices (Chapter 10) contribution is a tribute to GregoryBateson, who wrote about interpersonal relationship processes, in which positions of power

and control are defined. Price uses this approach to make a hypothesis about depression:People with depression are unable to get up, like losers in a fight, giving relationship power to othersa novel and largely untested idea. Burns (Chapter 11) discusses the possibilitythat schizophrenia is a social brain disorder, in the sense that social consciousness is animportant and complex trait, and when that trait does not develop properly, something akinto schizophrenia results. One wonders then if it is possible that every major and complexhuman skill has a disordered equivalent. After all, things that need to be built willsometimes malfunction.

We highly recommend this book for anyone interested in the application of evolutionary thinking to psychological disorders. It is a great read. We also recommend the

book for teaching, especially with students who already have some background in

evolutionary psychology. Can anything make sense in psychiatry and abnormal psychologywithout the light of evolution? These fields have advanced tremendously without it, buttaking the next step might require it.

References

Cosmides, L., and Tooby, J. (1999). Toward of evolutionary taxonomy of treatableconditions. Journal of Abnormal Psychology, 108 , 453-464.

Tinbergen, N. (1963). On aims and methods in ethology. Zeitschrift fr Tierpsychologie,20 , 410-433.

the challenges of a darwinian approach to psychological disorders

Documents