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Troisi A. An evolutionary analysis of the applicability and utility of the clinico-pathological method in psychiatry. Neurosci Biobehav Rev 2024; 159:105599. [PMID: 38387837 DOI: 10.1016/j.neubiorev.2024.105599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
Unlike other medical specialties, psychiatry has not been involved in the theoretical shift that replaced the syndromal approach with the clinico-pathological method, which consists in explaining clinical manifestations by reference to morbid anatomical and physiological changes. Past and present discussions on the applicability of the clinico-pathological method in psychiatry are based on a pre-Darwinian concept of biology as the study of proximate causation. Distinguishing between mediating mechanisms and evolved functions, an evolutionary perspective offers an original contribution to the debate by overcoming the opposite views of dualism (i.e., the clinico-pathological method is not applicable to disorders of the mind) and neuroessentialism (i.e., the definitive way of explaining psychiatric disorders is by reference to the brain and its activity). An evolutionary perspective offers original insights on the utility of the clinico-pathological method to solve critical questions of psychiatric research and clinical practice, including the distinction between mental health and illness, a better understanding of the etiology and pathophysiology, the classification and differential diagnosis of psychiatric disorders, and the development of more efficacious psychiatric treatments.
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Affiliation(s)
- Alfonso Troisi
- Department of Systems Medicine, University of Rome Tor Vergata, Viale Montpellier 1, Rome 00133, Italy.
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Verona E, McKinley SJ, Hoffmann A, Murphy BA, Watts AL. Psychopathy facets, perceived power, and forms of aggression. Personal Disord 2023; 14:259-273. [PMID: 35357882 PMCID: PMC10053744 DOI: 10.1037/per0000562] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite research indicating that exerting dominance and control is characteristic of psychopathy, no research has examined the role that feelings of and desire for power plays in psychopathy-related aggression. Borrowing from various literatures and novel conceptualizations, we investigated the contributions of feeling powerful and/or desiring power and distinct psychopathy facets in explaining aggression manifested in different forms (i.e., physical, verbal, indirect) across 4 samples. Results from regression analyses within each sample and a meta-analysis across the samples indicated that the impulsive facet of psychopathy was generally related to multiple forms of aggression, and the unique variance in the affective facet was primarily related to physical aggression across samples. In contrast, the unique variance of the interpersonal facet showed a primary relationship with indirect aggression (e.g., relational, passive). Desiring power made unique contributions in relation to multiple forms of aggression, whereas feeling powerful was generally unrelated and/or negatively related to aggression. In sum, the unique variance in the psychopathy facets showed fairly specialized relationships with forms of aggression, and desire for power may be an independent explanatory construct for multiple forms of aggression proneness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Edelyn Verona
- Department of Psychology, University of South Florida
- Center for Justice Research & Policy, University of South Florida
| | | | - Amy Hoffmann
- Department of Behavioral Health, VA Pittsburgh Health Care System
| | - Brett A. Murphy
- Department of Psychology, University of North Carolina - Chapel Hill
| | - Ashley L. Watts
- Department of Psychological Sciences, University of Missouri
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Mullen JN, Liu P, McDonnell CG, Stanton K, Kotelnikova Y, Johnson SL, Hayden EP. Assessing the dominance behavioral system in early childhood using observational methods. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2023; 11:216-227. [PMID: 38014381 PMCID: PMC10654335 DOI: 10.5114/cipp/156767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/04/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The dominance behavioral system (DBS) is a biologically based system that underpins individual differences in motivation for dominance and power. However, little is known about the DBS in childhood. In order to make strong claims about the DBS's trait-like properties and predictive validity, a clearer understanding of its early development is required. PARTICIPANTS AND PROCEDURE In a pilot study aimed at developing a behavioral coding system for dominance, a key facet of the DBS, we collected and coded observational data from 58 children, assessed at ages 3 and 5-6. These data were examined in conjunction with measures of child temperament via observational measures, and symptoms of psychopathology. RESULTS Dominance was moderately stable in early childhood to a degree comparable to other early child temperament traits. Consistent with the study hypotheses, boys were more dominant than girls, and dominance was negatively associated with children's behavioral inhibition, effortful control, and internalizing symptoms. CONCLUSIONS These results provide initial support for the validity and developmental sensitivity of an objective coding system for assessing facets of the DBS in early childhood. Ultimately, the use of this coding system will facilitate future studies of how early DBS predicts psychological adjustment later in life.
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Affiliation(s)
| | - Pan Liu
- Western University, London, Ontario, Canada
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Murphy BA, Casto KV, Watts AL, Costello TH, Jolink TA, Verona E, Algoe SB. “Feeling Powerful” versus “Desiring Power”: A pervasive and problematic conflation in personality assessment? JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Gilbert P, Basran JK, Raven J, Gilbert H, Petrocchi N, Cheli S, Rayner A, Hayes A, Lucre K, Minou P, Giles D, Byrne F, Newton E, McEwan K. Compassion Focused Group Therapy for People With a Diagnosis of Bipolar Affective Disorder: A Feasibility Study. Front Psychol 2022; 13:841932. [PMID: 35936292 PMCID: PMC9347420 DOI: 10.3389/fpsyg.2022.841932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/01/2022] [Indexed: 11/21/2022] Open
Abstract
Background Compassion focused therapy (CFT) is an evolutionary informed, biopsychosocial approach to mental health problems and therapy. It suggests that evolved motives (e.g., for caring, cooperating, competing) are major sources for the organisation of psychophysiological processes which underpin mental health problems. Hence, evolved motives can be targets for psychotherapy. People with certain types of depression are psychophysiologically orientated towards social competition and concerned with social status and social rank. These can give rise to down rank-focused forms of social comparison, sense of inferiority, worthlessness, lowered confidence, submissive behaviour, shame proneness and self-criticism. People with bipolar disorders also experience elevated aspects of competitiveness and up rank status evaluation. These shift processing to a sense of superiority, elevated confidence, energised behaviour, positive affect and social dominance. This is the first study to explore the feasibility of a 12 module CFT group, tailored to helping people with a diagnosis of bipolar disorder understand the impact of evolved competitive, status-regulating motivation on their mental states and the value of cultivating caring and compassion motives and their psychophysiological regulators. Methods Six participants with a history of bipolar disorder took part in a CFT group consisting of 12 modules (over 25 sessions) as co-collaborators to explore their personal experiences of CFT and potential processes of change. Assessment of change was measured via self-report, heart rate variability (HRV) and focus groups over three time points. Results Although changes in self-report scales between participants and across time were uneven, four of the six participants consistently showed improvements across the majority of self-report measures. Heart rate variability measures revealed significant improvement over the course of the therapy. Qualitative data from three focus groups revealed participants found CFT gave them helpful insight into: how evolution has given rise to a number of difficult problems for emotion regulation (called tricky brain) which is not one's fault; an evolutionary understanding of the nature of bipolar disorders; development of a compassionate mind and practices of compassion focused visualisations, styles of thinking and behaviours; addressing issues of self-criticism; and building a sense of a compassionate identity as a means of coping with life difficulties. These impacted their emotional regulation and social relationships. Conclusion Although small, the study provides evidence of feasibility, acceptability and engagement with CFT. Focus group analysis revealed that participants were able to switch from competitive focused to compassion focused processing with consequent improvements in mental states and social behaviour. Participants indicated a journey over time from 'intellectually' understanding the process of building a compassionate mind to experiencing a more embodied sense of compassion that had significant impacts on their orientation to (and working with) the psychophysiological processes of bipolar disorder.
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Affiliation(s)
- Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Jaskaran K. Basran
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Joanne Raven
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Hannah Gilbert
- The Compassionate Mind Foundation, Derby, United Kingdom
- Department of Psychology, University of Roehampton, London, United Kingdom
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy
- Compassionate Mind ITALIA, Rome, Italy
| | - Simone Cheli
- School of Human Health Sciences, University of Florence, Florence, Italy
| | - Andrew Rayner
- The Compassionate Mind Foundation, Derby, United Kingdom
| | - Alison Hayes
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Kate Lucre
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Paschalina Minou
- Department of Philosophy, University College London, London, United Kingdom
- College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
| | - David Giles
- Lattice Coaching and Training, Chesterfield, United Kingdom
| | - Frances Byrne
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Elizabeth Newton
- College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
| | - Kirsten McEwan
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
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