Evolutionary psychopathology: why isn't the mind designed better than it is?

Compassion Focused Group Therapy for People With a Diagnosis of Bipolar Affective Disorder: A Feasibility Study

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.

Population Modelling in Affective Disorders

Purpose of Review

The prevalence of affective disorders is on the rise. This upward trajectory leads to a substantial personal and societal cost. There is growing body of literature demonstrating decision-making impairments associated with affective disorders, and more studies are using computational modelling methods to infer underlying mechanisms of these impairments from participant choice behaviour. However, lack of population modelling suggests that data resources may still be underutilised.

Recent Findings

A number of recent studies associated major depression with abnormal risky decision-making as well as impairments in temporal discounting and social decision-making. These domains capture relevant aspects of real-life decision-making. Consequently, data from these studies can be used to define behavioural phenotypes for major depression.

Summary

The manuscript describes a detailed proposal for population modelling to capture changes in the prevalence rate of major depression. The population modelling approach can also identify which decision-making domains can account for a larger part of impairments in psychosocial functioning and how behavioural interventions built on computational principles can target these to improve real-life psychosocial functioning in patient groups.

Creating a Compassionate World: Addressing the Conflicts Between Sharing and Caring Versus Controlling and Holding Evolved Strategies

For thousands of years, various spiritual traditions and social activists have appealed to humans to adopt compassionate ways of living to address the suffering of life. Yet, along with our potential for compassion and self-sacrifice, the last few thousand years of wars, slavery, tortures, and holocausts have shown humans can be extraordinarily selfish, callous, vicious, and cruel. While there has been considerable engagement with these issues, particularly in the area of moral psychology and ethics, this paper explores an evolutionary analysis relating to evolved resource-regulation strategies that can be called "care and share" versus "control and hold." Control and hold are typical of primates that operate through intimidatory social hierarchies. Care and share are less common in non-human primates, but evolved radically in humans during our hunter-gatherer stage when our ancestors lived in relatively interdependent, small, mobile groups. In these groups, individualistic, self-focus, and self-promoting control and hold strategies (trying to secure and accumulate more than others) were shunned and shamed. These caring and sharing hunter-gatherer lifestyles also created the social contexts for the evolution of new forms of childcare and complex human competencies for language, reasoning, planning, empathy, and self-awareness. As a result of our new 'intelligence', our ancestors developed agriculture that reduced mobility, increased group size, resource availability and storage, and resource competition. These re-introduced competing for, rather than sharing of, resources and advantaged those who now pursue (often aggressively) control and hold strategies. Many of our most typical forms of oppressive and anti-compassionate behavior are the result of these strategies. Rather than (just) thinking about individuals competing with one another, we can also consider these different resource regulation strategies as competing within populations shaping psychophysiological patterns; both wealth and poverty change the brain. One of the challenges to creating a more compassionate society is to find ways to create the social and economic conditions that regulate control and hold strategies and promote care and share. No easy task.

Psychotherapy for the 21st century: An integrative, evolutionary, contextual, biopsychosocial approach

Fragmentation of processes and interventions plague the psychotherapies (Gilbert & Kirby, ). Part of the problem is that we have not agreed on a framework that could be the basis for integrating knowledge and the scientific enquiry of processes and interventions. This paper outlines an approach that brings together a variety of different disciplines in the service of consilience (Wilson, , Consilience: The unity of knowledge, Vintage, New York, NY; Siegel, ). It presents the importance of an evolutionary framework for understanding the proclivities and dispositions for mental suffering and antisocial behaviour, and how they are choreographed in different sociodevelopmental contexts. Building on earlier models (Gilbert, , Human nature and suffering, Routledge, London, UK; Gilbert, , Clin. Psychol. Psychother., 2, 135; Gilbert, , Br. J. Med. Psychol., 71, 353; Gilbert, , Case formulation in cognitive behaviour therapy: The treatment of challenging cases, Wiley, Chichester, UK, pp. 50-89) the call is for an integrative, evolutionary, contextual, biopsychosocial approach to psychology and psychotherapy. PRACTITIONER POINTS: Evolutionary functional analysis is part of an evolutionary, contextual, biopsychosocial approach to mental health that can serve as a scientific platform for the future developments of psychotherapy. Therapist skills and training will increasing need to focus on the multidimensional textures of mental states especially the context-social-body linkages. Therapies of the future will also focus more on the moral aspects of therapy and address the need to promote prosocial and ethical behaviour to self and others.

Psychosocial roots of paranoid ideation: The role of childhood experiences, social comparison, submission, and shame

BACKGROUND

Social experiences have a significant impact on cognitive functioning and appraisals of social interactions. Specifically, recalls of antipathy from parents, submissiveness, and bullying during childhood can have a significant influence on paranoid ideation later in life.

METHOD

Multiple hierarchical regression analysis was performed on a sample of 91 patients diagnosed with paranoid schizophrenia in remission and active phase, their first-degree relatives (n = 32) and unaffected controls (n = 64).

OBJECTIVES

Exploring the impact of distal (events from childhood) and proximal factors (current cognitive, emotional, and behavioural aspects of social functioning) in the frequency, degree of conviction, and distress resulting from paranoid ideation in the participants from 4 samples.

RESULTS

Proximal and distal factors (shame, submissive behaviour, negative social comparison, antipathy from father) predicted several aspects of paranoid ideation. Those variables had a differential impact in affected patients and healthy controls.

DISCUSSION

Finding suggests different variables being involved in paranoid ideation, and the specificities of patients with paranoid schizophrenia should be considered in the development of more effective psychotherapeutic interventions.

Influence of Family and Childhood Memories in the Development and Manifestation of Paranoid Ideation

Several studies point out to the influence of social experiences on perceptions of the environment and others in cognitive functioning and different aspects of psychopathology. The current study aimed at studying the influence of the psychosocial risk factors in a mixed sample of participants from the general population and affected by paranoid schizophrenia. The extent to which the existence of negative life events and events that are threatening to the inner models of the self (i.e., history of maltreatment, physical, social or psychological abuse) or the memories of these traumatic events occurring during childhood are related to the existence of paranoid beliefs in adulthood was explored. Results suggested that memories of parental behaviours characterized by antipathy from both parental figures, submissiveness and bullying victimization were important predictors of paranoid ideation in adult life. This further emphasizes the need for understanding the family and social dynamics of people presenting paranoid ideations to the development of therapeutic interventions that can effectively reduce the invalidation caused by severe psychopathology, as is the case of schizophrenia. Copyright © 2015 John Wiley & Sons, Ltd.

KEY PRACTITIONER MESSAGE

Memories of family dynamics characterized by behaviours of antipathy from both parental figures, submissiveness and bullying victimization are important predictors of paranoid ideation in adult life. The study highlights the importance of exploring subjective recalls of feelings and behaviours associated with early rearing experiences, peer relationships and themes related to social rank theory in the roots of internal models of relationship with the self and others in the general sample, patients diagnosed with schizophrenia and their first-degree relatives. Our findings indicate that schizophrenic patients in active phase differ regarding memories of threat and submission and are more likely to remember childhood experiences perceived as threatening during an active phase than when in remission. It is possible that by changing these internal models and social interaction styles, patients may be able to get involved in more cooperating and affiliative interactions, disconfirming these early beliefs about others being rejecting, critical or hostile towards the self, and more effectively reducing the invalidation caused by positive and negative symptomatology of schizophrenia on social functioning.

Atacar será a melhor defesa? A influência das experiências precoces e da paranoia na agressividade dos jovens açorianos || Is the offence the best defense? Influences of childhood experiences and paranoia in the aggression in Azorean youths

A ideação paranoide é um processo cognitivo e social que pode ser considerado normativo (e.g. sentimentos de desconfiança ocasionais) ou disfuncional, constituindo-se, neste ultimo caso, como um sintoma psicopatológico (e.g. delírios paranoides). Mesmo em níveis subclínicos, a ideação paranoide pode constituir um entrave para o bom funcionamento interpessoal, na medida em que o comportamento disruptivo que dela advém pode afetar todas as esferas de funcionamento do indivíduo (e.g. relações familiares, entre pares, profissionais e/ou académicas). O presente estudo explorará a influência dos estilos parentais e o papel mediador da ideação paranoide na agressividade durante a adolescência, bem como as implicações para a prevenção e intervenção em contextos clínicos e educacionais.

An Evolutionary Approach to Emotion in Mental Health With a Focus on Affiliative Emotions

Emotions evolved to guide animals in pursuing specific motives and goals (e.g., to find food, avoid harm, seek out sexual partners, rear offspring). They function as short-term alertors and regulators of behaviour and can be grouped into their evolved functions (evolutionary function analysis). Emotions can coregulate/influence each other, where one emotion can activate or suppress another. Importantly, affiliative emotions, that arise from experiencing validation, care and support from others, have major impacts on how people process and respond to threats and emotions associated with threats. Hence, exploring how affiliative emotional experiences change and transform the capacity to cope with threat and pursue life goals, are salient research issues.

Stress and anxiety: counterpart elements of the stress/anxiety complex

The relationship between stress and anxiety is complicated. Stress initially arises from one's environment; anxiety overlays physiological arousal, cognitive appraisals, emotional states, and behavioral responses. Both are components of a stress-anxiety complex, which has evolved to enable individuals to adapt to their environment and achieve equilibrium. Anxiety disorders, which result when this mechanism goes awry, occur along a spectrum. One of the main variables affecting anxiety disorders is the extent of stress. Each anxiety disorder should be evaluated along a stress axis, leading to improved case conceptualization and intervention strategies.

Beliefs about God and mental health among American adults

This study examines the association between beliefs about God and psychiatric symptoms in the context of Evolutionary Threat Assessment System Theory, using data from the 2010 Baylor Religion Survey of US Adults (N = 1,426). Three beliefs about God were tested separately in ordinary least squares regression models to predict five classes of psychiatric symptoms: general anxiety, social anxiety, paranoia, obsession, and compulsion. Belief in a punitive God was positively associated with four psychiatric symptoms, while belief in a benevolent God was negatively associated with four psychiatric symptoms, controlling for demographic characteristics, religiousness, and strength of belief in God. Belief in a deistic God and one's overall belief in God were not significantly related to any psychiatric symptoms.

Emotional, cognitive and behavioral reactions to paranoid symptoms in clinical and nonclinical populations

Background: Paranoia is a disruptive belief that can vary across a continuum, ranging from persecutory delusions presented in clinical settings to paranoid cognitions that are highly prevalent in the general population. The literature suggests that paranoid thoughts derive from the activation of a paranoid schema or information processing biases that can be sensitive to socially ambiguous stimuli and influence the processing of threatening situations. Method: Four groups (Schizophrenic participants in active psychotic phases, n=6; stable participants in remission, n=30; participants' relatives, n=32; and healthy controls, n=64) were assessed with self-report questionnaires to determine how the reactions to paranoia of clinical patients differ from healthy individuals. Cognitive, emotional and behavioral dimensions of their reactions to these paranoid thoughts were examined. Results: Paranoid individuals were present in all groups. Most participants referred the rejection by others as an important trigger of paranoid ideations, while active psychotic were unable to identify triggering situations to their thoughts and reactions. This may be determinant to the different reactions and the different degree of invalidation caused by paranoid thoughts observed across groups. Conclusion: Clinical and non-clinical expressions of paranoid ideations differ in terms of their cognitive, emotional and behavioral components. It is suggested that, in socially ambiguous situations, paranoid participants (presenting lower thresholds of paranoid schema activation) lose the opportunity to disconfirm their paranoid beliefs by resourcing to more maladaptive coping strategies. Consequently, by dwelling on these thoughts, the amount of time spent thinking about their condition and the disability related to the disease increases.

The origins and nature of compassion focused therapy

Compassion focused therapy (CFT) is rooted in an evolutionary, functional analysis of basic social motivational systems (e.g., to live in groups, form hierarchies and ranks, seek out sexual, partners help and share with alliances, and care for kin) and different functional emotional systems (e.g., to respond to threats, seek out resources, and for states of contentment/safeness). In addition, about 2 million years ago, (pre-)humans began to evolve a range of cognitive competencies for reasoning, reflection, anticipating, imagining, mentalizing, and creating a socially contextualized sense of self. These new competencies can cause major difficulties in the organization of (older) motivation and emotional systems. CFT suggests that our evolved brain is therefore potentially problematic because of its basic 'design,' being easily triggered into destructive behaviours and mental health problems (called 'tricky brain'). However, mammals and especially humans have also evolved motives and emotions for affiliative, caring and altruistic behaviour that can organize our brain in such a way as to significantly offset our destructive potentials. CFT therefore highlights the importance of developing people's capacity to (mindfully) access, tolerate, and direct affiliative motives and emotions, for themselves and others, and cultivate inner compassion as a way for organizing our human 'tricky brain' in prosocial and mentally healthy ways.

Belief in life-after-death, beliefs about the world, and psychiatric symptoms

Data from the 2010 Baylor Religion Survey were analyzed by structural equation modeling (SEM) to test five hypotheses: (1) that religious commitment is positively related to belief in life-after-death; that belief in life-after-death is (2) positively related to belief in an equitable world, and (3) negatively related to belief in a cynical world; (4) that belief in a cynical world has a pernicious association with psychiatric symptoms; and (5) that belief in an equitable world has a salubrious association with psychiatric symptoms. As hypothesized, religious commitment was positively related to belief in life-after-death (β = .74). In turn, belief in life-after-death was negatively associated with belief in a cynical world (β = -.16) and positively associated with belief in an equitable world (β = .36), as hypothesized. SEM further confirmed that belief in a cynical world had a significant pernicious association with all five classes of psychiatric symptoms (β's = .11 to .30). Belief in an equitable world had a weaker and less consistent salubrious association with psychiatric symptoms. The results are discussed in the context of ETAS theory.

Anorexia nervosa: Valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice

Anorexia nervosa (AN) is highly valued by people with the disorder. It is also a highly visible disorder, evoking intense emotional responses from others, particularly those closest to the person. A maintenance model of restricting anorexia nervosa, combining intra- and interpersonal factors is proposed. Four main maintaining factors (perfectionism/cognitive rigidity, experiential avoidance, pro-anorectic beliefs, response of close others) are suggested and the evidence supporting these is examined. These factors need to be integrated with what is known about starvation-related maintenance factors. This model departs from other models of AN in that it does not emphasize the role of weight and shape-related factors in the maintenance of AN; that is, it is culture-free. Implications for clinical practice and research are discussed.

Joining the dots: neurobiological links in a functional analysis of depression

Depression is one of the major contributors to the Total Disease Burden and afflicts about one-sixth of Western populations. One of the most effective treatments for depression focuses upon analysis of causal chains in overt behaviour, but does not include brain-related phenomena as steps along these causal pathways. Recent research findings regarding the neurobiological concomitants of depressive behaviour suggest a sequence of structural and functional alterations to the brain which may also produce a beneficial outcome for the depressed individual--that of adaptive withdrawal from uncontrollable aversive stressors. Linking these brain-based explanations to models of observable contingencies for depressive behaviour can provide a comprehensive explanation of how depressive behaviour occurs and why it persists in many patients.

Religion, evolution, and mental health: attachment theory and ETAS theory

This article reviews the historical origins of Attachment Theory and Evolutionary Threat Assessment Systems Theory (ETAS Theory), their evolutionary basis and their application in research on religion and mental health. Attachment Theory has been most commonly applied to religion and mental health in research on God as an attachment figure, which has shown that secure attachment to God is positively associated with psychological well-being. Its broader application to religion and mental health is comprehensively discussed by Kirkpatrick (2005). ETAS Theory explains why certain religious beliefs--including beliefs about God and life-after-death--should have an adverse association, an advantageous association, or no association at all with mental health. Moreover, it makes specific predictions to this effect, which have been confirmed, in part. The authors advocate the application of ETAS Theory in research on religion and mental health because it explains how religious and other beliefs related to the dangerousness of the world can directly affect psychiatric symptoms through their affects on specific brain structures.

Beliefs about God, psychiatric symptoms, and evolutionary psychiatry

The present study analyzed the association between specific beliefs about God and psychiatric symptoms among a representative sample of 1,306 U.S. adults. Three pairs of beliefs about God served as the independent variables: Close and Loving, Approving and Forgiving, and Creating and Judging. The dependent variables were measures of General Anxiety, Depression, Obsessive-Compulsion, Paranoid Ideation, Social Anxiety, and Somatization. As hypothesized, the strength of participants' belief in a Close and Loving God had a significant salutary association with overall psychiatric symptomology, and the strength of this association was significantly stronger than that of the other beliefs, which had little association with the psychiatric symptomology. The authors discuss the findings in the context of evolutionary psychiatry, and the relevance of Evolutionary Threat Assessment Systems Theory in research on religious beliefs.

Neurobiological Pathways between Chronic Stress and Depression: Dysregulated Adaptive Mechanisms?

Stress-related diseases have been predicted to become major contributors to the Global Disease Burden within the next 20 years. Of these, depression is one of the principal identifiable sources of concern for public mental health, and has been hypothesized to be an outcome of prolonged stress. Examination of the hyper-responsiveness of the Hypothalamic-Pituitary-Adrenal axis, consequent elevated serum cortisol, plus the effects of this upon brain structure and function, provides a model for understanding how chronic stress may be a causal vector in the development of depression. Evidence from studies of the effectiveness of antidepressants aimed at reducing cortisol within depressed patients supports this model and suggests avenues for future research and treatment of stress-induced depression.

The great opportunity: Evolutionary applications to medicine and public health

Evolutionary biology is an essential basic science for medicine, but few doctors and medical researchers are familiar with its most relevant principles. Most medical schools have geneticists who understand evolution, but few have even one evolutionary biologist to suggest other possible applications. The canyon between evolutionary biology and medicine is wide. The question is whether they offer each other enough to make bridge building worthwhile. What benefits could be expected if evolution were brought fully to bear on the problems of medicine? How would studying medical problems advance evolutionary research? Do doctors need to learn evolution, or is it valuable mainly for researchers? What practical steps will promote the application of evolutionary biology in the areas of medicine where it offers the most? To address these questions, we review current and potential applications of evolutionary biology to medicine and public health. Some evolutionary technologies, such as population genetics, serial transfer production of live vaccines, and phylogenetic analysis, have been widely applied. Other areas, such as infectious disease and aging research, illustrate the dramatic recent progress made possible by evolutionary insights. In still other areas, such as epidemiology, psychiatry, and understanding the regulation of bodily defenses, applying evolutionary principles remains an open opportunity. In addition to the utility of specific applications, an evolutionary perspective fundamentally challenges the prevalent but fundamentally incorrect metaphor of the body as a machine designed by an engineer. Bodies are vulnerable to disease - and remarkably resilient - precisely because they are not machines built from a plan. They are, instead, bundles of compromises shaped by natural selection in small increments to maximize reproduction, not health. Understanding the body as a product of natural selection, not design, offers new research questions and a framework for making medical education more coherent. We conclude with recommendations for actions that would better connect evolutionary biology and medicine in ways that will benefit public health. It is our hope that faculty and students will send this article to their undergraduate and medical school Deans, and that this will initiate discussions about the gap, the great opportunity, and action plans to bring the full power of evolutionary biology to bear on human health problems.

Beliefs, mental health, and evolutionary threat assessment systems in the brain

This article reviews aspects of the literature on neuroscience, psychiatry, and cognitive and evolutionary psychology to illustrate how primitive brain mechanisms that evolved to assess environmental threats underlie psychiatric disorders, and how beliefs can affect psychiatric symptoms through these brain systems. Psychiatric theories are discussed that (a) link psychiatric disorders to threat assessment and (b) explain how the normal functioning of threat assessment systems can become pathological. Three brain structures that are consistently implicated in psychiatric symptomology also are involved in threat assessment and self-defense: the prefrontal cortex, the basal ganglia, and parts of the so-called limbic system. We propose that as these structures evolved over time they formed what we refer to as evolutionary threat assessment systems, which detect and assess potential threats of harm. Drawing on various psychological and psychiatric theories we propose how beliefs about the world can moderate psychiatric symptoms through their influence on evolutionary threat assessment systems.

Animal defense strategies and anxiety disorders

Anxiety disorders are classified according to symptoms, time course and therapeutic response. Concurrently, the experimental analysis of defensive behavior has identified three strategies of defense that are shared by different animal species, triggered by situations of potential, distal and proximal predatory threat, respectively. The first one consists of cautious exploration of the environment for risk assessment. The associated emotion is supposed to be anxiety and its pathology, Generalized Anxiety Disorder. The second is manifested by oriented escape or by behavioral inhibition, being related to normal fear and to Specific Phobias, as disorders. The third consists of disorganized flight or complete immobility, associated to dread and Panic Disorder. Among conspecific interactions lies a forth defense strategy, submission, that has been related to normal social anxiety (shyness) and to Social Anxiety Disorder. In turn, Posttraumatic Stress Disorder and Obsessive-Compulsive Disorder do not seem to be directly related to innate defense reactions. Such evolutionary approach offers a reliable theoretical framework for the study of the biological determinants of anxiety disorders, and a sound basis for psychiatric classification.

Darwinian models of depression: a review of evolutionary accounts of mood and mood disorders

Over the last ten years, there has been increased interest in the evolutionary origins of depressive phenomena. The current article provides a review of the major schools of thought that have emerged in this area. First, we consider important Darwinian explanations of depressed mood, including an integrative social risk hypothesis recently proposed by the authors. According to the social risk hypothesis, depression represents an adaptive response to the perceived threat of exclusion from important social relationships that, over the course of evolution, have been critical to maintaining an individual's fitness prospects. We argue, moreover, that in the ancestral environment, depression minimized the likelihood of exclusion by inducing: (i) cognitive hypersensitivity to indicators of social risk/threat; (ii) signaling behaviours that reduce social threat and elicit social support; and (iii) a generalized reduction in an individual's propensity to engage in risky, appetitive behaviours. Neurobiological support for this argument is also provided. Finally, we review three models that endeavour to explain the relationship between the adaptations that underlie depressed mood and clinically significant, depressed states, followed by a consideration of the merits of each.

The Social Risk Hypothesis of Depressed Mood: Evolutionary, Psychosocial, and Neurobiological Perspectives

The authors hypothesize that depressed states evolved to minimize risk in social interactions in which individuals perceive that the ratio of their social value to others, and their social burden on others, is at a critically low level. When this ratio reaches a point where social value and social burden are approaching equivalence, the individual is in danger of exclusion from social contexts that, over the course of evolution, have been critical to fitness. Many features of depressed states can be understood in relation to mechanisms that reduce social risk in such circumstances, including (a) hyper-sensitivity to signals of social threat from others, (b) sending signals to others that reduce social risks, and (c) inhibiting risk-seeking (e.g., confident, acquisitive) behaviors. These features are discussed in terms of psychosocial and neurobiological research on depressive phenomena.

Clinical Psychology and Evolutionary Psychology: Toward a Dialogue

The growth of evolutionary psychology as a theoretical framework for the study of human behavior has been spectacular. However, evolutionary psychology has been largely ignored by clinical psychology. This article is an attempt to encourage greater dialogue between the two. First, some of the major principles of evolutionary psychology are outlined, followed by consideration of some of the criticisms that have been made of this approach. Second, an attempt is made to trace the influence of evolutionary theory on the history and development of clinical psychology. Third, the authors describe how an evolutionary perspective has enhanced the understanding and study of autism and depression. Finally, some implications of an evolutionary perspective for etiological theory, assessment, treatment, and ethics are discussed.

Evolutionary Approaches to Psychopathology and Cognitive Therapy

This opening article outlines some key themes of an evolutionary approach to psychopathology, and explores possible implications for cognitive therapy. Evolutionary psychology suggests that many of our mental mechanisms are designed to promote survival and reproduction, not happiness, or even mental health, as such. This article focuses on the concept of evolved strategies and their phenotypic expressions, to fit specific niches. It suggests that evolved strategies and their phenotypic expressions partly operate through two psychobiological systems, called the defense and safeness systems, which detect and respond to threats and punishments, and safeness and potential rewards, respectively. Various cognitive schemas, rules and automatic thoughts, especially those linked to psychopathology, are often products of the linkages in strategies as coded in defense and safeness systems. The latter part of the article gives a brief exploration of the view that self-to-self relationships (self-evaluations and “self-talk”) evolved from social cognitions and behavior. Negative self-evaluations, self-criticism, and self-attacking are viewed as internalized interactions between a hostile, dominant part of self, and an appeasing, subordinate part of self. One way of undermining this interaction is to introduce the notion of compassion for the self. A brief consideration is given to the development of “compassionate mind” in work with shame-prone people as expressed in high self-criticalness and/or self-hating. Throughout the text the main problems addressed are those of the more chronic, emotional difficulties often associated with some degree of what is called personality disorder.

Toward an integration of interpersonal and biological processes: evolutionary psychiatry as an empirically testable framework for psychiatric research

Phenomenological, biological, and interpersonal aspects of psychiatric disorders lack an integrative empirical framework. In this paper evolutionary psychiatry is proposed as a meta-theory to integrate biological and interpersonal aspects of psychopathology. Pathological cognition, emotions, and behaviors may be examined according to specific biosocial goals originally pursued to increase the individual's inclusive fitness, similar to the ways that "normal" processes have been analyzed by evolutionary psychology. Sex-specific differences in prevalence rates and symptomatology of psychiatric disorders may also be better understood if divergent problems of adaptation for men and women in human evolutionary history are taken into account. Instead of mistaking the evolutionary approach for being deterministic and empirically untestable, it may rather be appropriate to provide a functional classification which adds to the contemporary psychiatric nosology through analysis according to specific conflicts of adaptation (at the ultimate level), the pursuit of biosocial goals, and proximate specifiers such as genetic, developmental, and interpersonal causes of disorders.

Evolutionary approaches to psychopathology: the role of natural defences

OBJECTIVE

Psychoanalytic theories of the mind emerged in the immediate post-Darwinian era of the 1880s and 1890s. Since that time much has changed in both psychoanalytic and evolutionary theorizing. This paper explores recent evolutionary thinking on psychopathology.

METHOD

Relevant literature was reviewed.

RESULTS

This paper outlines some of the common behavioural defence mechanisms and then explores ways in which they are represented in various disorders, with a focus on depression. This paper suggests that 'symptoms' can be related to the activation of evolved defence mechanisms to respond to losses and threats. Such will involve, for example, anxious arousal and heightened vigilance and attention to the threat, with the type of defence (e.g. fight, flight, submit, help seeking) being mirrored in particular symptom presentations.

CONCLUSION

Defences can become pathological when they are too easily aroused or prolonged, are arrested (aroused but not expressed) and/or ineffective.

Adjustment to cancer - coping or personal transition?

The term 'adjustment' is widely used within the psycho-oncology literature and, although it is a topic of central importance to the lived experience of people with cancer, the psychological mechanisms of adjustment have rarely been described. Rather than regarding it as the absence of psychopathology or the end-point of coping with the global threat of cancer, adjustment refers to the psychological processes that occur over time as the individual, and those in their social world, manage, learn from and adapt to the multitude of changes which have been precipitated by the illness and its treatment. However, these changes are not always for the worse: sometimes they precipitate 'healthy personal growth' in a number of areas. It is only from explicit theories of adjustment that progress can be made in understanding how and why psychological disorders so frequently develop in cancer and what steps may be taken to prevent them. This paper combines the complementary assets of coping theory and social-cognitive theory and proposes the Social-Cognitive Transition (SCT) model of adjustment, a clinical model which also accounts for the frequent reports of healthy personal growth associated with cancer.

Advantages of bias and prejudice: an exploration of their neurocognitive templates

Bias is common in mental-processing tasks as diverse as target recognition, heuristic estimation and social judgment. This paper holds that cognitive biases stem from the covert operation of neural modules, which evolved to subserve adaptive behavior. Such modules can be innate or forged early in development. Research shows links between (i) biases in cognitive tasks and (ii) neural devices, which may mediate them. Evidence is included from biases that arise spontaneously in artificial neural networks during recognition/decision tasks. Two linked propositions follow. First, there are continuities in biasing strategies across different levels of cognitive processing. Second, a proclivity for stereotyping and prejudice depends on the biased functions of lower-level neural modules that promote adaptations to social environments. The propositions rest on evidence of biological preparedness for stereotyping and of deficits in social judgment in patients with neurological lesions. To test such claims, research studies are suggested at the boundary of cognitive neuroscience and social psychology. Advantages of bias and prejudice as evolved tools may include their: (1) speeding of scrutiny and improving of target detection in changing or uncertain situations; (2) aiding of a rapid choice of practical short-term rather than optimal longer term plans; (3) allowing appraisal of a workable world by creating fairly stable categories; (4) motivating of exploration and completion of problem-solving which might otherwise be abandoned too early. The biological priming of social biases need not mean that they are immutable; understanding them could lead to better ways of controlling them.