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From:

The Handbook ofEvolutionary Psychology


Edited by David Buss
Jolm Wiley and Sons, Hoboken, NJ, 2005

CHAPTER

32

Evolutionary Psychology
and Mental Health
RANDOLPH 1\1. NESSE

N EVOLUTJONi\RY PERSPECTIVE revolutionized our understanding of be


havior over a generation Jgo, b u t most tnental health clinicians and
researchers stil l view evolution as an interesting or even thratcning al
ternative, instead of recognizing it as an essential basic science for understanding
mental di sorders. l'v1any factors explain this lag in incorporating new knowledge,
but the n1ost important 1nay be the clinician's pragn1atic focus on finding ways to
help people nmv. Evolutionary researchers have not found a new treatment for a
single mental disorder, so why should n1ental health clinicians and researchers
care about evolutionary psychology (EP)? This chapter attempts to answer that
question. The greatest value of an evolutionary approach is not some specific find
ing or ne\v therapy, but is in stead the framework it provides for uniting a l l JSPL'cts
of a biopsychosocial model. Perhaps equa l ly valuable is the deeper empathy fos
tered by an evolutionary perspective on l ifl's vicissitudes. An evolutionary per
spective does not con1pctc with other theories that try to explain why some people
have ment.1l diorders and others do not. Instead, i L aks a fundamental ly d i ffer
ent question: Why has natural selection left a l l hun1ans so vulnerable to 1nental
d isorders? At first, the question seems senseless. Natural selection shapes mecha
n isn1s that \vork, so how can it help us understand why the mind fails? It is also
d i fficult to sec how i t is useful to know vvhy we are vulnerable. Who cares why a l l
humans are vulnerable t o depression, when the goal i s t o help the individual who
is depressed here and now? Surmounting these conceptual hurdles is a challenge
that requires time and effort. Researchers and cl inicians w i l l n1ake the effort when
they know what evolution offers to the understanding of mental disorders.

WHAT EVOL U T IO N O F F E RS
l'v1any ha\'C contributed to the grmv th of evolutionary psychiatry, but the contri
butions are in d iverse sources and not ahvays consistent. Early applications of
903

902

EvoLUTJONIZING TRADIT IONAL. DtsciPLJNES OF PsYCHOLOGY

Szasz, T. S. (1974). Tfu: myth ofmenlnl illness: Foundations ofa theory of persona! conduct (Revised cdi
tionr New York: Harper & Row.
Tinbergcn, N. (1963). On aims and methods of ethology. Zl'ifschrift fiir Ticrpsychofogic, 20, 410-433.
Wakefield,]. C. (1992a). The concept of mental disorder: On the boundary between biological facts
and social values. American Psychologist, 47, 373-388.
Wakefield, J. C. (1992b). Disorder as harmful dysfunction: A conceptual critique of DSM-III-R's
definition of mental disorder. Psychological Rct'icw, 99, 232-247.
Wakefield, J. C. (1997). Di01gnosing OSM: Pt. 1. DSM and the concept of m.ental disorder. Bcluwior
Research and Thcmpy, 35, 633-650.
Wakefield, J. C. (1999a). Disorder as a black box essentiolist concept. journal of Al111ormal Psyclwlogy,
lUS, 465-472.
Wakefield, J. C. (1999b). Evolutionary versus prototype analyses of the concept of di sorder. jou rnal
of Abnormal Psychology, 108, 374-399.
Wakefield, J. C. (2000). Spimdrels, vestigia! organs, and such: Reply to Murphy and Woolfolk's
"The harmful dysfunction analysis of mental disorder." Philosophy, Psycltinfry, and Psyclwlogy, 7,
253-270.
Wakefield, J. C. (2004). The myth of open concepts: Meehl's analysis of construct meaning versus
black box essenti illism. Applied and Preventive Psychology, 11, 77-82.
Wakefield, J. C., & First, M . (2003). Clarifying the distinction between disorder and non-disorder:
Confronting the overdiagnosis ("false positives") problem i n DSM-V. In K. A. Phillips, M . B.
First, & H. A. Pincus (Eds.), Advancing DSM: Dilemmas in psychiatric diaguosis. Washington, DC:
American Psychiatric Press.
Wakefield, J. C., Pottick, K. ]., & Kirk, S. A. (2002). Should the DSM-lV diagnostic criteria for con
duct disorder consider social context? American journal of Psycltiatry, 159, 380-386.
Wil liams, G. C. (1966). Adaptation and natural selection. Princeton, NJ: Princeton University Press.
Willi ams, G. C. (1992). Natural selection: Domains, fn,cls, and challenges. New York: Oxford University
Press.
Wright, L. (1973). Functions. Philosophicnl Review, 82, 139-168.
Wright, L. (1976). Tcleologicnl explanations. Berkeley, CA: University of California Press.

904

EVOLUTIONJZINC TRADITIONAL DISCIPL I NES OF PSYCHOLOGY


Table 32.1
Eight Fundamental Contributions

An evolutionary perspective on mental disorders:


1. Asks new questions about why natural selection has left us all vulnerable to mental
disorders, questions with six kinds of possible answers,
2. Offers the beginnings of the kind of functional understanding for mental health professions that physiology provides for the rest of medicine,
3. Provides a framework for a deeper and more empathic understanding of individuals,
4. Explains how relationships work,
5. Provides a way to think clearly about development and the ways that early experiences influence later characteristics,
6. Provides a foundation for understanding emotions and their regulation,
7. Provides a foundation for a scientific diagnostic system,
8. Provides a framework for incorporating multiple causal factors that explain why some
people get mental disorders while others do not.

ethology to mental disorders (McGuire & Fairbanks, 1977; White, 1 '174) gave rise
to mort> specific and comprehensive evolutionary approaches (McCuin & Troisi,
1998; Pitchford, 2001; Stevens & Price, 1996; Wcncgrat, 1990). Several books cover
specific conditions (Baron-Cohen, 1 99. 1 997; Cilbert, 1 992; Wcn<'grat, 1995).
while others take a more anthropological approach (Fabrcga, 2002). Many articles
address specific mt'ntal disorders, and some provide a new found<.llion for defin
ing the categories that describe disordc'rs (Cosmidcs & Tooby, 1 YY9; Wakefidd,
1992). Mony chapters in this Handbook ,md many ,;eneral books about El' tackle
one or another mental disorder (Badcock, 2000; Barkow, Cosmidcs, & Tooby, 1992;
Barrett, Dunbor, & Lycctt, 2002; Buss, 1994, 1 995, 2003, 2004; Crow ford, Smith, &
Krebs, 1 987; Caulin & McBurney, 20ll1 ; Wright, 1 994). The ideas in these sources
are too 1nany and too diverse to even list, but many can be summ.1rizcd in a list of
eight fundamental contributions that an evolutionary pcrspectiH' offers to psy
chiatry and clinical psychology (Table 32.1 ) A brid summary uf c-.1ch sl'ls the
stage for considLring specific disorders.
.

EXPLAJNJNG VULf\..'EHABl!JTY TO M t: N TAL O!ORDERS

The task of explaining why \Ve are vulnerable to mental disorders is no different
from that of explaining why we arc vulnerable to physical diseases. Tht' tendency
in both cases l1as been to oversimplify the problc1n by attributing v ulnerability to
the limited powers of natural selection. ThesE' limits are important expl.1n,1tions
for some disl'ases, but there arc five other posslblc reasons thut tlw body and
mind are not better designed, starting with the mismatch bchvccn our bodies ,1nd
our environments (Nessc & Willi<Jms, 1 994; Willia1ns & Ncsse, 1991).
Mismatch Most common chronic diseases arc caused by novel cnvironn1cntcd
factors. For instance, atherosclerosis and breast cancer arc prcv<1knt now be
cause our bod ics are not \veil dcsign(:d for life in <l xnodcrn en\' ironnwnt (Eaton
et al., 2002). Whether rates of mental disorders are also increasing remains un
certain. An internationzd effort to gather prevalt'llet' data on mental disorders
frmn 72,000 interviews in 1-l countrhs (Kessler & Ustun, 2000) uses urban or

Evolutionary Pst;clzologt; and Mental Health

905

rural agricultural sites. No con1parable effort is estilnating d isorder rates i n


hunter-gatherer populations. This i s unfortunate because such studies m a y not
be possible in the next generation, but understandable because o f the method
ological obstacles.
Mental d iorders are often blamed on the modern environment. When reading
and writing vverc first -spreading, Burton at tributed n1clancholy to excessive
study and "too little Venus" ( Burton, 1624/1911 ) . Much more recentlv, retrospec
tive data seemed to suggest th,lt depression rates were increasing r,1pidly with
each generation (Cross-Na tional Collaborah\re Croup, 1 992). l--fo-wever, data gath
ered using consistent questions in the same population over n'cent decades
showl'd no such increase (J. M. lvfurphy, Laird, fv'lonsun, Sobol, & Leightun, 2000).
For drug <1nd a l cohol problems, the story is more clL'ar-cut. The rapid spread o f
i!lcohol-making technology ch,1nged our \Vorld i n \vays o u r species has n o t yet
adapted to (Institute of Medicine, 1987), although selection n1ay have increased
the frequency of a defective aldehyde dehydrogenase gene Lhat may protect Asian
populations from alcoholism (M. Smith, 1986).
Infection and Coevolution Infections persist because our every evolutionary nd
vance to escape bacteria and viruses is mEJtched by their Ln faster evolution
(A . S. Brown ct a l . , 2004; Ewald, 1 994). Furthermore, the ddcnses that protect
us, espt' c i a l l y in1mune responses, tend to cause problen1s t hen1sclves. Some
men t a l d isorders mi!y resu 1t from arms races 1.vith pathogens and their <Juto
i rnnTune :-;equelae. For instance, some cases of obsessive-compulsive disorder
n1ay result fn}m streptococcal-induced autoimmune dan1agc to t11e caudate nu
cleus (S\-vcdo, l.eonard, & Kiesling, Fl94). Prena tal exposure to infection n1ay
pred i.:-;pose to schizophrenia (lxdgLrwood, Ewald, & Cochran, 200:1) cls sug
gested by inc re<lsed rates of schizophrenio in babies born during influenza epi
delnics ( Kunugi e t a l., 1995) <1nd a sevenfold risk increase for babies born to
motl1ers who had influenza during tlw first trinwstcr (A. S. Brown ct al., 2004).
Infectious causes h ;we been proposed for a wide range o f nwntal disordt'rs, es
p ec i a l l y a f fe c tive disorders (Ewilld, 2000).
A mort' insid ious resul t of rapid coevolution arises fron1 con1petition within
our species that induces more and mon' t>xtreme traits, especially thosl' th<1t lead
to winning social con1pcti tions (A ll'x,1ndcr, 197-!-; Humphrey, 1 976; Whiten &
Byrne, 1 997). I f sexual select ion has shaped mental traits ( M i ller, 2000), this could
account for vulnerabil i t y to certain disorders, espl'cia l l y thuse associated with
creativity ( R ich8rds, Kinner, Lunde, & Bt'net, 19.S8; ShanL'r, M i ller, & Mintz,
2004). Even aside from cmnpcting for p<1rtncrs, competing for status absorbs vast
human energy ( Bj]rkow, 1989; Veblen, UN9) and gives rise to much suffL-ring from
cn1.Ty and the ncgntlve emotions associ;1ted with f<1ilures (Gilbert, Price, & /\Ilen,
1995). Such emotional tendt'ncies might well result from arms races that often
l cmTe us in zero-sum competitions ( Fr(]nk, lSJ99).
Tmde-0/}s Design trc1de-offs makL' pcrftction in1possible for any trajt, natural or
hun1an n1ade. A car tha t gets 60 m i les pt'r ga l lon w i l l not get to hO mi lt's per hour
in 6 seconds. Wt' humans could run faster i f our legs were longt>r, but our bones
vvould be Inon fr<1gile. \Ve could han:' ltss anx iety, but only a t the cost of being
more l ikt'l.Y to be injured or killed.

906

EvoLuT rONIZJNG TRADITIONAL DrsC!PUNES oF PsvcHoLocv

Constraints Systen1s shaped by natural selection are subject to several special


constraints, especially path dependence. For instance, we are stuck with eyes
'".rhose vessels and nerves run between the light and the retina. Fu r thern1ore, in
contrast to consciously created designs, biological designs are products of selec
tion that involve lilnited options, random effects, inaccu rate tran smission of the
DNA code, and the vagaries of intPraction effpcts with difft>rent environments.
Far from a.:-1suming that everything it'i adaptive, an evolutionary approach cal ls at
ten tion to defective and substandard designs that result from multiple trade-offs,
constraints, and errors.
SelccUon Is for Reproductive Success, Not Health Many imagine that selection
shapes bodies zmd minds that arc healthy, long-lived, and coopcratiVl'. I t does,
wl1E'n those traits increase reproductive SUCCC'SS (RS). HowenT, cl gene that de
creases health, longevity, or coopl'rativeness \vill nonetheless spread if it in
creases RS. Such genes are likely responsible for many of ou r least valued
characteristics, such as bitter competition, envy/ greed, and unqutnchable sexual
desire and jealousy ( Buss, 2000). The djfferl'nces between the seAL'S arise largely
because different reproductive stratE'gics shape different physic1l and n1cntal
traits, even at the expense of longevity and individual wel l-being: (C ronin, 199 1 ;
Daly & Wilson, 1 983; Geary, 1 998; Kruger & Ncsse, 2004).

Pain, cough, fever, and other protective responses are unpleasant but
useful responses that protect us from dangl'r and loss. The prevalent tendency to
confuse these defenses with disease's <Jnd defects has been called "The Clinician's
ll lusion" ( Ncsse & Williams, J994). Most physicians knmv that cough and infldm
mation are adaptations, but the utility of fl'\rcr, diarrhea, and anxiety is less widely
rccoh:rnized. A naYve view sues our vulnerJbility to neg;1tive emotions as examples
of poor design. But notural selection does not care <1 fig for our happiness; it just
mindkssly shapes whatever emotional tcndenciL'S incrc'ase RS ( Nessc, 1 991n;
Tooby & Cosmides, 1990). While positive emotions are useful in situations whefl'
energy and risk-taking pay off ( Fredrickson, 1 998), they ciln be fataJ in dangerous
situations ( N cssc, 2004).
Dcfcn::;cs

Summing Up Six Causes Smne evolutionary approaches to mental disorders em


phasize one of the preceding six possible explan<ltions. For instance, some au
thors attribute much psychopathology to living in a modern environment (Clantz
& Pearce, 1989); others e mphasize infection (Ewald, 2000), constraints, tradc-offs,
or poth dependencies (Crow, 1997; Horrobin, 199K). Others propose thot mental
disordL'rs persist because of fitness benefits, even for conditions such as schizo
phrenia (J. S. A l len & Sarich, 1988; Shaner et o l., 2004), bipolar disorder (Wilson,
1998), and suicide (dcCatanzaro, 1900). The resulting confusion is substantial for
those in the field and overwhelming for others.
\.Vhik the hu m;:m mind prefers monoc<us;:d explanntions, a full evolutionary
explanation for onl' disorder may include scVL'ral different factors. For l'xamplc,
vuhwrability to depression may CJrisc from novel aspects of modern life, fron1 in
fection, from constraints and trade-offs/ zmd because lcnv n1ood may be a defense
that can increase RS at the expense of }Wrsonal happiness. Par frnm offering a

Evolutionary Psychology and Mental Health

907

silnplistic approach to the causes of mental disorders, an evolutionary perspective


provides a framework for organizing the genuine complexity into a biopsychoso
cial perspective (Weiner, 1998).
AN EVOLUTIONARY FRAMEWORK FOR UNDERSTANDING HUMAN
BEHAVIOR AND EMOTIONS

When a patient comes to the gl'neral 1nedical clinic with cough or kidney failure,
the physician knows that cough is a protective response and that the kidney fil
ters out toxins and rq;ulates salt and \Vater babncc. By contr,lst, when a p<ltient
comes to a mental health clinic with a phobia, the utility of anxiety may never be
considl'rcd. VVhen someone conws with jealousy, consideration of its normal func
tions is unlikdy. Mental health profession<Jls l<1ck <1 body of knowledge about nor
mal emotional functions comparable to the understanding physiology offers to
general medicine. EF is beginning to provide this missing body of knowlcdgC', as
shmvn by tlw chapters in this 1-landbook, and by evolutionary perspectives on mo
tivation (French, Kamil, & Leger, 2000), emotion (Plutchik, 2003), and specific
topics such as grid (Archer, 19Y9).
U NLJEHSTAND!NC I0.iDIV!UUAL L Jv J:s

EP can bring information about an individual's idiosyncratic values, goals, and


life situations into a scientific framework. Consider John, a dt>pressed 20-year-old
man \Vho \vorks two jobs in local stores to support his disabled metlwr.-Whcn he
vvc1s 14, his dying father made him promise to t<.1kc care of his mother always. He
has been doing th<Jt ever since, but with increasing resentment and depression.
These three sentt>nces give more insight into his depret'ision than a dozen derno
gr<lphic variables and a brain scan. An evolutionary understanding of motivation
can begin to bring such inform<ltion into a nomothetic fraJnC'work based on bc
haviural ecology categories of life history effort. Tlw tradc-offs among these catc
gorh.'s are as universal as tlwy arc problL'mc1tic (Krebs & Davies, 1984; Stearns,
1992). No solution can be perfect, and tht' conflicts account for much human suf
fering (Chisholm, 1999; Low, 2000; E. A. Smith & Wintcrhalder, 1992; Sterelny &
Griffiths, 1999). UndL'rstanding these tradc-offs fosters realistic clinical thinking
<1nd enhances empathy for the vicissitudes of people's lives.
REL;\TJC)NS!-!JPS

EP's greatest contribution may be a deeper understanding of rebtionships.


For instance, Bmvlby's (1969) insights about the evolutionary functions of attach
ment have been extended by suggestions that apparently "abnormal" kinds of at
tachnwnt may represent alternativL' strategies for infants to get resources fron1
mothL'rs in difficult circumstances (Belsky, ]999; Chisholm, 1Y96) and a deeper
understanding of women's n'productive stratt.gies in gerwral (Hrdy, 1999).
Analysis of mutually beneficial re-ciprocal exchanges has led to extensive studit>s
of econmnic games (Fchr & Fischbaclwr, 2003) that illuminate the origins of
the social en1otions (Fessler, in press; Fiske, 1992; Henrich & Cil-Whitc, 2001).
Hmve\'tT, interpreting all human relationships as calcubtcd exchanges ignores

908

EvotunoNJZING TRADITIONAL DiSCIPLINES oF PsYCHOLOGY

aspects of human behavior that are essential to understanding n1ental disorders,


such as our capacities for moral action and the emotions of pride and guilt (Katz,
2000). Selection n1ay have shaped capacities for conunitment that are superior to
rational calculation (Frank, 1988; Gintis, 2000; Nesse, 2001a).
Freud's theories are ridiculed because some are wrong and be
cause psychoanalysis is not reliably effective. However, the reality of repression is
a profound fact of human nature that needs an evolutionary explanation (Bad
cock, 1988; Sulloway, 1985), along with phenomena such as the Oedipus complex
!Ericson, 1993). Trivers and Alexander separately suggested that self-deception is
a strategy for deceiving others (Alexander, 1975; Trivers, 1976, 2000), but people
also may repress the sins of others to preserve valuable rC'Iationships (Nesse,
1990b). Closely related is Trivers's (1974) insight that regression may be an effec
tive strategy used by offspring to manipulate their parents into providing re
sources that would be appropriate only if they were younger or sick. His more
general theory of parent-offspring conflict is the neglected foundation for under
standing many childhood disorders. Attempts to provide an evolutionary founda
tion for psychodynamics are developing (Badcock, 1988; Slavin & Kriegman, 1992;
Sulloway, 1985) but remain relatively unappreciated by psychoanalysts, perhaps
because an evolutionary view fosters skepticisn1 that undermining repression
will be helpful routinely (Slavin & Kriegman, 1990).
Psychodynamics

Development Developmental psychology now offers sophisticated assessments of


extensive data about what children do at different stages of life and how these
phenon1ena vary across cultures. It increasingly takes evolution into account
(Bateson & Martin, 2000; Geary & Bjorklund , 2000; Rutter & Rutter, 1993). In the
midst of a burst of interest in facultative developmental mechanisn1s and their
role in evolution (Hall, 1998; West-Eberhard, 2003), evolutionary psychologists
have begun looking for mechanistns that use environment inputs to adjust devel
opmental pathways. An obvious facultative adaptation is the regulation of female
reproductive onset by fat stores (Surbey, 1987). Less well supported are proposals
that early father absence induces early reproduction (Belsky, Steinberg, & Draper,
1991; Draper & Harpending, 1982; Surbey, 1990). A possible adaptation with par
ticular relevance for mental disorders is the adjustment of the gain in the hypo
thalamic pituitary axis system in response to early stress and the transmission of
this sensitivity across the generations by maternal influences on fetal brain de
velopment (Essex, Klein, Eunsuk, & Kalin, 2002; Teicher et a!., 2003).

EMOTIONS A ND T H E ElVIOTIONAL D ISORDERS

Most mental disorders are emotional disorders. People come for treatment be
cause they experience anxiety, deprl'Ssion, anger, or jealousy. Many assume that
such negative emotions are abnormal, but they are usefut at least for our genes.
People with depression and anxiety are so obviously impaired that it is difficult
to see how such emotions could be useful. However, selection has shaped emo
tion regulation mechanisms that often give rise to normal but useless suffering
(Nesse, 2004, 2005). An evolutionary foundation for studies of emotions is now
routine (Ekman, 1992; Nesse, 1990a; Plutchik, 2003; Tooby & Cosmides, 1990) and

Evolutionary Psychology and Mental Health

909

recognition is growing that en1otions are special states shaped by selection to


give advantages in fitness-significant situations that have recurred over evolu
tionary tilne.
OJ/\CNOSIS

When is an e1notion abnonnal? The criteria for psychiatric diagnoses are based on
intensity, dur.:Jtion, and associated disability (American Psychiatric Association,
]994). The extremes are abnormal, but without knmving the functions of emo
tions, the line between normal and abnormal re1nains subjective (D. Murphy &
Stich, 2000; Ncsse, 2001b; Troisi & McGuire, 2002; Wakefield, 1992). The lack of an
evolutionary foundation fosters serious errors including describing continuous
emotions as categories and neglecting abnormal conditions characterized by ex
cess positive or deficient neg<ltive enwtions. Jn addition, diagnostic criteria do not
consider the appropriateness of an emotion to the situation. If general nwdicinc
n1ade diagnoses according to the strategy used in psychiatry, it would diagnose
abnormal cough disorder based on cough frequency and severity without consid
ering \Vhcther the cough \va;.; a norma] response in certain situations. Far from
genuine] y atlworetical, the Diag1wstic and Statitical Mmwal (f Mental Disorders sys
tL'l11 (DSi\1; A1nerican Psychi,1tric Association, J994) fosters a crudt' biological
view (Horwitz, 2002).
Many agree that the DSM system inhibits understanding (Phillips, First, & Pin
cus, 2003), and several authors have suggested hmv evolutionary principles can help
to m,1kc diagnosPs more scientific. D. Murphy and Stich (2000) take}he DSM to task
for its atheoretical approach and suggest distinguishing disorders that arise from
brain abnormalities from those that arise from normal brains exposed to novd C'nvi
ronmcnts. Tlwy propose categories based on the presumed modularity of cognitive
design. VVakefield (1992) offers a strong critique of the DSM, using tlw concept of
"harmful dysfunction" to clarify what is and is not a disorder. This sophisticatLd
evolutionary analysis of psychiatric diagnosis argues that it is essentiJ.l for mental as
well as physical disorders to separate normcll from abnormal phenomena based on
whether thl'y arc h<umful and whether tlwy arise from a dysfunction. This sophisti
cated understanding of evolutionary function is the scientific foundation for future
psychi<1tric diagnostic systems (Wakefield, this volume).
An C\'olution,uy view highlights the central flJw in the DSM criteria; they do
not rcfll'ct the most basic distinction in medical diagnosis: that between diseases
and symptoms of diseases. Negative emotions such as anxiety and sadness cue
useful ciJpacitics shaped by natural selection. Determining \Vhen they are abnor
mal requirL'S undt>rstanding when <1nd hmv they are ueful.
An approach based on Darwinian medicine, following Wakefield, suggests
global cakgories of mental problems based on ansvTrs to three questions: ( 1 ) Are
cognitive and brain mc'chanisn1s normal or defective? (2) Do the symptoms arise
frmn non'I aspects of the environment, <lnd (3) Are the symptmns in the interests
of the individual, his or her genes, or neither? The rC'sulting categories are:
1 . Emotional, cognitive, or behavioral responses that arise from normal systl'lns:
a. Useful responses that miJy be a\'ersivc (ordinary anxiety and anger).
b. Normal responses that bl'ncfit the indiv idual's gcnl's, at the expense of
the individual's interests.

910

EvoLUTlONIZING TRADJTTONAL D rscrrLTNES oF PsYCHOLOGY

c. Responses that arise from norn1al system b u t that are not useful in the
particular instance.
d . Nonnal responses that are useless or harmful now but would not have
been in the ancestral environment.
e. Normal responses that do not harm the individua I b u t that are defined as
abnormal by a group or culture.
2. Sy1nptoms arising from abnormal regulation of a normal emotion or cap<Kity.
a . Specific defects, genetic or acquired, account for the dysrcguL1tion (cau
sation from below, hardware problems).
b . Dysregulation arising from soci;1l dilemmas or complexities (c<1tJSiltion
from abovL', software problems).
c. E x tremes of a trait d i stribution that increJse vulnerability.
3. Abnormalities of behavior, cognition, and emotion that arisL' from funda
nlental brain or cognitive abnormalities not pri1narily involved vvith systems
that regulate e motion and behavior (e.g., lead poisoning).

INDIVIDUAL DrFFERFNC'ES

Most psychiatric research attcn1pts to explain individual differences. Despite


growing agreement on the importance of gene-environment intcroctions (Kendlcr,
Kuhn, & Prescott, 2004; Ridky, 2003; Rutter & Rutter, 1993), m<>jor disagreenwnls
persist about why some people get i l l and others do not. D ifferent authorities L'm
phasize different causal factors (gem,tic, developmental, situational, ttc.). Far
from emphasizing genetic differences, an evolutionary view provides a framl'\Vork
that highlights the relationships among a l l fJctors and levels. 1 t also contributes
strategies for avoiding some s i mple n1istakes.
Much misunderstanding arises from confusing attempts to expla i n the exis
tence of a trait with attempts to explzli n variations in a trait. It is scnscltss to ask
whetlwr a rectangle is caused 1norc by its length or its w i d th. However, rect,1n
gles can vary in area only if thei r width or length (or both) chrmges. Likcw isL>,
variutions among individuals can result only from diffl'rcncf's in glIWS, differ
ences in environments, and the interactions between thcn1. The proportion of
variance <1ttributablc to each component is not fixed, but varies dl'pL'nding on tlw
particular environment and the range of genotypes. Preoccupation wdh n<lture
versus nurture has distracted atkntion from the tnany different routes to < J dis
order. An evolutionary approach fosters s imultaneous cont>idtration of the m,1ny
fc1ctors that may explain i ndividual variation in a trait, some of which <lrc listed in
Table 32.2.
The task of accounting for individual differences should not bL' reduced to <tr
guing about the relative importancl' of one factor compared tu another. It is,
instead, the challenge of explicating how each contributes to individual diffl'r
e ncl's in a particular trait and how their contributions to a particuLn trait m;1y
be different not only between families, populations, or cultures, b u t even be
t'\Vel'n indiv iduals. The responsible factors may be mainly genetic in one i ndi
vidual and tnainly environmental in another. This has practical implic,ltions for
mentol health research. For instance, we need to take SL'riously the possibility
that 1nany different genes contribute to depression v u l nerability by many d_if
ferent routes.

Evolutionary Psychology and Mental Health

911

Table 32.2
Twelve Sources of Individual Differences
1. Additive genetic differences among individuals that result in phenotypic differences
(in this environment)
2. Variation resulting from Gene x Environment interactions
3. Variation resulting from Gene x Gene interactions
4. Assortative mating-nonrandom mating increases or decreases trait variance
5. Random factors in development, such as the stochastic paths of neuron migration
6. Effects of cues that influence development via facultative mechanisms to a trajec
tory suited to the particular environment, such as early heat exposure influencing
the number of adult sweat glands
7. Effects of trauma, toxins, and other environmental exposures outside the range of
normal that damage the organism or distort its development
8. Effects of environmental factors that influence the organism "topdown" via percep
tual experience without resulting in damage or acting via a specific facultative
mechanism
9. Effects of environmental factors that influence the organism from the "bottom-up"
that are neither damaging nor mediated via facultative adaptations
10. Effects of individual learning that facilitate flexible coping with current aspects of
the environment
11.

Experiences shared within a culture that are incorporated into values and emotional
proclivities that may be difficult to change later (such as values or sexual attitudes)

12. Experiences shared within a culture whose effects account for variation that
changes readily when conditions change

SPECIFIC DISORDERS

An evolutionary perspective calls attention to a distinction that is fundamental


and well recognized in 1nost of medicine, but unaccountably neglected in psychi
atry. Son1e 1nedical conditions, such as cancer and epilepsy, are diseases that arise
from some abnormality in the body's mechanisms, while others, such as pain and
cough, are protective responses. Some mental disorders, such as schizophrenia
and autism, are allnost certainly specific diseases or clusters of diseases, while
others, such as depression and panic disorder are fundamentally different in that
they are useful protective mechanisn1s, albeit ones that readily go awry. Not all
mental disorders are c1notional disorders, but n1any are, and they deserve consid
eration together.
EMOTIONAL D ISORDERS

Most mental disorders are emotional disorders, but they are not yet based on
knowledge about the origins and functions of emotions. Instead, intense or pro
longed negative emotions are said to be abnormal, irrespective of the situation,
while deficits in negative emotions and excesses of positive emotions are rarely rec
ognized as disorders. An evolutionary perspective provides a n1ore balanced view.
Although anxiety can be usefut a dry mouth and tre1nor
when standing before a large group seem worse than ust:'1ess. Likewise, the
symptoms of panic may help escape fron1 a lion, but they are unhelpful in a gro
cery store. We novv have a vast amount of knowledge about the responsible brain

Anxiety Disorders

912

EvoLUTIONlZ!NG TRADITIONAL DJSCJPLTNES or PsYCHOLOGY

n1echanisms, but no comparable body of knowledge about the evolutionary ori


gins and utility of social anxiety or panic (Nesse, 1987). Similarly, hundreds of
studies document every aspect of excessive anxiety states, but only a handful
look for states of deficient anxiety, the hypophobias (Marks & Nesse, 1994). One
study tried to confirm that fear of heigbts often results from severe falls early in
life. It found adult fC'ar of heights in 18%) of the control group but only 3% of the
group that had experiL'nced a fall early in life. Those \">'ith hypophobia early in
life still had deficient anxiety decades later (Poulton, Davies, Menzies, Langley, &
Siha, 1998).
Anxiety illustrc1tes the diversity of the body's regulation mechanisn1s (Barlow,
, 1 9H8; Marks, 1987; Poulton & Menzies, 2002; Stein & Bouwer, 1997). For instance,
rigid defensive responses to fixed cues, such as chicks hiding from hawk-shaped
shadows, are useful when a correct response to the first encounter is esscntiat
but they n:sult in many false alarms and do not protect against novel dangers.
Fll'xible learning mechanisms protect against novel cbngcrs but may fail during a
crucial initial exposure, and they are prone to result in phobias. Social lC'arning is
another solution. Infzmt rhesus monkeys show no innate fear of snakes; hmvever,
a single observation of another monkey displaying fear of snakes induces long
lasting <woicbncl'. Wutching another monkey display fear of a fluwer induces no
such fc,ar (Mineka, KC'ir, & !'rice, 1980).
Exposu rl: treatment is effective for phobias, but the fear rcsponst' is not un
leamC'd (Borlow, 19k8; Foa, Stekl'lce, & Ozarow, 1905; Marks & Tobena, 1990). In
stead, a new cortical process suppresses the fear response (Quirk, 2002). Exposure
to dzmger disrupts this suppression. Thus, the great flood in Moscow caused the
reemergence of previously extinguished fears in Pavlov's dogs. This rnay rdlcct a
constraint in a path-dependent mechanism; simple unlearning apparently may be
in1possiblc.
Otlwr fears cannot bv Pxtinguished. For instilncc, posttraumatic stress disorder
(PTSD) illustrates Olw-time Jparning of the strongest sort. A single !ifc-thn'<ltcning
experience induces a subsequent terror response to any cue that suggl'sts a
recurrence of the dangerous situ<ltion (Breslau, Davis, & Andreski, 1995). Proxi
Inate science is steadily honing in on the mechanisms that account for this syn
drome (Pitman, 1989; Yehuda, Halligan, Colit>r, Grossman, & Bierer, 2004), but it
has lwen morL' difficult to find ways to diffenntiate altf'rnative evolution<1ry hy
potlwses. PTSD could result from damage to JncchanisJns not desiplC'd to copl'
\vith such extreme situations. Howe\'er, nearly dying is so important to fitness
that it might well havL' sharwd a one-time learning mcchunism th<lt gives rise to
the symptoms of postiT<lUHlatic stress that might Iwlp prevent a recurrence.
Fear has distinct subtypes that St.'l'ITI to have been partially differentioted from
generic clnxiE'ty to cope with domain-specific challenges (M,1rks & Nessc, 1994).
For instance, p<lnic flight is just the ticket to l'Scupc from a prcdutor, but frozen
immobility is superior whl'n teetpring on a cliff. Soci,ll anxiety is present in most
peopk (Cilbcrt, 2001; Leary & Kowalski, !99'i), and pcopk wbo l<Kk it are often
insuffl'rabk', even if tlwy do not qualify for a psychiatric diilgnosis. WL' wonder
how they would ha\'e fared in small hunkr-gatht..'rer groups. The char<lctl'ristics
of subtypes of c1l1Xil'ty m.1p vvcll onto the challenges posed by diffen'nt threats.
The smoke dl:tl'ctor principlL' helps to explain sonw apparent pcculiaritiL'S of
the nwch<tnisms that regulatl' anxiety and other defLnses (Nesse, :2.005; Stein &
Buuvver, 1997). Because nwst ,1nxiety rcsponsL'S arL' incxpensi\e and protect

Evolutionary Psychology and Mental Health

913

against huge potential harms, an optimal system will express many alarms that
are unnecessary in the particular instance, but nonetheless perfectly norn1al.
This suggests that using drugs to block defenses may be safe in most instances
but that in some situations blocking a defense may be fatal.
Mood Disorders The utility of sachwss and depression is less obvious than for
anxiety, but Bib ring CI 953) long ago suggeste-d that depression signaled the need
to detach when libido persists in a connection to an unre\varding object. Ham
burg, Hamburg, and Barchas ( 1975) and Klinger ( 1 975) described how L'motions
regulate goal pursuit more generally, with inability to reach a goal first arousing
aggrct-Jsive attempts to overcoml' an obstacle, then low mood motivating disen
gagement. If the person docs not give up, the m'gative affect escalates into de
pression. This principle, nmv confirmed by much research ( Brickmtm, '19H7;
Carver & Scheier, 1990, 1998; Emmons & King, 1988; Janoff-BulmcH1 & Brickman,
1982; Little, 1999; Wrosch, Scheier, & Miller, 2003), provides the foundation for a
1nore general approach to n1ood as a mechanism that allocates effort proportionzll
to propitiousness (Ncsse, 1991b, 2000). When payoffs are high, positive mood in
creases initiative and risk-taking. \Vhcn risks are substantial or effort is likely to
be vvastcct lovv n1ood blocks in\'estments. In this perspective, ordiniJry episodes
of sadness and low mood motivate ch,1nging behavioral strategies (Watson & An
drews, 2002). If no alternative is found <1nd the goal is essentict!, persistenn may
result in depression (Klinger, 1975; Wrosch, Scheier, & Carver, 2003).
Observations of chickens and monkeys \vho lost their positions in the hicr<trchy
have suggested a view of depression as "involuntary yielding" thilt protects against
continuing attack (Cilbert 1992; Sloman, Price, Gilbert, & Gardner, 1991). This is
consistent with dcltZl shovving that stressful events cause dL'pression mainly if they
are char,lCtcrizcd by humiliation and/or being trapped in an impossible quest
(G. W. Brmvn, l:--Iarris, & Hepworth, 1995; Kendlcr, Hcttema, ButL'ra, Gardner, &
Prescott, 2ClrJJ ) . Also related is the suggestion that sex diffL'fl'l1Cl'S in ckpn:ssinn
may Jrisc from the male tendency to strive for position i.lnd resources, lc<1ving
many women vulnerable to depression because they huve fewer options (Gilbert,
1992; WL'ncgrat, 1Sl9S).
Deprt'ssion has also been vie\.ved as a social m;:mipulation (HagL'n, 2002; VVatson
& Andrews, 2002). Hagen sees postpartum depression as a " blackmail threat" to
abandon the infant, but otlwr theories can ;dso l'xplain thL' association of postpar
tu_m depression \Vith poor resourres and relationships. fn a n'lated but more gen
eral view, Watson <llld /\ndrews (2002) suggest that depression facilitates "socicd
naYig<ltion" by signaling that current strategies are failing <Jnd nevv' directions arc
needed. This approach echoes psychoanalyst Emmy Cut's (1 9H9) work on produc
tive and unproductive elL-pression. Nettle (2004) notes inadequacies of the social
navigation hypotlwsis and emphasizes the possible adaptive value of neuroticism.
DL'Catanzaro (1 9.SO) proposed that suicide can bt adaptive if an individuJ.l has
no chance for rq;roduction but can increilst: future reproduction of kin by ceasing
to use resources that they could usc instead. DiJta showing that suicides are more
conunon in old <llld sick pl'ople are consistent; hmvever, alternative' explanations
are mailabh:, separation from kin docs not protect against suicide, and there are
no animal examples. In a rt'\'crsc twist on lhis perspective', the benefits of social
support result more from hl'lp given than help received. lndi\iduals who provide
help to others have higher mood ;:1nd incrL'ascd longcvity (R. Brmvn, Dahll'n,

914

EVOLUTJONIZING TRADITIONAL DJSCIPUNES OF PSYCHOLOCY

Mills, Rick, & Biblarz, 1999; S. L. Brown,Nessc, V inokur, & Smith, 2003). The role
of the group is also central toN. B. Allen and Badcock's (2003) model, in which
people carefully monitor what they can contribute to a group. People who realize
they can contribute little retreat into depression that is hypothesized to prevent
active expulsion frmn the group.
These approaches are guitC' different from the prevalent view that depression is
a brain disorder (Andreasen, 1984; Valenstein, 1998; Wolpert, 1999). The brain
mechanisms that mediate 1nood certainly can go awry, but two questions neC'd
consideration. First, is low mood a useful response like cough or ,111 abnormality
unrelated to defenses like epileptic seizures? Second, do individual differences in
vulnerability to depression arise n1ainly fronl primary brain differences or from
brain changes mediated by social experience (C. W. Brown & Harris, 1978; Mon
roe & Sin1ons, 1991)? These are not mutually exclusive alternatives, and most de
pression i s best understood as the outcome of gene x environnwnt interactions
(Caspi ct a!., 2003). Also, there arc different routes to depression, some of which
progress irrespective of environment, others of which arise from life circum
stances, perhaps especially those invoh'ing pursuit of unreachable goals.
Anxiety and dE'pnssion get all the atlt'ntion, but every
emotion is subject to at least two kinds of disorckr: excesses or deficits. For in
stance, pathological jealousy is common, but few clinicians know why jealcmsy
exists (Buss, Larsen, Westen, & Semml'lro1h, 1992). Jealousy may arise for good
reasons (Buss et al., 1999) or from delusions. Feelings of inadequacy make son1e
men think that their partners might \veil prefer someone else <lnd then that they
do prefer someone else. Depression treatml'nt often relieves pathological jealousy
(Stein, Hollander, & Josephson, 1994). The syndrome of pathological lack of jeal
ousy has yet to be described.
Comparable pathologies exist for every C'n1otion. People arc t<lkcn over by
envy, love, suspicion, anger, awe, or rapture. Whether it is normal or abnormnl
depends on the situation. I<ecognizing the evolutionary origins and functions of
emotions provides a framework for describing their disorders and the long
sought scientific basis for distinguishing emotional disorders from emotions
that are si1nply unwanted.
Other Emotional Disorders

BEI-IAVJORAI_, DISORDERS

Other disorders involve inability to control behavior. Most obvious arc the add ic
tions and other habits, but other proble1ns of behavioral control range from e<Jting
disorders to violence.
The human toll taken by addictions is magnified bec;-mse their effects
harm others as well as the addict. A whole iss1w of Addiction \Nas devoted to l'\'olu
tionary approachE'S (Hill & Newlin, 2002), with suggestions about the adaptive
significance of oddiction (Sul!iv,ln & Hagen, 2002), life history thc,,rv (Hill &
Chow, 2002), and the significance of fermentation (Dudley, 2002), among others.
One of the most important evolutionary insights is simplt>, hmve\'L'f. Learning is
chemically mediated, so exogenous subst.1nccs e<m din'ctly stimulate rl'\-vard
n1echanisms (Nesse, 1994; Nesse & Berridge, 1997). The subjective sensations arc
pleasurable, and the associated reinfurcemcnt incn.a:-.vs the frequency of drug-

Addictions

Evolutionary Psychology and Mental Health

915

taking behavior. Aversive withdrawal sympton1s become cues that stimulate fur
ther drug taking. Over time, the subjective pleasurable " liking" wanes, the with
dravval effects become more severe, and the habit strength of "wanting" increases,
trapping the addict in a vicious cycle that may offer little pleasure, even as it con
sumes most of what is valuable in life.
VuLnl'rability to substance abuse results from our novel environn1cnt. The
aY,lilahility of pure chen1icals and clever routes of achninistration increase the
ratL' of drug taking. Tobacco administered via the technological advance of ciga
rettes is the must widespread and harmful addiction, vvith alcohol a close sec
ond. The so-c1lll'd bard drugs of abuse, such as amphetamine and cocaine, act
even more directly on ascending dopamine tracts to establish addiction. Sub
stancL' dbuse is a universal human vulnerabillty to drugs that hijack reward
mech,ln isms.
VVhy peoplL differ in vulnerability is a fundamentally different question.
Those \-vho find it difficult to quit have different gcnl'S and more psychiatric
syn1ptoms (Ponwrleau, FN7). The responsible genes arc not "defective" ; they
GlUSL'd no harm until the modern t'nvironment. Other vulnerability factors arise
from cnvironnwntal exposures, such as adverse circumstances that arouse aver
sive emotions that increase the reinforcing properties of drugs.
Ha[;if::; Vulnerabilities to otlwr habits have related evolutionary explanations.
Carnbling dot'S not directly influence brain chemicals, but it is as potent for son1e
people clS heroin. Men without other options may take big risks to get a possible
big rt'\Vt"lnt thus possibly t'xplaining why poor people 1non.' often plaY the lottery.
Gambling is a bigger problem for men than 1-vomen, probably because over evolu
tionary history substantial resources brought increased mating success for men
n1on' than women. The tendency to persist in games of chance with known long
tcrn1 negative payoffs, such as slot machines, reflects the distortions built into
human decision making (Kahnen1an, Slavic, & Tversky, 1 982). Similarly, our
cvoJvcd bch,wior regulation mechanisms lead to n1uch other nonadaptive behav
ior in modern environments such as watching pornography, going to prostitutes,
habitu<ll web brovvsing, reading cheap novels, and engaging in private rituals,
such <lS organizing and reorganizing a collection of stamps or coins.

Half of iunC'ricans are now overwcight, and a third arc clinically


obet:. They spc'nd billions on books and treatment, but nothing works very well.
Vast amounts of research have tried to understand what is wrong with the heavy
half. An evolutionary appro,1ch suggests a different question: Why are we all vul
nerable to obesity? A silnpk answer is that our behavior regulation mechanisms
wcrl' hapcd in the very different environment of the African savannah where the
penalt} for eating too little was swift and fa_tal. Even when food was plentiful,
obesity' remained rare btcause choices were li1nitcd and getting food involved
burning as many calories per day as a modern aerobics instructor (Eaton, Shostak,
& Konrwr, 19HH).
Attempts to control \veight by willpowL'r leod to the other eating disorders,
anorexia llLT\'OS<l and bulin1ia. Adaptive explanations for anorexia as a \ariant mat
ing str<1tegy h,wc been suggested (Surbey, 1987; Voland & Voland, 1989). Hmvevcr, a
simpln c.:L1rting place is the nhs0rv<1tion that these disorders usually hegln with
strenuous diets. Such diets cause episodes of gorging, a hallmark of bulimiJ, but
Entinx Oi,<ordcrs

916

EvOLUTJONIZfNG TRADITIONAL DrscrPLJNES OF PsYCHOLOGY

life-saving during famine. G orging precipitates shame, feelings of lack of control,


more intense fear of obesity, and new resolutions in a vicious cycle of escalating
anorexia and bulimia. Eating disorders are also fostered by the intense mating
c ompetition in large social groups, augmented by media images that make real
bodies seem inadequate. In light of the pervasiveness of mating competition, this
makes perfect sense (Buss, 1988, 1994). As \vith other syndromes, vulnerability
varies for many reasons.
C ivcn its in1portancc, you might think selection would have
n1ade sex foolproof. Instead, it exe1nplifies tl1e vulnerabilities of .:1 trait shaped by
....ntultiple strong forces of .'-.election (Troisi, 2003). For instance, men compbin
about premature orgus1n while \Vornen cmnplain about lack of orgasm. . Why? Sex
differences in br<.lin nwchanisn1s and differences in anatomic proximity to stimu
lation, yes, but these are proxi1n<1tc explanations. VVhy is the syskm so poorly de
signed for mutu<l l satisf<Jction? Because selection docs not shape mechanisms for
n1utual sCJtisfaction. Women who had orgasms very quickly might well have had
fewer children, as might men \Vho dallied too long when intcrruptiun is likely.
This is c onsistent with the observation th<:1t premature ejaculation is <l problt>1n
mainly for men \Vho an young or fearful.
Another dram,ltic sex difference is 1.vhat it takes to initiate <HOUS<ll. For many
men, the answer is almost any sexual cue, anytinw, any\vlwre (Symons, "1 979).
Pornography is a male pursuit; even magazines thi1t display male bodies Jre bought
mainly by men. Then there is the related problematic issue of why such a wide
range of stimuli arouses men. We might suppose that sdectiun would ensure th;1t
men want only potcntia.tly fertile partners, and most do. However, about 2qi) ,1tT l'X
clusively homosexual, others are preoccupied \Vith immature girls, and many hdvc
fantasy lives that involve domin;1tion or a fetish objt.>c t. One explanation may be ,1n
error managpmcnt theory for why men so system<ltically and optimistically distort
the intentions of wonwn (Hasdton & Buss, 2000). As for why so many indJ,iduals
an.' exclusively hon1osexual, this remains unanswered, but not for want of tlwurics
(Ruse, 19R8).
Sexual Disorders

BRAIN DIS( lRln-:n.s

Public relations campais'11s, many supportt. d by pharmaceutical companies, pro


mote the view that n1ental disordt.'rs ;uc brain disorckrs. This is necessarily true in
the sense that brain changes medi,1tc zdl emotion i1nd behavior. However, slogans
such as "depression is a brain disease" leave the mistaken impression that brain
abnormalities arc always the primary causes and that drugs are the only appropri
ate trt.'atm:.:nt. For son1e disorders such as schizophrenia, bipobr disorder, and
autism, brain abnormalities are indeed i hc primary and usually sufficient cause.
Other disorders, however, c<Jn ocn1r in a brain that is perfectly normal or a br<lin
that was nonnal until it experienced unnatural stimuli such ,1s psychological
tr<uma, drugs of abuse, severe dieting, or trying to work in a hostile bureaucracy.
As noted alre ady, an evolutionary pt.'rspectivc fosters a sophisticated .1sscssnwnt
of the many bctors that explain individual differences. Snnw mental disordL'rs are
normal aversive emotions, others are dysrcgulated emotion:-:;, <Jnd some ;:uisL' from

Evolutionary Psyclzology and Mental Hmltlz

917

factors only distantly related to the normal regulation of en1otions, cognition, and
behavior (Nesse, 1984). We turn to this last group to see what an evolutionary
view can offer.
Schjzophrenia is the most serious comn1on mental disorder. The
symptoms have little to do \Vith a "split n1ind" but instead H'flcct a systematic
breakdown of perception, cognition, and emotion (Jablcnsky, Satorius, & Ern berg,
1 992). W hile precursor syn1ptoms can usually be detected, fulJ-flcdgL'd psychosis
most often begins just as the individual is trying to establish an individual iden
tity in a social group. i\..1any patil' nts first feel excluded, then suspicious, then
frankly paranoid with delusions that others arc trying to harm them. Datil shm.v
ing strong i nfluences of genetic factors Jnd brain changes hmc' convinced most
researchers that the schizophrenias (there an' multiple disordL'rs) JIT best under
stood as the manifestations of hr,1in abnorn1alities. Some have suggestl'd Jdaptivc
functions for symptmns of schizophrenia (J. S. Allen & Sarich, 1 98H; Feicrman,
19H2; jarvik & Chadw ick, 1972), but little evidence supports this idc,l.
Delusions and hallucinations <lrC not part of the routine experience of most hu
mans. They are more like sei7lllTS ,1 nd quite unlike <tdaptivc defenses such as
fever, cough, or anxiety. Schizophrcni;1 prevalence Lltes <.Hc consistent at about
1 % across cuHures (J,1blcnsky ct al. , 1992), undermining the idL'a th<lt novelty ex
plains psychosis. There is zdso strong cvidenct> that schizophrenics hJvc lm.ver
than average RS: .3 of avLrage for m,1les and .5 for femtdcs { AviLl, Thaker, &
Adami, 2()(Jl ; Pulver l't aL, 2004). The same data show no incrcacd fitness of their
close rt'lativcs, arguing against any st'lective benefit manifest in otl;s'r individu
als. It ha.s lwen suggeshd th;1t schizophrenia nli.lY persist " because it is the unat
tractivl', low-fitness cxtnnw of a highly variable InenLll trait that evolved ,ls a
fitness ('good gpnes') indicator through mutual mate choice" (Shil ncr, Mil ler, &
Mintz, 2004). Also, as mentioned alnady, infection has been implicated as an ex
planation for some cases of schizophrenia.
Tradc-uffs Jnd the limits of natural selection mJy be import.1nt. Schizophrenia
is not a uni\'t:rsal human trait like the appendix; it is a rare syndrome. The evolu
tionary question is why natural scledion has not elin1in<1ted such fitness-reducing
gemtic variations. There art' many possibilities. Selection might not be pcnvcrful
enough to purg" rccurrL'nt deleterious mutations from the gene pool. This is un
Jikl'ly bl'causc the uniformity of incidence across cultures argul'S against a muLl
tion occurring in the past 1 00,000 years, long enough to purge most seriously
deleterious mutL1 tions. Another possibility is that so 1nany genes are involved
that sclccti,)n can act on them only weakly. A n'Llted perspccti\'l' is that normal
izing selection can never shape a desib'll parameter to an extremel y narrow zone
(Keller, in press). Even traits coded for by only ,1 few genes are products of inkr
aclions \Vith other gcnl'S ,1nd environmental factors that introduce substi.lntial
variation, leaving some individual:-; Jt maladaptive c'xtreincs.
A phylogcrwtic perspectivl' ofkrs rl'latcd explanations. Human c<1pacities for
language and social cognition have ndvanced at a lightning p<tcc in the past
100,000 .v c,us, almost certainly bccausL' thL'Y offer major fitness ,1 dvantages
(Humphrey, "1976). Such strong selection has costs that might \">'ell predispose to
serious problctns (Crow, 1 997). Schizophrenia genes might also spread if tlwy are
linked to trongly beneficial genes l Burns, in press), but pll\iotrupic effects arc
Schizophrcni11

918

EvoLUTIONIZJNC TRADITIONAL DISCIPLINES O F PsvcHOLOCY

more important. Cliff-edge effects offer a related possibility. For instance, race
horse breeding has resulted i n longer and t h i n ner leg bones that increase speed
but are increasingly prone to fracture. I f son1e mental characteristic gives increas
ing fitness up to a point where catastrophic fa ilure becomes a problem, such cliff
edge effects could account for the genetic patterns seen i n schizophrenia and
n1anic-deprcssive i l l ne:-;s (Ncsse, 2005) .
The sa m e l i nes of reasoning apply also to other seven_' mental diseases th at a l so
have a n i n cidence of tlbout 1 in l OO autism in particular. Baron-Cohen (2002) has
suggested that the manifestations of autism arc examples of a pathological ex
treme of cogn itive styles that ore typically male. Thb would help to explain the
predom i n ance of males who get the disorder.
Otlwr hypotheses also tksen:c con sideL1tiun. For inst,1ncc, it bas bc'L'n con
firm,:d rl'ccntly that tlw rates of schizophrenia increase d rt.1 m,1 tical ly for childn'n
who \..VL'n: conceivLd \Vhen their fathers vverc over 10 ( Byrnc, Ag<.:'rbo, E1.va ld, Ec1ton,
& Mortl'nsen, 2003; M,1laspina el al., 2002). Cencs transmitted by the mother have
divided only 24 t iml'S pl'f generation, com}hlH'd to SOU cell divisions for the DNA
i n sperm of older L1tlwrs, suggesting thilt many cases of schizophrenia arisl' from
recurring Ill'W mutations. Among other implications, this falsifies the idea that
\.VOnwn chooSl' older men to gl't good genes.
Obse;;sivc-COJilp iil:;itll' Disorder ()bsessivc-cmnpulsive d isordl;r (()CD) also shows
subsL.l ntial heritab ility and ,1 l 'X1 incidence. Tlw condition is characterized by rit
u a l i s tic rq_tctitive bt>h,wiors and fears that sonw small O\'l'rsight w i l l lc,ad to d i s
aster. People 1vith OCD tend to have <l smaller than normal e<1udate nucleus in the
pons, and as already nott.' d , some cases result from an autoilnmune reaction to
streptococcal infection (Swedo, Lctmard, Gan'l'y, & M i ttleman, 1996). It rcn1,1ins
uncl'rLlin if OCD is dysrcgulation of useful nwchanisn1s or i f it is something en
tirely separate (Rapoport & Fiske, 1998).

ATITNTION D JSOJ.;:DERS

The cvolution,ny origins of attention deficit hyperactivity disorder (ADHD ) have


been the focus for several articles suggesting possible functions ( Baird, Stevenson,
& Williams, 2000; Brody, 2ll01; jensen et a!., 1997; Shcll<y-Trcmblay & Rosen, 1996)
or th,1t i t is a facultative adaptation to certain environments (Jensen et al., 1997).
The striking male bias o f the sex ratio, over 5 to 1, gives hints that ADHD 1nay sim
ply be the extreme end of a continuum on which males tend to be higher than fe
males, much a k i n to a reet:nt suggestion about <mtism ( Baron-Cohen, 2002). I n the
ancestral en\irunnwnt, a tendency to move quickly to a new activity when current
efforts ,1re unproductive' is a foraging strategy that may pay off 1nnre for hunting
males than gatlwring females. As for the capacity to sit in one place indoors for
hours under L'nforced contact \Vitll a boring book, that i s t-iO far frmn anything the
natural l'nvironment ever required, it is astounding that any of us can do it. The
heritability of ADHD is high, and associations with candidate genes, notably
DRD-l, offer promising leads (Biederman & Spencer, 19Y9). Because the 71\ a l lele is
common and in ;-,trong l inkage disequilibrium, it mJy ho\'e experienced recent pos
itive seiLction (Crady ct al., 2003).

Evolutionary Psychology and Mcnlnf Hcnlth

919

RELAT!ONSHIP DIFF!CULTIES

The enormous importance of relationships in causing (and occasionally curing)


n1en t a l disorders i s so obvious that it _i s easy to neglect its significance. Mental
health professionals often bclit'Ve thot normal relationsh ip s are worm, loving, and
bacd. on moral and emotional cmnn1itrnents. VVould that it were o. By contrast,
an evolubonary view of reL1 tionships emphasiZl'S the costs and pzryoffs of d i ffer
ent social strategies in Lcrn1s of resources, reciprocal hdp, or i nclusive fitness that
can explain most tendencies to <1Hruism (Fiske, 1992; l-l i n dc', 1979; Hofer, 1984;
Kirkpatrick, 1998). Evol utionary approaclll's hmie aLso emphasized the prevalence
of deceptive strategies and self-deception ( Krebs & Dawk i ns, 1 9H4; Lnckard &
Paulhu, "1988; I-\ue, '\ 994; Slav i n & Kriegman, 1 992; Trivcrs, 20UO), thus opening a
l i ttk-travl'lcd avenul' betwet>n EP ,1nd psychoanalysis. Other ch<lpters i n this
Handl100k shm-v how selection shapL'd the lllL'Chtmisms that nwdiatc rcL1tionships,
k n ovvledgt' crucial to understanding hovv relationships go vvTong.
Scxu,1 l relationships and strategies have been a focus for EP, and the results of
that research arc ripe for application to clin ical situations ( Buss, 1 994; Buss &
M a l a mulh , 1996). For species \'\'i t h mating systems s i milar to those of hunt.:ms,
careful choice nf partners benefits females more th<ln males, und efforts to get
milny matings lwnefit females n1on: than mahs. As a result, sexual jL',l lousy i s
morL' intense for n1ahs, ,1 nd opposition to maks g i v i ng resources to others tl'nds
to bP greater for women ( Buss & Schmitt, 199]). Moreover, as every grandmother
k nlHV S, the facts of prq:;nancy and mz dc' jealousy makL! short-term nwtings less
costly and predictably more common i n malts.
Cltild Abuse C h i ld abuse h a s been a major focus for mental lwalth preVLntion
and trcatmL'nt. Understa n ding the l'\'olutionary origins and functions of attach
ment has helped to explain why most parents do not abusL' their children despite
provocations ( Bowl by, 1984). /-\n evolutionary perspective n1otivated two bch<Jv
ior'-1 1 ecologists to ask the now-obYious question: b child abuse mort' common i n
f<l m i l ies with a stepparent? Their atounding result i s that death <1 t t-he hands of
parents i s .SO t i mes more common if there is a shpparcnt i n the hcmsL' ( Daly &
W ilson, 1 9?--\H). T h is f i n di ng i s com_rnnnly presented in a context franwd by the tc'n
dency of m<.1 lcs i n many species to k i l l a l l unwca1wd i n hn ts shortly ,1 ftcr they
take oVL'r a fem;:1 lc mating group (I-I rely, ] 977). I lowcver, tlw mat i ng pattLrn of hu
mans docs not routinely involH' males fighting to take ovtr a harem \V ith multi
ple fcrna [es who clTL' nursing i nf.lnts, S O tJW clna Jogy i s incorrL'Ct. l nstl>ad, thL'
mt'cha nisms that protect babies i n fam i liL'S w i th two related parents seem more
prone to fai l in nconst ituted fa m i l ies (GC'llcs & Lancastc'r, 1 987).

CONCLUSIONS
A l l i t \\'Otlld take i s d iscovery of a single cure. Even d i scovery of the def i n i t i ve
caust' for a single illness would do. If EP let1ds d irectly to such a treatment or dis
covery, it w i l l g rovv quickly. Is this Z! legiti mate hope? Superficial ly, the a nsvvcr is
no. I nstead of explanations for why some i nd ividuals gd sick c1nct others do noC
EP explains wl1y mechanisms a rc the vvay they ,:ne and vvhy natural selection
has not e l i m i n a ted the genl'tic \,1riatinns that result i n d isease for so1ne. Its most

920

EVOLUTIONIZING TRADITJON!\L DISCIPLINES or PSYCJ--IOLOCY

profound contribution i s a solid framework for understanding hovv behaviors are


regulated to accomplish the many con f l ic ting tasks of life, from getting food and
surviving, to finding mates an d protecting children. Instead of vic,wing one
kind of life as normal and others as deviations, it sees the inherent conflicts i n
relationships, the struggles that go on i n groups, and the dilemiTI<lS every person
faces to allocate efforts among a host of competing needs. Far from providing a
rigid and cold perspective, c:m evolu tion<1ry v ievv fosters deepl'r e1npathy for the
challenges we all face and deeper amazement that so many people arc able to
f i nd loving relationships, meaningful \.Vork, and a \Vay to juggle a bevy o f re
sponsibi l i t ie s w i t h good humor and even joy.
Does this presage a new kind of psychotherapy? There certainly are major iin
plications for how to do psychotherapy (Cilbert & Bailey, 2000) and psychoanaly
sis (Slavin & Krieg1nan, 1992), but they do not constitute a new kind of therapy
competing with hundreds of others. Every kind of therapy should n1ake use of
evolutionary principles. The juggernaut now is psychopharmacology, soon to be
united with genetics to yield nt:w methods for tnanipulahng c_motions and be
havior that we cannot yet imagine. I n the near futu re, they should yield more ef
fective treJtments for schizophrenia <lnd manic-depressive i l l ness. Evolu t ionary
investigations can assist in these quests by defining phcnotypt's and identifying
evol ved behavior regulation tnechanisms. These same gtnctic ,1nd pha.rmat:ologic
technologies will make it easier to 1nanipulate normal <lS \vei l as abnorm<ll l'tno
tions. Tlwir focus exclusively on prox i mate perspectives holds tlw risk t h a t we
will block negative emotions and promote positive ones cYen before \VC grasp
why they exist 11t all. Cautionary tales ;1bound. For instance, vvhen cortisol was
first discovered, it was used to rel ieve the symptcnns of < 1 1 k i n d s of inf L:1mn1<1t i on.
I t worked like a miracle and patients felt better, so why not? J n a few years, how
ever, the serious consequences of blocking these normJ.l reactions became clt,ar.
An evolutionary view of 1nental disorders docs not nwan acnpting the pains
a n d difficulties of the hum<Jn condition. Many Cln be prcventc>d or eli minated
s afely, but only when we better understand the functions of nl'gative emotions.
Furthermore, a signal detection analysis of their regulation suggests that in many
s ituations they are about as useful as pain after surgery. I t i s l'ven cmKeivdbJe
that the personality tendencies that foster envy and bitter competition, to say
nothing of violence, m i gl1t we'll be n1odifiahle. None of this \Vi l l be simph', how
ever. Moreover, every such new major capacity for intervention \vi l l be far safer
and more sensible i f developed in a sophisticated evol ution<uy context.

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