Evobiopsychosocial medicine.

The biopsychosocial model remains the de facto framework of current healthcare, but lacks causational depth, scientific rigour, or any recognition of the importance of evolutionary theory for understanding health and disease. In this article it is updated to integrate Tinbergen's four questions with the three biopsychosocial levels. This 'evobiopsychosocial' schema provides a more complete framework for understanding causation of medical conditions. Its application is exemplified by tabulating depression, rheumatoid arthritis and COVID-19 within its format, which highlights the direct research and practical applications uniquely offered by evolutionary medicine. An evobiopsychosocial framework can serve as a useful tool to introduce evolutionary concepts into mainstream medicine by highlighting the broad and specific contributions of evolutionary analysis to researching, treating and preventing health conditions, providing a suitable next step for the mainstream model of medicine.

How evolutionary science can help us understand vaccine refusal in the COVID-19 pandemic.

Unvaccinated people have a mortality rate from COVID-19 that is 32-fold that of fully vaccinated people. Yet, in the UK, more than 4% of adults have not accepted a vaccine to protect them against COVID-19 and at the time of writing only 73% of people were fully vaccinated. Psychological and societal factors underlying vaccine hesitation or refusal are complex. In this paper, we use evolutionary science to help explain how vaccine refusal can be the result of an historic adaptation to protect against the repetition of past trauma, including, for many, that of systemic racism and/or deprivation, and misguided attempt to preserve fertility. We discuss some resulting cognitive biases and conclude with recommendations for practice.

Evolutionary biology: an essential basic science for the training of the next generation of psychiatrists.

Evolutionary science can serve as the high-level organising principle for understanding psychiatry. Evolutionary concepts generate new models and ideas for future psychiatric study, research, policy and therapy. The authors accordingly make the case for the inclusion of evolutionary biology in the postgraduate education of psychiatric trainees.

Evolutionary Psychology of Eating Disorders: An Explorative Study in Patients With Anorexia Nervosa and Bulimia Nervosa.

Prior research on non-clinical samples has lent support to the sexual competition hypothesis for eating disorders (SCH) where the drive for thinness can be seen as an originally adaptive strategy for women to preserve a nubile female shape, which, when driven to an extreme, may cause eating disorders. Restrictive versus impulsive eating behavior may also be relevant for individual differences in allocation of resources to either mating effort or somatic growth, reflected in an evolutionary concept called "Life History Theory" (LHT). In this study, we aimed to test the SCH and predictions from LHT in female patients with clinically manifest eating disorders. Accordingly, 20 women diagnosed with anorexia nervosa (AN), 20 with bulimia nervosa (BN), and 29 age-matched controls completed a package of questionnaires comprising measures for behavioral features and attitudes related to eating behavior, intrasexual competition, life history strategy, executive functioning and mating effort. In line with predictions, we found that relatively faster life history strategies were associated with poorer executive functioning, lower perceived own mate value, greater intrasexual competition for mates but not for status, and, in part, with greater disordered eating behavior. Comparisons between AN and BN revealed that individuals with BN tended to pursue a "fast" life history strategy, whereas people with AN were more similar to controls in pursuing a "slow" life history strategy. Moreover, intrasexual competition for mates was significantly predicted by the severity of disordered eating behavior. Together, our findings lend partial support to the SCH for eating disorders. We discuss the implications and limitations of our study findings.

Evolutionary psychiatry: a new College special interest group.

Evolutionary science remains an overlooked area in psychiatry and medicine. The newly established Royal College of Psychiatrists' Evolutionary Psychiatry Special Interest Group aims to reverse this trend by raising the profile of evolutionary thinking among College members and others further afield. Here we provide a brief outline of the importance of the evolutionary approach to both the theory and practice of psychiatry and for future research.

Eating disorders and intrasexual competition: testing an evolutionary hypothesis among young women.

The sexual competition hypothesis (SCH) contends that intense female intrasexual competition (ISC) is the ultimate cause of eating disorders. The SCH explains the phenomenon of the pursuit of thinness as an adaptation to ISC in the modern environment. It argues that eating disorders are pathological phenomena that arise from the mismatch between the modern environment and the inherited female adaptations for ISC. The present study has two aims. The first is to examine the relationship between disordered eating behavior (DEB) and ISC in a sample of female undergraduates. The second is to establish whether there is any relationship between disordered eating behavior and life history (LH) strategy. Participants completed a battery of questionnaires examining eating-related attitudes and behaviors, ISC, and LH strategy. A group of 206 female undergraduates were recruited. A structural equation model was constructed to analyze the data. ISC for mates was significantly associated with DEB, as predicted by the SCH. DEB was found to be predicted by fast LH strategy, which was only partially mediated by the SCH. The results of this study are supportive of the SCH and justify research on a clinical sample.

Rebuilding mental health services in Iraq.

Since 2003 Iraq has experienced significant challenges in reforming and rebuilding its health services. A national mental health survey reported a high level of mental health problems consistent with a country that has experienced widespread violence and trauma. The survey also highlighted limited access to services. This paper outlines developments in and plans for mental health services in Iraq.

A reformulation of the social brain theory for schizophrenia: the case for out-group intolerance.

This article proposes a reformulation of the social brain theory of schizophrenia. Contrary to those who consider schizophrenia to be an inherently human condition, we suggest that it is a relatively recent phenomenon, and that the vulnerability to it remained hidden among our hunter-gatherer ancestors. Hence, we contend that schizophrenia is the result of a mismatch between the post-Neolithic human social environment and the design of the social brain. We review the evidence from human evolutionary history of the importance of the distinction between ingroup and out-group membership that lies at the heart of intergroup conflict, violence, and xenophobia. We then review the evidence for the disparities in schizophrenia incidence around the world and for the higher risk of this condition among immigrants and city dwellers. Our hypothesis explains a range of epidemiological findings on schizophrenia related to the risk of migration and urbanization, the improved prognosis in underdeveloped countries, and variations in the prevalence of the disorder. However, although this hypothesis may identify the ultimate causation of schizophrenia, it does not specify the proximate mechanisms that lead to it. We conclude with a number of testable and refutable predictions for future research.

The evolutionary psychology of eating disorders: female competition for mates or for status?

The relationship between eating disorders and female intrasexual competition (ISC) was studied. More specifically, it was predicted that Female ISC for mates would be the strongest predictor of bulimia, and that, in contrast, Female ISC for status would be the strongest predictor of anorexia nervosa. A group of 202 undergraduate women, attending the University of Arizona, Tucson, USA, participated in this study. These respondents completed surveys that contained the following measures: the Female competition for mates scale, the Female competition for status scale, the General Competitiveness Scale, the Eating Disorders Inventory (EDI), and an additional measure specific to Anorexia. The internal consistencies of the measures were computed using Cronbach's alpha, and the measures were found to have adequate measurement reliability. Correlations were computed and a structural equation model was constructed for all the subscales within the measures. The resulting model demonstrated that ISC for mates was ultimately the driving factor that contributed to Female competition for status, General competitiveness, Perfectionism, Body dissatisfaction, Drive for thinness, and both Bulimia and Anorexia. Contrary to initial expectations, the results supported a mostly spurious causal relationship between Female competition for status and anorexia, with the only indirect causal effect being through the influence of perfectionism, which was uniquely on anorexia and not on bulimia. The role of perceived personal and Ideal partner mate value was also explored. Although they were strongly positively related to each other, these were shown to have nearly equal and opposite effects on body dissatisfaction.

Tyranny and mental health.

Tyrannical states came into existence with the emergence of the state as a socio-political phenomenon a few thousand years ago and are, therefore, novel creations from the standpoint of human evolution. A recent and particularly virulent form of tyranny was invented during the twentieth century in the form of totalitarianism. Such states utilise physical and psychological coercion as their primary method of governance. It is proposed that this will have mental health consequences on both the rulers and the ruled. The psychological roots of tyrannical systems are explored and some of the possible socio-psychological effects are discussed. The Iraqi Ba'th regime is used as an exemplar of a third world totalitarian state. It is suggested that the prevention of mass violations of basic human rights should become an international responsibility and this may, therefore, require a redefinition of the concept of sovereignty. Furthermore, it is proposed that the international community should share the responsibility of assisting in the process of social repair in the aftermath of the fall of tyrannical states.

Does having offspring reduce the risk of suicide in women?

OBJECTIVES: To assess the effect of having offspring, dependant offspring (<18 years), non-dependant offspring (> 18 years) and no offspring on suicide rates in women. Also to ascertain whether the offspring living at home or away from home altered the outcome. METHODS: Sixty records held by the coroner of female suicides in Rotherham over a 10-year period (1991-2001) were studied. The 1991 Census for South Yorkshire and the Office For National Statistics (England and Wales) provided comparative data for the general population. Data obtained for both groups included the age of the woman, number of children, age of children, whether the children lived with their mother or away from home. The results were subjected to chi-squared statistical analysis. RESULTS: There was no difference in the percentage of childless women when comparing the female suicide population of Rotherham with the general female population. However, females with offspring living at home regardless of age were significantly underrepresented in our sample (P < 0.001). CONCLUSION: The protective effect offspring confer on their mother against suicide appears to operate so long as the offspring lives at home irrespective of off spring's age. The protective effect appears to be lost once they leave home. These findings are discussed in the context of the kin selection hypothesis and deCatanzaro's Darwinian hypothesis on human suicide. (Int J Psych Clin Pract 2004; 8: 25-29).

An evolutionary hypothesis for obsessive compulsive disorder: a~psychological immune system?

A new hypothesis is presented within the framework of evolutionary psychology that attempts to explain the origins of obsessive-compulsive disorder. It is suggested that obsessions and compulsions originate from the overactivity of a mental module that the majority of humans possess and has the function of generating risk scenarios without voluntary intervention. It is hypothesised that obsessional phenomena function as an off-line risk avoidance process, designed to lead to risk avoidance behaviour at a future time, thus distinguishing it from anxiety and related phenomena as on-line emotional states, designed to lead to the avoidance of immediate and direct risks. Finally, the hypothesis makes a number of specific predictions that are testable and refutable. It is contended that the present hypothesis if supported by empirical evidence could serve as a basis for future research on this important disorder.