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EVOLUTIONARY CLASSIFICATION DISORDER: x |
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A |
B |
C |
D |
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1.
Malf- |
1.1 |
1.1A |
1.1B |
1.1C |
1.1D |
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1.2 |
1.2A |
1.2B |
1.2C |
1.2D |
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2.
Dys- |
2.1
Environmental Uniqueness |
2.1A |
2.1B |
2.1C |
2.1D |
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2.2 |
2.2A |
2.2B |
2.2C |
2.2D |
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3. Asocialisation |
3.1 By-product (trade off) |
3.1A |
3.1B |
3.1C |
3.1D |
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| 3.2 Defense |
3.2A | 3.2B | 3.2C | 3.2D | ||
I argue that the general evolutionary explanations (vertical y-axis) and the organism-specific archetypal (functional) disruption (horizontal x-axis) should be grouped together because they are complementary for any organismic dysfunction.
General evolutionary explanations have been derived from the work of a number of researchers in the area (most notable is Nesse (1999)) and my system nicely mirrors that of the the Bio-PsychoSocial model (Engel 1980) used in psychiatry to develop formulations to explain why a mental disorder has developed in a particular individual at that point in their life course, which ideally should be considered alongside atheoretical DSM diagnoses. Malfunction correlates with "Bio", Dysfunction with "Psycho" and Sociability with "Socio". Maintaining a BPS framework makes the evolution from an atheoretical to a theoretical classification system that much easier, whilst providing a solution for the Descartian Bio-PsychoSocial dualism inherent in BPS model and DSM, which leads to multiple problems that I have indicated elsewhere.
There are three evolutionary explanations, corresponding to the BPS framework: Disorders of 1. Malfunction, 2. Dysregulation, and 3. Sociability. These are defined below. I propose that there is a left to right flow effect, with disorders of Malfunction, Dysregulation and Sociability leading to the functional disruptions of the archetypal systems (A-D).
Archetypal disruption is derived mainly from the work of Stevens & Price (2000), who argue that mental disorders result from a failure to meet biosocial imperatives by lifespan-specific context-sensitive archetypal propensities.
The association between these processes has been modelled by plotting them along x-y axes, with a resultant grid of 6 general evolutionary explanations and 4 archetypal disruptions, resulting in 24 possible evolutionary classifications.
Thus, each DSM disorder may have anywhere between 1-24 possible evolutionary explanations. Each archetypal disorder may have up to 6 possible causes, and each evolutionary explanation (e.g. disorders of modular malfunction - 1.1) may disrupt anywhere between 1-4 of the 4 evolved archetypes.
EVOLUTIONARY CLASSIFICATION DISORDER: x |
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|
A |
B |
C |
D |
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1.
Malf- |
1.1 |
1 |
7 |
13 |
19 |
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1.2 |
2 |
8 |
14 |
20 |
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2.
Dys- |
2.1
Environmental Uniqueness |
3 |
9 |
15 |
21 |
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2.2 |
4 |
10 |
16 |
22 |
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3. Asocialisation |
3.1 By-product (trade off) |
5 |
11 |
17 |
23 |
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| 3.2 Defense |
6 | 12 | 18 | 24 | ||
Definitions of the 3 types of Evolutionary Explanation and 4 types of Archetypal Disruption follow:
 | Evolutionary explanations
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Archetypal disruption
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There is repetition of some DSM mental disorders*** because this classificatory system is aetiology-based, in contrast to DSM's descriptive classificatory system. Therefore, there may depressive disorders or anxiety disorders, for example, that result from any or all of these three pathways. The specific aetiology may or may not have bearing on the symptoms, severity or course of the disorder.
*** DSM mental disorders:
| Developmental - Mental Retardation ; Learning disorders ; Autism, Asperger's ; ADHD ; Tic |
|
Cognitive Disorders - Delirium ; Dementia ( Alzheimer's , Vascular , Pick's , CJD , Substance-induced ) ; Amnestic ; Personality change due to general medical disorder |
| Substance-Related disorders |
| Psychotic disorders - Schizophrenia ; Schizophreniform ; Schizoaffective ; Delusional ; shared psychotic ; due to general medical disorder |
| Mood disorders - Depressive; Bipolar I ; Bipolar II ; Dysthymic ; Cyclothymic ; due to general medical disorder |
| Anxiety disorders - Panic ; Agoraphobia ; Specific phobia ; Social ; OCD; PTSD ; GAD ; Separation anxiety ; due to general medical disorder |
| Somatoform disorders - Somatisation ; Conversion ; Pain ; Hypochondriasis ; Body Dysmorphic ; Somatoform |
| Factitious disorders |
| Dissociative disorders - Amnesia ; Fugue ; Identity ; Depersonalisation |
| Sexual disorders - Dysfunction ; Paraphilias ( Exhibitionism , Fetishism , Frotteurism , Pedophilia , Masochism , Sadism , Transvestic Fetishism , Voyeurism ) |
| Gender Identity disorders |
| Eating disorders - Anorexia Nervosa, Bulimia Nervosa |
| Sleep disorders - Insomnia ; Hypersomnia ; Parasomnia |
| Impulse-Control disorders - Explosive ; Kleptomania ; Pyromania ; Pathological Gambling ; Trichotillomania |
| Adjustment disorders - with depressed mood ; anxiety ; mixed ; conduct disturbance |
| Personality Disorders - Paranoid ; Schizoid ; Schizotypal ; Antisocial ; Borderline ; Histrionic ; Narcissistic ; Avoidant ; Dependent ; Obsessive-Compulsive |
| Relational problems - parent-child ; partner ; sibling |
| Problems related to abuse or neglect - child physical abuse ; child sexual abuse ; child neglect abuse ; adult physical abuse ; adult sexual abuse |
| Additional - Non-compliance ; Malingering ; Borderline intellectual functioning ; Age-related cognitive decline ; Bereavement ; Spiritual problem ; Acculturation problem |
There have been previous attempts to classify mental disorders using an evolutionary framework. As early as 1863, Karl Ludwig Kahlbaum (1828 -1899) of East Germany suggested doing so in "Grouping of psychiatric diseases and the classification of mental disorders" based on Carl von Linné's classification of animals and plants (Kahlbaum KL, 1863). Kahlbaum challenged the established psychiatric nosology based on an evolutionary perspective only 4 years after Darwin's epoch-making publication On the Origin of Species by Means of Natural Selection (1859), whose relevance to psychiatric research Kahlbaum mentioned explicitly [p.178]. Kahlbaum considered psychiatric disorders to be "experimental states provided by nature" and he emphasised what he called the "clinical method" in psychiatry, analogous to the methodology of other natural sciences, consisting of unprejudiced behavioural observation, thorough description and recording of all psychic and somatic phenomena (Kahlbaum, 1874). Kahlbaum's intention was to link the empirically acquired clinical material with neuropathological correlates. The clinical method became re-invented in ethology as a valuable process of data acquisition (Brune, 2000).
Nesse
(1999) suggests the following evolutionary explanations for disease
Novelty
From
pathogens or competitors
From
aspects of the modern environment
Trade-offs
Genes
with costs as well as benefits
All
traits have positive and negative trade-offs
Constraints
Accidents
and mishaps too rare to shape defenses
Defenses that are often confused with diseases
He argues that an evolutionary approach encourages sharp attention to distinction between manifestations of disease that are defects versus those that are defenses, and it forces us to acknowledge that much suffering can be adaptive.
Bracha (2006) argues that classification of "stress and fear circuitry disorders" should be mode-of-acquisition and brain-evolution based.
He argues for an evolutionary classification of anxiety disorders based on evolved fear circuitry traits that have outlived their usefulness, divided by four "time-depths" (inspired by the theory of the emergence of culture by Klein & Edgar, 2002 and derived from research reviewed by Dawkins (2004).
Bracha argues that each Era has produced a different type of fear-circuitry associated with characteristic anxiety disorders:
| Era | Time-depth | Fear circuits | Inheritance type |
| 1. Mesozoic Era mammalian-wide evolved fear circuits (fear adaptations) |
140,000,000 yrs | Extreme fear of adult non-kin males in toddlers
Extreme fear of high elevations in adults Separation anxiety |
"Normal fears", probably hard-wired by wild-type alleles nearing fixation in humans and most other mammals |
| 2. Cenozoic Era simian-wide evolved fear circuits |
20,000,000 yrs | Fear of snakes
Fear of reptiles Fear of confined spaces Fear of darkness Fear of water immersion CO2-induced panic attack (fear of suffocation during forest fire?) Lactate-induced panic attack (fear of muscle exhaustion while under predation?) Acute-fear-induced jaw-clenching and chronic stress-induced incisor-grinding |
Limbic circuits posited to be firm-wired (strongly prepotentiated) by alleles that are the major variants in a stable polymorphism. As a result, simians may have a phylogenetically prepotentiated predisposition to acquire instantaneously fears of certain objects or situations that may have once have posed a life threat to early simian ancestors. |
| 3. Mid/Upper Paleolithic H. Sapiens-wide evolved fear circuits |
200,000-70,000 yrs (mid)
70,000-12,000 yrs (upper) |
Compulsive lock checking
Compulsive stove checking Compulsive washing and obsessive fear of contamination Compulsive hoarding (especially of tools, weapons and leather goods) Extreme fear of insects or mice Fear of scrutiny by non-kin conspecifics (Generalized Social Phobia) |
Firm-wired in a small % of extant humans by common minor alleles that spread from single ancestral copies primarily driven by mate choice related stabilising selection |
| 4. Neolithic culture-bound genome specific evolved fear circuits | 12,000 years | UNLOCALIZED (PSEUDO-SOMATIC) SYMPTOMS IN THE
CONVERSIVE DISSOCIATIVE SPECTRUM:
Pseudo-cytokine-driven (pseudo-infectious) fear symptoms Epidemic pseudo-cytokine driven (pseudo-infectious) fear symptoms Primary dissociative disorder? PSEUDO-LOCALIZED (PSEUDONEUROLOGICAL “CONVERSIVE”) Psychogenic non-epileptic attacks (pseudoseizures) Epidemic sociogenic illness “epidemic hysteria” Psychogenic pseudoparalysis (e.g. limping) Psychogenic imbalance (Pseudocerebellar symptoms) Psychogenic blindness |
Species atypical (psychopathological) fear circuits firm-wired (prepotentiated) in a small no. of extant humans by previously rare allele variants, spread after the emergence of human Neolithic tribalism (cultures) & mostly by gene-culture co-evolution & by mate-choice driven stabilising selection. |
More in detail can be found in the Anxiety Disorders page.
Bracha argues for a new category - "overconsolidational disorders" - "anchored around PTSD". He suggests a broader "overconsolidational spectrum category" that "straddles the fear circuitry spectrum disorders and the affective spectrum disorders categories".
