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A natural history of paranoia Towards a Darwinian psychodynamics

A natural history of paranoia Towards a Darwinian psychodynamics. Andreas De Block & Pieter Adriaens (Nijmegen (NL) /Leuven (B)) Human Behavior and Evolution Society Berlin, July 2004. Overview. 1. Some history 2. Dimensional versus categoric 3. The distributional model

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A natural history of paranoia Towards a Darwinian psychodynamics

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  1. A natural history of paranoia Towards a Darwinian psychodynamics Andreas De Block & Pieter Adriaens (Nijmegen (NL) /Leuven (B)) Human Behavior and Evolution Society Berlin, July 2004

  2. Overview • 1. Some history • 2. Dimensional versus categoric • 3. The distributional model • 4. The harmful dysfunction model • 5. The Darwinian psychodynamics model • 6. Darwinian psychodynamics and paranoid schizophrenia • 7. Darwinian psychodynamics and creativity A Natural History of Paranoia

  3. 1. Some history From queen of madness to schizophrenic subtype  Greek antiquity: - (‘out of mind’)  19th century: paranoia versus dementia praecox (schizophrenia)  Today (DSM-IV): A Natural History of Paranoia

  4. Emil Kraepelin (1856-1926) A Natural History of Paranoia

  5. Diagnostic and statistical manual of mental disorders (DSM-IV, 1994) A Natural History of Paranoia

  6. 2. Dimensional versus categoric • DSM-I (1952) & DSM-II (1967): a dimensional perspective • ‘A continuum between mental health and mental illness’ • DSM-III (1980) & DSM-IV (1994): a categoric perspective • ‘Mental disorders differ qualitatively from normality, as well as from each other’ • Evolutionary psychiatry’s distributional model • Evolutionary psychiatry’s harmful dysfunction model A Natural History of Paranoia

  7. 3. The distributional model • What? Mental disorders are real blow-ups of very useful adaptations • Why blow-ups? ▪ Smoke detector principle ▪ Lack of fine-tuning ▪ Childhood experiences • Which illnesses? Paranoid personality disorder, delusional disorder, … • Problems? Cannot account for bizarre delusions in (paranoid) schizophrenia A Natural History of Paranoia

  8. 4. The harmful dysfunction model (Wakefield 1997) • What? ‘A harmful failure of internal mechanisms to perform their naturally selected functions’ (Wakefield 1999, 374) • Which illnesses? Schizophrenia,… • Why failure? ▪ Neuropathology, genetics, neuroimaging ▪ Schizophrenia’s heritability ▪ Decrease of reproductive success • Problems? Cannot account for schizophrenic subtypes A Natural History of Paranoia

  9. Schizophrenia’s subtypes • Four subtypes: paranoid, disorganized, catatonic & undifferentiated • Schizophrenic subtypes do not ‘breed true’ Some quotes: ▪ ‘[T]he aetiology of subtypes may differ from the aetiology of schizophrenia’ (Onstad et al. 1991, 203). ▪ ‘Familial factors strongly affect an individual’s liability to develop the syndrome of schizophrenia but do not greatly influence the specific subtype that will emerge’ (Kendler et al. 1988, 60). A Natural History of Paranoia

  10. 5. The Darwinian psychodynamics model • What? ‘Some mental disorders can be defined by referring to the fixated and overactive use of defences, cognitive mechanisms, and the like, in a context where either no defences are needed, or other defences would be more appropriate’ • Which illnesses? Paranoid & catatonic schizophrenia, OCD, certain paraphilias,… • Why psychodynamic? Freud: some mental illnesses are due to the fixation of particular defense mechanisms (e.g. the case of Daniel Paul Schreber) • Problems? Cannot account for many other mental illnesses A Natural History of Paranoia

  11. John Bowlby (1907-1990) & Sigmund Freud (1856-1939) A Natural History of Paranoia

  12. 6. Darwinian psychodynamics and paranoid schizophrenia • Brain abnormalities in schizophrenia cause abnormal sending and filtering of information • ‘Hemispherical confusion’ & lack of indexicality resulting in: ▪ Inappropriate defence mechanisms, e.g. suspicion ▪ ‘Fight or flight’-response ▪ Overactivity of Theory of Mind Module • If suspicion proves ineffective, other evolved strategies are developed: ▪ Megalomania ▪ Catatonia A Natural History of Paranoia

  13. 7. Darwinian psychodynamics and creativity • The interconnectivity of mental modules (transmodularity) enhances human creativity (Mithen 1996) • Being able to link up proper and actual modular domains (Sperber 1994) is an important adaptation • Paranoid schizophrenics are unable to discriminate between proper and actual domains of suspicion A Natural History of Paranoia

  14. Conclusion Meet some of evolutionary psychiatry’s models: • The distributional model (PPD, Delusional disorder,…) • The harmful dysfunction model (Schizophrenia,…) • The darwinian psychodynamics model (Paranoid schizophrenia, OCD,…) A Natural History of Paranoia

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