A natural history of paranoia towards a darwinian psychodynamics
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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

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
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


1 some history
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


Emil kraepelin 1856 1926
Emil Kraepelin (1856-1926)

A Natural History of Paranoia


Diagnostic and statistical manual of mental disorders dsm iv 1994
Diagnostic and statistical manual of mental disorders (DSM-IV, 1994)

A Natural History of Paranoia


2 dimensional versus categoric
2. Dimensional versus categoric (DSM-IV, 1994)

  • 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


3 the distributional model
3. The distributional model (DSM-IV, 1994)

  • 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


4 the harmful dysfunction model wakefield 1997
4. The harmful dysfunction model (Wakefield 1997) (DSM-IV, 1994)

  • 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


Schizophrenia s subtypes
Schizophrenia’s subtypes (DSM-IV, 1994)

  • 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


5 the darwinian psychodynamics model
5. The Darwinian psychodynamics model (DSM-IV, 1994)

  • 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


John bowlby 1907 1990 sigmund freud 1856 1939
John Bowlby (1907-1990) & Sigmund Freud (1856-1939) (DSM-IV, 1994)

A Natural History of Paranoia


6 darwinian psychodynamics and paranoid schizophrenia
6. Darwinian psychodynamics and paranoid schizophrenia (DSM-IV, 1994)

  • 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


7 darwinian psychodynamics and creativity
7. Darwinian psychodynamics and creativity (DSM-IV, 1994)

  • 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


Conclusion
Conclusion (DSM-IV, 1994)

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