A Usable Evolutionary Classification System for Mental Disorders Gary Galambos MB BS FRANZCP Consultant Psychiatrist St John of God Hospital, Burwood APS.

A Usable Evolutionary Classification

System for Mental Disorders

Gary Galambos MB BS FRANZCP

Consultant Psychiatrist

St John of God Hospital, Burwood

APS Evolutionary Psychology Interest Group

10th March 2010

Overview The paradigmatic failure of psychiatry

Benefits of an evolutionary approach

Does evolutionary psychology or psychiatryhave any answers?

Unveiling an evolved classification system…

Test-driving 2 DSM disorders using the model

The Paradigmatic Failure of Psychiatry

Failed Schools Perspectives Objective-descriptive

(Kraeplin, Janet, Bleuler, Maudsley, Beck)

Psychoanalytic (Charcot, Breuer, Freud)

Existential (Jaspers, Minkowski,

Binswanger) Interpersonal/Social

(Meyer, Sullivan)

Eclecticism– DSM– The Biopsychosocial Model

(Engel 1980)

Disease

Behavioural

Life-story

Dimensional

Disease

DSM a failure? Achieves its aims of:

– Accurate descriptions (language free of theoretical biases)

– Reliability among multiple users (high cross-clinician agreement)

– Empirical (Akiskal 1989)

allowing researchers to study comparable groups

BUT….

Criticisms– not guided by any theory about the

structure and function of normal minds– encourages simplistic thinking of

psychiatric syndromes as discrete diseases (Kendell 1984)

– Splits psychiatry from general medical disorders, giving the false impression that the mechanisms are different for both

(Waterman 2001)

– Neglects maladaptive psychological processes

BOTTOM LINE….

Poor validity

Developing a descriptive vocabulary that achieves a high degree of cross-clinician agreement may be served by summative reasoning, but its service to condition validity is another matter

(McGuire & Troisi 1998)

The BPS model a failure?

Essential in vaccinating against dogmatism (biological reductionism or psychoanalytical orthodoxy)

Provides room for an eclectic approach utilising psychotherapy and social work in a neuroscience dominated environment

But…

Criticisms of the BPS Model

“It is like going to a restaurant & receiving a list of the ingredients rather than a menu” (McHugh 1998)

“Too eclectic to provide useful organising concepts around which to understand psychiatry” (Ghaemi 2005)

Fundamentally dualist model - “Descartes without the pineal connection” - due to linguistic conceptual conventions

(Waterman 2001)

Consequences

Separation of psychiatry from the rest of medicine

Inequitable distribution of resources Confusion of aetiology & pathogenesis Impairment in ability to communicate to

students & general public modern psychiatric concepts

Stigmatisation of patients

(Waterman 2001)

Benefits of an evolutionary approach

Answers “why”

– Reductionistic (proximate) approaches miss half the story because most research attempts to explain “what” and “how”

– Evolutionary approaches examine

“why” we are susceptible to maladaptive mental & behavioural phenomena by considering design characteristics

What might evolutionary approaches add?

A theory of gene-environment-behaviour interactions– A theory of behaviour, motivations and

function Causal hypotheses

–A non-judgmental, normalising, humanising explanatory model for patients

Integration of prevailing models into a framework

–An evolutionary classification?

McGuire & Troisi

1998

Nesse

What is a mental disorder from an evolutionary view?

Abnormal phenomena causing biological disadvantage (Scadding 1967)

Disorders are the result of things that have gone wrong with evolved structures that allow for adequate functioning (Klein 1978)

(which, unabated, leads to reproductive disadvantage)

Also: social undesirability (Wakefield 1992)

Why are our minds are poorly designed?

DALYs Western Females18-45yo

(WHO)

Percentage distribution of YLD by mental disorders and nervous system disorders, Australia 1996

0

10

20

30

40

50

60

70

0-14 15-34 35-54 55-74 75+

Years of age

Per

cent

of t

otal

YLD

Mental disorders

Nervous system disorders

Bottom line:

Vast prevalence Huge comorbidity Onset at age of peak health Waxing & waning courses Huge fitness costs

Does evolutionary psychology or psychiatry

have any answers?

Darwin’s view on emotions

Pleasurable sensations … stimulate the whole system to increased action.

Hence … pleasurable sensations serve as … habitual guides.

But pain or suffering… lessens the power of action, yet is well adapted to make a creature guard itself against any great or sudden evil.

…if long continued, causes depression

Darwin Francis (ed), Darwin Francis (ed), The Life & Letters of Charles The Life & Letters of Charles DarwinDarwin, 1887., 1887.

What are emotions? “Adaptations” shaped by Natural Selection Each emotion is a specialised state that

adjusts cognition, physiology, subjective experience & behaviour so that the organism can respond effectively in a particular kind of situation

Positive & negative emotions are derived from the two types of basic arousal…

Cellular instincts

Arousal

Inaction/Avoidance Disengagement/WithdrawalSelf-defense

ThreatOpportunity

AcquisitionEngagementAttack

Who do emotions benefit?

The emotions were “designed not to promote the happiness & survival of the individual, but to favor maximum transmission of the controlling genes”

(EO Wilson)

EvoPsych

"In the distant future I see open fields for far more important researches. Psychology will be based on a new foundation, that of the necessary acquirement of each mental power and capacity by gradation."

(Darwin, Origin of Species)

Cosmides & Tooby 1995

Our cognitive architecture resembles a confederation of hundreds or thousands of functionally dedicated computers (modules) designed to solve adaptive problems endemic to our hunter-gatherer ancestors…

The Massive Modularity Hypothesis“Human nature” refers to the accumulated specialized neural circuits common to every member of a species

Our modern skulls house a stone age mind

A Darwinian module

(Adapted from Murphy & Stich 1998)

Mental architecture posited by evopsych



A proposed EvoPsych classification

1. Disorders Within the Personi. Internal to the module

an individual's special-purpose computer is malfunctioning

ii. External to the module problematic module output due to problematic input

(garbage in = garbage out)

2. “Environment/Selection Mismatch”– Genome lag hypothesis

3. Adaptive “deviant” behavioural strategies

(Murphy & Stich 1998)

Evolutionary Neuroanatomy: Triune Brain

(MacLean 1973)

The Four “Time-Depths” classification of

“Stress & Fear Circuitry” (Anxiety) Disorders

Based on evolved fear circuitry traits that have outlived their usefulness

Bracha, 2006

Time depths Classification (from Bracha)

1. Mesozoic Era

Mammalian-wide fear circuits

(140 MYA)

Separation anxiety

Extreme fear of adult non-kin males in toddlers

Extreme fear of high elevations in adults

2. Cenozoic Era

Simian-wide fear circuits (20 MYA)

Fear of snakes, reptiles, confined spaces, darkness, water immersion, suffocation during forest fire, muscle exhaustion under predation

Acute jaw-clenching

3. Paleolithic Era

H. Sapiens-wide fear circuits (200-14 TYA)

Compulsive Lock & stove checking, washing (Obsessive fear of contamination), hoarding (esp.

tools, weapons & leather goods), fear of insects or miceFear of scrutiny by non-kin conspecifics (Generalized Social Phobia)

4. Neolithic era

Culture-bound genome-specific fear circuits (12 TYA)

Primary dissociative disorder

Somatoform states: Pseudoseizures, Pseudoparalysis (e.g. limping), Imbalance (Pseudocerebellar symptoms),

BlindnessEpidemic sociogenic illness (“epidemic hysteria”)

Archetype disorders

Mental disorders may manifest as a failure to meet biosocial imperatives (goals or social roles)

by the 4 archetypal propensities

Stevens & Price 2000

Biosocial goals

1. The stranger archetype

2. The affiliation and bonding archetype

3. The hierarchical ranking dominance-submission archetype

4. The courtship & mating archetype

(Stevens & Price, 2000)

1. Defense (fight or flight)

2. AttachmentAttachment

3. Dominance-striving

4. Reproduction

(Gardiner, 1988)

Archetypal systems

Why are our minds so poorly designed?

Because of past evolutionary compromises & trade offs organisms are not optimally designed

McGuire & Troisi 1998 Mayr 1983

Selection does not optimise adaptive traits or strategies as much as it gradually eliminates unfit traits/strategies

Tuomi et al 1983

A proposed general evolutionary

classification1. Novelty

– From pathogens or competitors – From aspects of the modern environment

2. Trade-offs – Genes with costs as well as benefits – All traits are a two-edge sword

3. Constraints 4. Accidents and mishaps (too rare to shape

defenses)

5. Defenses (often confused with diseases)

Nesse RM 1995

A proposed psychiatric evolutionary

classification

1. Primary brain abnormalities

2. Environmental trauma or uniqueness

3. Byproducts (adaptive but distressing)

(adapted from Nesse RM 1991)

Unveiling an upgraded BPS model…

The

MMalfunction-

DDysregulation-

AsAsocialisationModel

The MDAMDA Model

Places the DSM & BPS (atheoretical) models within a (theoretical) evolutionary framework

General evolutionary explanations (y-axis) grouped alongside

organism-specific archetypal (functional) disruption (x-axis)

EVOLUTIONARY CLASSIFICATION

DISORDER: x

Archetypal Disruption (H. Sapiens)Disorders of:

AAttachmen

t/Affiliation Archetype

BHierarch

ical/Ranking Archety

pe

CCourtshi

p/ Mating

Archetype

D Threat

Response

Archetype

1. Mal-function

2. Dys-regulation

3. Asocial-isation

Maintaining a BPS framework

Malfunction correlates with “Bio” Dysregulation correlates with

“Psycho” Asocialisation correlates with

"Socio-cultural”

… Makes the evolution from an atheoretical to a theoretical classification system easier, and reduces dualism inherent in BPS and DSM

Descriptions vs aetiology

Proposal that each DSM disorder may have more than one possible aetiological basis


DISORDER: x

Archetypal DisruptionDisorders of:

AAttachme

nt/Affiliation Archetype

BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmenta

l Trauma 2.1A 2.1B 2.1C 2.1D

2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation

3.1By-product (trade off)

3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D


DISORDER: x


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmenta

l Trauma2.1A 2.1B 2.1C 2.1D

2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation


3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D

1. Disorders of Malfunction

1.1 Modular - Mental disorders resulting from localised (modular) brain malfunction due to abnormal differentiation.

1.2 Integrative - Mental disorders that result from NON-localised brain malfunction, causing widespread cerebral dysconnectivity.

Secondary to injuries of the developing central nervous system in the context of genetic vulnerability


DISORDER: x


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmenta


2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation


3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D

1.1 Modular Malfunction Intracranial lesion causing psychosis,

mood disorder or cognitive impairment Malfunction of Theory-of-Mind (ToM) “module”

– causes “mindblindness” (Baron-Cohen 1997)

– Pts with Autism, Aspergers & acute SCZ perform worse on ToM tasks (Brune 2005)

(ToM proposed to be a crucial component of a “social” module in humans)

Machiavellian intelligence is a domain-specific faculty of inferring mental states of others (Brune 2001)


DISORDER: x


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmenta


2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation


3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D

1.2 Integrative Malfunction Schizophrenia

– a disorder of integration (Andreason) a disorder of integration of the social brain (Burns

2004)

– A disorder of over-pruning investigatory evidence for reduced cortical

connectedness neural network computer simulation

– adaptive advantage of robust network pruning = the enhancement of cog functioning …until it pushes up against a “psychotogenic threshold”

(McGlashan & Hoffman 2000)


DISORDER: x


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmenta


2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation


3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D

2. Disorders of Dysregulation

Mental disorders that result from dysregulation of established defenses

2.1 Environmental trauma or mismatch– mental disorders may result from normal brain mechanisms becoming dysregulated as a result of exposure to novel environmental circumstances, idiosyncratic learning histories or sensory trauma causing maldevelopment of mind programs. 2.2 Maladaptive memes - behavioural dysfunction resulting from contagious propagation of maladaptive ideas.

Types of brain trauma

2.1– Blunt

– Toxins

– Somatosensory 2.2

– Ideational


DISORDER: x


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmenta


2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation


3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D

2.1 Environmental Dysregulation

Epidemic of Depression– N=39,000 in 9 studies, in 5 global locations

youth more likely to have had MDE than their elders, esp. in higher economically developed cultures

– Mass communications increased competition, unreachable goals,

dissatisfaction with selves & family decreased interactions,

– New technology disintegration of families & communities

(Nesse & Williams, Why We Get Sick, 1995)

Triggers of Depression

Loss of attachment – carer, mate Loss of rank – social status Loss of resources

– Internal Trauma Bodily damage

– External Bad decisions e.g. wasted effort pursuing

risky goals Disruption to major life goals and

enterprises

(Nesse 2000)

(Stevens & Price, 2000)

(Bowlby)

Depression as an Adaptation

Communicate need for help

Signal yielding in hierarchy conflict

Disengage from unreachable goals

Regulate patterns of investment

(Nesse, AGP, 2000)

(Price, Sloman, Gardner, Gilbert, Rohde, BJP, 1994)

(Darwin, 1872)

Why doesn’t recovery occur?

Brain Level

Alternative strategies of the Triune Brain

Winning (Escalating)

(Positive arousal)Losing (De-escalating)

(Negative arousal)1. CORTEX (Reason) Fight to win Actively submit

2. LIMBIC (Emotion) Get angry Feel chastened

3. REPTILIAN (Instinct) Mood elevation

Depression

(Stevens & Price, 2000; MacLean, 1973)

Adaptive Depression

Brain Level

Alternative Strategies

Winning (Escalating) Losing (De-escalating)

1. CORTEX (Reason) Fight to win Actively submit


3. REPTILIAN (Instinct) Mood elevation Depression

Adaptive depression is where the triune is unified in choosing a de-escalating strategy

Maladaptive Depression Due to Conflict within the "Triune"

Brain Results when all three "central

processing assemblies" are not pulling together towards the same objective

Stevens & Price suggest that maladaptive depression requires pharmacotherapy whereas adaptive depression requires psychotherapy

Involuntary yielding or "blocked higher level losing"

Brain Level



1. CORTEX (Reason) Fight to win

Actively submit


3. REPTILIAN (Instinct) Mood elevation DepressionDepression

People may develop a depressive illness when the losing strategy of the reptilian level is activated in conjunction with ... adoption of the winning strategy at the (neo)cortical &/or limbic levels. i.e. "blocked higher level losing".

Reasons for an “upper block”

1. Internal factors : – predisposing personality traits

obsessive & narcissistic traits high sensitivity to insult

2. External factors : – loser cannot provide winner’s demands– winner continues attacks forcing victim into

"learned helplessness"

Anger-propagating Depression

Brain Level



1. CORTEX (Reason) Fight to win Actively submit

2. LIMBIC (Emotion) Get angry

Feel chastened

3. REPTILIAN (Instinct) Mood elevation Depression

Intractable anger causing maladaptive depression when something very unjust has been done to the person, which leads to resistance to yielding - often develops secondary to Chronic PTSD

PTSD An “Over-learnt Survival

Response” with asynchrony caused by a failure of cortical inhibition to limit the trauma rehearsal (“overconsolidation”) generated by the limbic lobe

(Silove 1998; Bracha 2006)

Sequence of events in PTSD:

Fear response causes excessive activation of threat response neural circuitryInadequate orbital prefrontal feedback Failure to switch off activation of the threat response system Failure of recovery


DISORDER: x


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmenta


2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation


3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D

2.2 Meme Dysregulation Meme = evolution of culture (ideas)

– Competitive co-evolution b/w genes & culture

– Man must adapt to novel “cultural” environments/ influences

(Dawkins, The Selfish Gene, 1976)

Mental disorder caused by:– Conflict b/w culture & gene – Inability to adapt to culture– “Garbage input = garbage output”

Mimetic Lexiconhttp://pespmc1.vub.ac.be/MEMLEX.html

meme – (pron. `meem') A contagious information pattern

that replicates by parasitically infecting human minds and altering their behavior, causing them to propagate the pattern. (Term coined by Dawkins, by analogy with "gene".) Individual slogans, catch-phrases, melodies, icons, inventions, and fashions are typical memes. An idea or information pattern is not a meme until it causes someone to replicate it, to repeat it to someone else. All transmitted knowledge is memetic. (Wheelis, quoted in Hofstadter.) (See meme-complex).

meme-complex A set of mutually-assisting memes which have

co-evolved a symbiotic relationship. Religious and political dogmas, social movements, artistic styles, traditions and customs, chain letters, paradigms, languages, etc. are meme-complexes. Also called an m-plex, or scheme (Hofstadter). Types of co-memes commonly found in a scheme are called the: bait; hook; threat; and vaccime. A successful scheme commonly has certain attributes: wide scope (a paradigm that explains much); opportunity for the carriers to participate and contribute; conviction of its self-evident truth (carries Authority); offers order and a sense of place, helping to stave off the dread of meaninglessness. (Wheelis, quoted by Hofstadter.)

A sociotype of an auto-toxic meme-complex, composed of membots and/or memeoids. (GMG) Characteristics of cults include: self-isolation of the infected group

(or at least new recruits); brainwashing by repetitive exposure (inducing dependent mental states); genetic functions discouraged (through celibacy, sterilization, devalued family) in favor of replication (proselytizing); and leader-worship ("personality cult"). (Henson.)

cult

An infection strategy in which a meme attempts to imitate the semiotics of another successful meme. Such as: pseudo-science (Creationism, UFOlogy); pseudo-rebelliousness (Heavy Metal); subversion by forgery (Situationist detournement). (GMG)

mimicry


DISORDER: x


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmental Uniqueness

2.1A 2.1B 2.1C 2.1D

2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation


3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D

3. Asocialisation Disorders

Diagnosed if the behaviour of the individual leads to severe subjective distress, objective distress (of family/community) AND negative social or harmful consequences.

Characterised by behaviours that are not acceptable to the individual's community BUT are adaptive for their genes (transmission).

The memes of the individual’s social group DIVERGE FROM the adaptive function of the individual's deviant behaviour.

Disorders of Sociability

3.1 By-product– Patterns of emotion or behaviour that are

painful or socially unacceptable, but nonetheless adaptive

3.2 Defense– An evolved solution to a challenge that

may cause suffering & distress as part of the strategy to respond effectively to the threat


DISORDER: x


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

1.1A 1.1B 1.1C 1.1D

1.2Integrative

1.2A 1.2B 1.2C 1.2D

2. Dys-regulati

on

2.1 Environmental Uniqueness

2.1A 2.1B 2.1C 2.1D

2.2Maladaptive

Meme2.2A 2.2B 2.2C 2.2D

3. Asocial-isation


3.1A 3.1B 3.1C 3.1D

3.2Defense 3.2A 3.2B 3.2C 3.2D

3.1 By-product

Delusional male sexual jealousy– a mate-guarding tactic – Although an uncomfortable, undesirable

state that can give rise to antisocial acts, it is likely to increase reproductive success & be maintained by NS.

(Daly, Wilson and Weghorst 1982; Symons 1979)

3.2 Defense

… to motivate to urgent action

for survival(Walter Cannon, 1929)

Startle may activate the Fight or Flight Program

Anxiety disorders– Panic disorder

Situations evoking anxiety as a defense

Harm from strange humans Stranger anxiety Separation from carer Separation anxiety Threats to status/group membership

Social anxiety Socially unaccepted impulses

Obsessive self-doubt Lack of food or other resources

Obsessive hoarding Getting sick

Hypochondriasis/Obsessive cleanliness Dangerous small animals Small animal phobias Potential attack to family members General anxiety Imminent attack by predator Panic Environment in which attack is likely Agoraphobia

(Adapted from Nesse, 1990)

The Fight or Flight Program

A two-edge sword Lungs: SOB, choking, parasthesia

Heart: Palps, chest pain, flushes

Muscles: Trembling, tension, sweating

GIT: Dry mouth, butterflies, nausea, belching

Brain: Dizziness, faintness, lightheadedness, catastrophic cognitions & fear

Lungs: ↑blood O2

Heart: ↑O2 blood delivery

Muscles: ↑O2 metabolism

GIT: ↓bld flow to gut

Brain: activation of fear circuitry

The Smoke-Detector Principle

Anxiety is a useful defense…but it uses extra calories, makes us less fit for everyday activities & damages tissues

So why is it so readily triggered? Because the cost of getting killed even

once is enormously higher than the cost of responding to 100 false alarms

Nesse, 2005

Test-driving MDD & Psychosis

EVOLUTIONARY CLASSIFICATION DISORDER: Major Depressive Disorder


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

Due to general medical disorder Drug-induced

Melancholic & psychotic depressionPseudodementia (subcortical)

Dysthymia due to deficit in reciprocal exchange module (McGuire, Murphy)

1.2Integrative

2. Dys-regulati

on

2.1 Environmental

Trauma Maladaptive depressions (conflict within the Triune brain) e.g. Anger-Induced

Depression2.2Maladaptive

Meme

3. Asocial-isation

3.1By-product

Dysthymic temperament for social cohesion (Akiskal)

Adaptive depressions e.g. due to Involuntary Yielding in Social Competition, to disengage from unreachable goals, to

regulate patterns of investment

3.2Defense


DISORDER: Psychosis


AAttachme


BHierarchic

al/Ranking

Archetype

CCourtshi

p/ Mating

Archetype

D Threat

Response Archetyp

e

1. Mal-functi

on

1.1Modular

Due to general medical disorderDrug-induced

Schizophrenia as Disorder of Integration due to Over-Pruning, As a Disorder of the

Threat Response Archetype

1.2Integrative

2. Dys-regulati

on

2.1 Environmental

Trauma

Shared psychotic (Folie au Deux)2.2Maladaptive

Meme

3. Asocial-isation

3.1By-product Delusional jealousy

Disorder of Spacing in SCZ3.2Defense

More…

http://www.ep.org.auLinks

BibliographyTheories

Interest Group

A Usable Evolutionary Classification System for Mental Disorders Gary Galambos MB BS FRANZCP Consultant Psychiatrist St John of God Hospital, Burwood APS.

Documents

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