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At root, Darwinian Psychiatry represents a encyclopedic, ambitious, and well-argued attempt to convince its readers that the field of psychiatry would benefit from the explicit incorporation of evolutionary theory, and offers nothing short of a complete reconceptualization of mental disorders. Michael McGuire and Alfonso Troisi, are writers of considerable distinction in the psychiatry literature, although this work represents their first joint attempt at a full monograph. Fortunately for a new science, their scholarship is unmistakable and their shared knowledge startlingly comprehensive, encompassing writings from the cutting edge of evolutionary biology and genetics, to animal behavior and cognitive science, to the minutiae of psychiatric diagnosis.
The purpose of the book is to introduce a novel and comprehensive evolutionary theory of human behavior (Chapters 3 through 6), to apply its principles to the understanding of a selected number of mental disorders, including depression, personality disorders, schizophrenia and phobias (Chapters 7 though 14), and to offer a treatment framework (Chapter 15).
The book begins with a critique of the current state of psychiatry (Chapter 2). As the authors correctly note, those who work in the field currently appear disinterested in the ultimate why questions of mental disorders, instead focussing on issues of definition and classification. According to the authors, such an emphasis makes data hard to interpret, theories hard to relate to one another, and treatments ad hoc and poorly understood in their terms, "a state of chaos". Although numerous other writers in psychology, psychiatry and medicine have voiced similar concerns, Darwinian Psychiatry along with the more medical Why We Get Sick (Nesse & Willliams, 1994) and the more psychological Maladapted Mind (Baron-Cohen, 1997) is one of a small number of works that is ceasing to simply remonstrate and is actually beginning the process of creating new explanatory frameworks. For this, McGuire and Troisi must be both recognized and commended, for such works are sorely needed.
In the strong version of evolutionary Darwinism they offer, humans, whom they somewhat petulantly insist on referring to as homo sapiens, have not been selected to be either happy or mentally healthy, but rather to successfully reproduce. This deceptively simple beginning forms the basis for a sweeping new system for organizing mental disorders around biologically basic behavioral systems. McGuire and Troisi argue that "most mental conditions [disorders] are conditions of failed mechanisms" (p. 44), and are "best described as clusters of suboptimal and dysfunctional traits" (p. 83). In many cases it seems, mental disorders may represent attempts to adapt. Further chapters are devoted to fleshing out the details of the basic theoretical framework, and attention is given to the specific consideration of psychological mechanisms, functional analysis, emotions, and the place of information-signaling and recognition. Although complex, the framework they present is also a source of great potential, enabling explanation for mental disorders at multiple and complementary explanatory levels.
Given the complexities involved in both the human mind and the etiology of many psychological disorders, it is perhaps inevitable that the initial chapters demand considerable application on the part of the reader. The model these authors proffer is so overwhelmingly comprehensive that the work should not be approached by the faint of heart (or those without considerable familiarity with evolutionary theory!) Despite the fact that a certain degree of terminological specificity and understanding are necessary for the topic they address, there are times where the introductory chapters become so heavily steeped in their own idiosyncratic jargon that they become somewhat inaccessible even to the seasoned reader. To my mind, this constituted the major weakness of the work, and persisted throughout despite the authors' occasional attempts to concretize the matter at hand. Similarly troubling was a recurrent tendency towards treating many research findings as if they were predicted within their framework, despite the fact that the preponderance of their so-called predictions are in fact post hoc. As with much evolutionary reasoning, the examples employed appear as much chosen for their supportive value as they do for their illustrative value or validity.
The overall tone of the work is relatively conversational, a style that well befits the obvious familiarity of the authors with the tenets of evolutionary theory and their knowledge of mental conditions. The applications of their model to the various mental disorders in the latter half of the book are well thought out, well-structured, and well written, a pleasant change from the highly abstract and complex labors of the first half's reading. Although the examples vary in how convincing they are, the conceptual richness is abundantly evident, and "viewing disorders in an evolutionary context [certainly] offers novel insights into disorder causes and consequences" (p. 250).
In many cases, as in the discussions of personality disorders (Chapter 9) and anorexia nervosa (Chapter 10), the application of their ideas is both comparatively straightforward and appropriately provocative. McGuire and Troisis discussion of sociopathy for example, urges us to remember that the disorders characteristics (e.g. an exploitative nature and disregard for the rights of others, lack of empathy or guilt) do not necessarily disadvantage the sociopath in terms of their genetic or reproductive fitness. In fact, being sociopathic may in some cases advantage them, enabling them to act when others would be constrained from doing so. The discussion of anorexia nervosa is similarly thought-provoking, underscoring the possibility of adaptive interpretations for mental disorders, in this case, the delaying of puberty as a means of avoiding female sexual competition and exploitation by males.
On balance then, this work contains sufficient nuggets to make the sweat of its reading worthwhile. Although there were times when the theory appeared unnecessarily complex, and I suspect that level of technical detail will make it inaccessible to many mainstream readers of the psychiatric literature, perseverance does unearth some engaging possibilities. While it is slightly unfortunate that the therapeutic implications stemming from their ideas are predominantly left for the reader to determine, the work is predominantly theoretical, and explanatory theories of this thrust, magnitude and ambition are clearly needed. Grand-scale theories are almost completely absent in contemporary psychiatry, hence new contributions are invariably a work in progress. In making such a well-informed and comprehensive initial attempt, these authors must be applauded.
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Having recently completed his dissertation in New Zealand, Nathan Consedine, Ph.D., is currently a postdoctoral fellow at the Center for Studies of Ethnicity and Human Development at Long Island University in New York. His many research interests include the development of evolutionary-functionalism, particularly as applied to emotion, consciousness and personality theory, as well as considering the relationships between emotions, aging, and health in an ethnic context. In his spare time, he writes on Internet methods in psychological research.