Homo medicus: The transition to meat eating increased pathogen pressure and the use of pharmacological plants in Homo

The relevance of the evolutionary approach for understanding health and disease of the human body and mind

Ultimate and proximate levels of analysis offer synergistic explanations can improve the search for causes of disease and their cures. Here we review how several principles of evolutionary biology such as historical contingencies, mismatches, trade-offs, sexual selection and genomic conflict are applied to problems in medicine and psychiatry. The application of evolutionary principles to many other domains of medicine, among them mental disorders, have not received the same reception from preclinical and clinical researchers. The lack of a well-coordinated interdisciplinarity may be one reason for the slow application of evolutionary principles to biomedicine and psychiatry. This is exemplified by the case of ethopharmacology, an evolutionary approach to psychopharmacology strongly proposed and applied by ethologists but apparently unknown to many evolutionary minded scholars. Another reason has to do with the lack of efforts from many medical schools to integrate evolution and its principles in their curriculum studiorum. Interestingly, this Darwinian approach is generating an important evolutionary epistemology for the study of body and human mind health and diseases.

Visual attention is not attuned to non-human animal targets' pathogenicity: an evolutionary mismatch perspective

A considerable amount of research has revealed that there exists an evolutionary mismatch between ancestral environments and conditions following the rise of agriculture regarding the contact between humans and animal reservoirs of infectious diseases. Based on this evolutionary mismatch framework, we examined whether visual attention exhibits adaptive attunement toward animal targets' pathogenicity. Consistent with our predictions, faces bearing heuristic infection cues held attention to a greater extent than did animal vectors of zoonotic infectious diseases. Moreover, the results indicated that attention showed a specialized vigilance toward processing facial cues connoting the presence of infectious diseases, whereas it was allocated comparably between animal disease vectors and disease-irrelevant animals. On the other hand, the pathogen salience manipulation employed to amplify the participants' contextual-level anti-pathogen motives did not moderate the selective allocation of attentional resources. The fact that visual attention seems poorly equipped to detect and encode animals' zoonotic transmission risk supports the idea that our evolved disease avoidance mechanisms might have limited effectiveness in combating global outbreaks originating from zoonotic emerging infectious diseases.

Evolutionary perspectives on substance and behavioural addictions: Distinct and shared pathways to understanding, prediction and prevention

Addiction poses significant social, health, and criminal issues. Its moderate heritability and early-life impact, affecting reproductive success, poses an evolutionary paradox: why are humans predisposed to addictive behaviours? This paper reviews biological and psychological mechanisms of substance and behavioural addictions, exploring evolutionary explanations for the origin and function of relevant systems. Ancestrally, addiction-related systems promoted fitness through reward-seeking, and possibly self-medication. Today, psychoactive substances disrupt these systems, leading individuals to neglect essential life goals for immediate satisfaction. Behavioural addictions (e.g. video games, social media) often emulate ancestrally beneficial behaviours, making them appealing yet often irrelevant to contemporary success. Evolutionary insights have implications for how addiction is criminalised and stigmatised, propose novel avenues for interventions, anticipate new sources of addiction from emerging technologies such as AI. The emerging potential of glucagon-like peptide 1 (GLP-1) agonists targeting obesity suggest the satiation system may be a natural counter to overactivation of the reward system.

Neighbours and relatives: accounting for spatial distribution when testing causal hypotheses in cultural evolution

Many important and interesting hypotheses about cultural evolution are evaluated using cross-cultural correlations: if knowing one particular feature of a culture (e.g. environmental conditions such as temperature, humidity or parasite load) allows you to predict other features (e.g. language features, religious beliefs, cuisine), it is often interpreted as indicating a causal link between the two (e.g. hotter climates carry greater disease risk, which encourages belief in supernatural forces and favours the use of antimicrobial ingredients in food preparation; dry climates make the production of distinct tones more difficult). However, testing such hypotheses from cross-cultural comparisons requires us to take proximity of cultures into account: nearby cultures share many aspects of their environment and are more likely to be similar in many culturally inherited traits. This can generate indirect associations between environment and culture which could be misinterpreted as signals of a direct causal link. Evaluating examples of cross-cultural correlations from the literature, we show that significant correlations interpreted as causal relationships can often be explained as a result of similarity between neighbouring cultures. We discuss some strategies for sorting the explanatory wheat from the co-varying chaff, distinguishing incidental correlations from causal relationships.

Signalling need for care: a neglected functional role of medical treatment

Background and Objectives

While the primary goals of medical treatment are typically to shorten illness or relieve symptoms, we explore the idea that an important additional goal for some patients is to communicate their needs. Drawing on signalling theory, we argue that undergoing treatments can help patients legitimize their illness and thereby enable access to crucial support during convalescence.

Methods and Results

Four pre-registered within-subjects experiments (n = 874) show that participants are more inclined to provide care to people who undergo treatment, especially when that treatment is painful. Results show this incentivizes the use of antibiotic treatments for viral infections as well as drug treatments for mental illness. A cross-sectional study of 194 chronic pain patients shows that those who experience stigma and doubt over the legitimacy of their illness are more likely to accept aversive treatments. Furthermore, two experiments (n = 653) indicate that subtle manipulations of one's sense of social support may increase willingness to accept treatment.

Conclusions and Implications

These results indicate that people make decisions to provide care in part based on the presence or absence of treatment and furthermore that patients' treatment decision-making is informed by the social consequences of their choices. Signalling theory may help explain the surprising longevity of some ineffective and costly medical procedures.