title: Human compulsivity: A perspective from evolutionary medicine.
abstract: Biological explanations address not only proximal mechanisms (for example, the underlying neurobiology of obsessive-compulsive disorder), but also distal mechanisms (that is, a consideration of how particular neurobiological mechanisms evolved). Evolutionary medicine has emphasized a series of explanations for vulnerability to disease, including constraints, mismatch, and tradeoffs. The current paper will consider compulsive symptoms in obsessive-compulsive and related disorders and behavioral addictions from this evolutionary perspective. It will argue that while obsessive-compulsive disorder (OCD) is typically best conceptualized as a dysfunction, it is theoretically and clinically valuable to understand some symptoms of obsessive-compulsive and related disorders in terms of useful defenses. The symptoms of behavioral addictions can also be conceptualized in evolutionary terms (for example, mismatch), which in turn provides a sound foundation for approaching assessment and intervention.
authors.affiliation: Department of Psychiatry, University of Cape Town, South Africa. Electronic address: dan.stein@uct.ac.za.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.affiliation: Department of Psychiatry, Tel-Aviv University, Israel.
authors.forename: Haggai
authors.initials: H
authors.lastname: Hermesh
authors.affiliation: Department of Zoology, Tel-Aviv University, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Eilam
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Cibersam, University of Barcelona, Spain.
authors.forename: Cosi
authors.initials: C
authors.lastname: Segalas
authors.affiliation: Department of Psychiatry, Chaim Sheba Medical Centre, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Cibersam, University of Barcelona, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Menchon
authors.affiliation: Centre for Evolution & Medicine, University of Arizona, USA.
authors.forename: Randolph M
authors.initials: RM
authors.lastname: Nesse
mesh_terms: D000818:Animals; D016739:Behavior, Addictive; D001522:Behavior, Animal; D005075:Biological Evolution; D003131:Combined Modality Therapy; D003192:Compulsive Behavior / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D003193:Compulsive Personality Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D003674:Defense Mechanisms; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008959:Models, Neurological; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D011587:Psychology, Comparative / Q000379:methods*; D013315:Stress, Psychological / Q000503:physiopathology / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D009626:Terminology as Topic
keywords: Evolutionary medicine; Evolutionary psychiatry; Obsessive–compulsive and related disorders; Substance-related and addictive disorders