To consider the power of principles derived from evolutionary biology to explain the causes and determinants of some forms of child and adolescent mental disorders.Method
The authors reviewed the scientific literature for evolutionary mechanisms proposed to contribute to the pathogenesis of early-onset disorders.Results
A diverse set of evolutionary mechanisms has been proposed. With the exception of certain genetically determined conditions, many of the proposed mechanisms have little empirical data to support them. One mechanism focuses on the vulnerabilities associated with conserved behavior patterns, such as separation anxiety and other alarm responses. These behavioral patterns are adaptive if they appear in some situations, but not in others. Other attractive theories include a co-optation of underlying neurobiology systems (substance abuse), environmental shifts (transformation of present day environments away from primeval environments), and evolutionary arms races as may occur in putative autoimmune disorders with neuropsychiatric sequelae.Conclusions
Evolutionary biology provides a potentially powerful framework for understanding disease pathogenesis in child psychiatry and should permit the integration of new knowledge from a broad range of scientific disciplines. Evolutionary explanations are typically population-based and fail to account for why a particular individual is affected. Consequently, any adequate account of disease pathogenesis requires that environmental events that impinge on CNS development be considered. Finally, the empirical testing of specific theories may prove to be difficult if not impossible. J. Am. Acad. Child Adolesc. Psychiatry, 1998, 37(10):1011–1021.