Causes of psychopathology
The causes of psychiatric and psychosomatic conditions can be categorized into two groups: proximate and ultimate (evolutionary) causes. Proximate causes comprise genetic factors, epigenetic modulation, childhood trauma and other life events, and senescence. Ultimate or evolutionary causes concern mismatch between adaptation and current environment, suboptimal design, and design compromises. Examples of evolutionary causes of dysfunction include cognitive and emotional adaptations to small-scale societies (mismatch), anxiety (suboptimal design), premature birth (design compromise), and other features associated with human life history. Furthermore, many ‘diseases of civilization’ fall under the category of mismatch, as well as immunological diseases that may arise from a lack of exposure to pathogens early in life. Prevention of psychopathology, though desirable, may not always be possible due to the fact that evolution does not select for emotional well-being. However, reducing the impact of early adversity and helping people develop alternative life-history strategies may be an attainable goal.