How evolution can help us understand child development and behaviour

Abstract

SummaryThe traditional disease model, still dominant in psychiatry, is less than ideal for making sense of psychological issues such as the effects of early childhood experiences on development. We argue that a model based on evolutionary thinking can deepen understanding and aid clinical practice by showing how behaviours, bodily responses and psychological beliefs tend to develop for ‘adaptive’ reasons, even when these ways of being might on first appearance seem pathological. Such understanding has implications for treatment. It also challenges the genetic determinist model, by showing that developmental pathways have evolved to be responsive to the physical and social environment in which the individual matures. Thought can now be given to how biological or psychological treatments – and changing a child's environment – can foster well-being. Evolutionary thinking has major implications for how we think about psychopathology and for targeting the optimum sites, levels and timings for interventions.

Fifteen-minute consultation: The angry child

“…Children who have suffered developmental trauma, such as abuse and neglect, have learnt to expect that the world is dangerous and that others are out to hurt them 6. They may thus be on high alert and misinterpret neutral signals as threats, which then triggers their fight-or-flight response.…”

Fifteen-minute consultation: Attachment as a model to understand and manage difficult doctor–parent relationships

“…This may be adaptive, as children learn to fit in with the environment that they are born into. 4 However, a hospital or healthcare setting is a different environment from what children know from home. Also, doctors and nurses may not be like their parents at all.…”

“…Best practice and fifteen-minute consultations sensitive and responsive to their own children. 4 They believe that doctors and other staff are competent and do not have problems entrusting their sick children to professionals. Such families are generally easy to help, as they seek help appropriately and follow professional recommendations.…”

“…The second most common attachment style at around 25% of the general population is termed 'avoidant' in children and 'dismissive' in adults, although this varies between cultures and countries-for example, it is much more common in Germany and much less common in Japan. 4 A child who has a primary caregiver who believes that children should be independent as soon as possible will grow up to learn that they need to fend for themselves and fulfil their own needs. Such children develop mental models of themselves as worthy of care, but others as unable or unwilling to help them.…”

“…In previous papers, I and others described how adults may respond in difficult ways when they are hospitalised and how doctors can change their approach in order to be most helpful. [1][2][3][4][5][6] In this paper, I want to expand that theory to the feelings parents have when they need to seek help for a sick child. Having a sick child is a strong attachment stressor and will trigger parents to respond in a similar way they would respond if they were ill themselves.…”