Human compulsivity: A perspective from evolutionary medicine

Dan J. Stein, Haggai Hermesh, David Eilam, Cosi Segalas, Joseph Zohar, Jose Menchon, Randolph M. Nesse

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


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.

Original languageEnglish
Pages (from-to)869-876
Number of pages8
JournalEuropean Neuropsychopharmacology
Issue number5
StatePublished - 1 May 2016
Externally publishedYes


  • Evolutionary medicine
  • Evolutionary psychiatry
  • Obsessive-compulsive and related disorders
  • Substance-related and addictive disorders


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