Psychological Medicine

Original Article

An exploration of evolved mental mechanisms for dominant and subordinate behaviour in relation to auditory hallucinations in schizophrenia and critical thoughts in depression

P.  GILBERT  c1 a1, M.  BIRCHWOOD  a1, J.  GILBERT  a1, P.  TROWER  a1, J.  HAY  a1, B.  MURRAY  a1, A.  MEADEN  a1, K.  OLSEN  a1 and J. N. V.  MILES  a1
a1 From the Mental Health Research Unit, Kingsway Hospital, Derby; and the Early Intervention Service, Northern Birmingham Mental Health Trust, Birmingham


Background. Mental mechanisms have evolved to enable animals (and humans) to be able to function in various social roles. It is suggested that the nature and functions of the mental mechanisms that enable animals to act as a hostile–dominant or threatened–subordinate can be distinguished. It is further suggested these can be internally activated and ‘play off’ against each other, such that a person ‘attacks’ themselves and then responds to their own internal attacks with subordinate defences. Hence, a depressed person can submit, feel defeated, belittled, beaten down, or want to run away (escape) from their own self-attacking thoughts, while psychotic voice hearers can feel similarly to their hostile voices. Such internal interactions may relate to depression in both psychotic voice hearers and depressed people.

Method. A group of 66 voice hearers with a diagnosis of schizophrenia and 50 depressed patients were compared on a series of self-report questionnaires measuring the power of hostile self-directed thoughts/voices and the activation of defensive responses, especially fight/flight.

Results. We present evidence that schizophrenic, malevolent voice hearers and self-critical depressed people experience their hostile, internally generated voices/thoughts as powerful, dominating and controlling (i.e. have typical characteristics of a hostile dominant). Moreover, these voices/thoughts activate evolved subordinate defences such as fight/flight and these are associated with depression in both depression and schizophrenia.

Conclusion. Conceptualizing aspects of depressed and psychotic thinking as relating to evolved mental mechanisms, which are role serving, but can internally play off against each other, may open new ways of investigating certain aspects of severe pathologies.

c1 Address for correspondence: Professor Paul Gilbert, Mental Health Research Unit, Kingsway Hospital, Derby DE22 3LZ.