Although psychopathy is widely conceptualised as a mental disorder, some researchers question the maladaptive nature of psychopathy, and argue that it might be advantageous from an evolutionary point of view. According to this view, psychopathy can be seen as an evolutionary adaptative strategy that relies on deception and manipulation to gain short-term reproductive benefits. Psychopathy is also identified as a fast life strategy in response to early life stress and an adaptation to harsh environments. This paper investigates the evidence that psychopathic traits are adaptive, while also addressing the limitations of current evolutionary models of psychopathy based on frequency-dependent selection and life history theory. We review recent studies on the fitness correlates of psychopathy and find that psychopathic traits present potential adaptive trade-offs between fertility and mortality, and offspring quantity and quality. On a proximate level, individual differences in stress reactivity and environmental risk factors in early development predispose to psychopathy through gene–environment interactions. We propose that environmental, developmental, social and cultural factors can mediate the relationship between psychopathic traits and fitness and therefore should be considered to make accurate predictions on the adaptive potential of psychopathy. We end by outlining gaps in the literature and making recommendations for future evolutionary research on psychopathy.

Early adversity is considered a major risk factor for adult posttraumatic stress disorder (PTSD). Simultaneously, however, early adversity is also known to contribute to psychological resilience, and, indeed, some high-adversity groups do not display elevated PTSD risk. We explored correlates of PTSD in the Study to Assess Risk and Resilience in Servicemembers military dataset to evaluate contrasting accounts of the relationship between early adversity and PTSD. The standard deficit model depicts ontogeny as inherently vulnerable to insult, such that early adversity yields a less robust adult phenotype. A complementary life history theory account holds that adverse early experiences cue a fast life history orientation that reduces investment in maintenance, yielding an adult phenotype less able to recover from trauma. An opposing life history theory account holds that early adversity cues expectations of an adverse adult environment, adaptively reducing reactivity to adverse events. We use principal component analysis to extract a latent variable representing several childhood experiences and multiple lifestyle factors that plausibly proxy life history orientation. After correcting for covariates, we find a strong positive influence of such proxies on PTSD risk, suggesting that early adversity may indeed increase risk for PTSD, and thus that either the standard deficit model, the reduced maintenance account or a combination are correct.

Ineffective, aversive and harmful medical treatments are common cross-culturally, historically and today. Using evolutionary game theory, we develop the following model to explain their persistence. Humans are often incapacitated by illness and injury, and are unusually dependent on care from others during convalescence. However, such caregiving is vulnerable to exploitation via illness deception, whereby people feign or exaggerate illness in order to gain access to care. Our model demonstrates that aversive treatments can counter-intuitively increase the range of conditions where caregiving is evolutionarily viable, because only individuals who stand to gain substantially from care will accept the treatment. Thus, contemporary and historical “ineffective” treatments may be solutions to the problem of allocating care to people whose true need is difficult to discern.

Why is it that some parasites cause high levels of host damage (i.e. virulence) whereas others are relatively benign? There are now numerous reviews of virulence evolution in the literature but it is nevertheless still difficult to find a comprehensive treatment of the theory and data on the subject that is easily accessible to non-specialists. Here we attempt to do so by distilling the vast theoretical literature on the topic into a set of relatively few robust predictions. We then provide a comprehensive assessment of the available empirical literature that tests these predictions. Our results show that there have been some notable successes in integrating theory and data but also that theory and empiricism in this field do not ‘speak’ to each other very well. We offer a few suggestions for how the connection between the two might be improved.

Evolutionary medicine acknowledges that many chronic degenerative diseases result from conflicts between our rapidly changing environment, our dietary habits included, and our genome, which has remained virtually unchanged since the Palaeolithic era. Reconstruction of the diet before the Agricultural and Industrial Revolutions is therefore indicated, but hampered by the ongoing debate on our ancestors' ecological niche. Arguments and their counterarguments regarding evolutionary medicine are updated and the evidence for the long-reigning hypothesis of human evolution on the arid savanna is weighed against the hypothesis that man evolved in the proximity of water. Evidence from various disciplines is discussed, including the study of palaeo-environments, comparative anatomy, biogeochemistry, archaeology, anthropology, (patho)physiology and epidemiology. Although our ancestors had much lower life expectancies, the current evidence does neither support the misconception that during the Palaeolithic there were no elderly nor that they had poor health. Rather than rejecting the possibility of ‘healthy ageing’, the default assumption should be that healthy ageing posed an evolutionary advantage for human survival. There is ample evidence that our ancestors lived in a land–water ecosystem and extracted a substantial part of their diets from both terrestrial and aquatic resources. Rather than rejecting this possibility by lack of evidence, the default assumption should be that hominins, living in coastal ecosystems with catchable aquatic resources, consumed these resources. Finally, the composition and merits of so-called ‘Palaeolithic diets’, based on different hominin niche-reconstructions, are evaluated. The benefits of these diets illustrate that it is time to incorporate this knowledge into dietary recommendations.

Our genome adapts slowly to changing conditions of existence. Many diseases of civilisation result from mismatches between our Paleolithic genome and the rapidly changing environment, including our diet. The objective of the present study was to reconstruct multiple Paleolithic diets to estimate the ranges of nutrient intakes upon which humanity evolved. A database of, predominantly East African, plant and animal foods (meat/fish) was used to model multiple Paleolithic diets, using two pathophysiological constraints (i.e. protein < 35 energy % (en%) and linoleic acid (LA) >1·0 en%), at known hunter–gatherer plant/animal food intake ratios (range 70/30–30/70 en%/en%). We investigated selective and non-selective savannah, savannah/aquatic and aquatic hunter–gatherer/scavenger foraging strategies. We found (range of medians in en%) intakes of moderate-to-high protein (25–29), moderate-to-high fat (30–39) and moderate carbohydrates (39–40). The fatty acid composition was SFA (11·4–12·0), MUFA (5·6–18·5) and PUFA (8·6–15·2). The latter was high in α-linolenic acid (ALA) (3·7–4·7 en%), low in LA (2·3–3·6 en%), and high in long-chain PUFA (LCP; 4·75–25·8 g/d), LCP n-3 (2·26–17·0 g/d), LCP n-6 (2·54–8·84 g/d), ALA/LA ratio (1·12–1·64 g/g) and LCP n-3/LCP n-6 ratio (0·84–1·92 g/g). Consistent with the wide range of employed variables, nutrient intakes showed wide ranges. We conclude that compared with Western diets, Paleolithic diets contained consistently higher protein and LCP, and lower LA. These are likely to contribute to the known beneficial effects of Paleolithic-like diets, e.g. through increased satiety/satiation. Disparities between Paleolithic, contemporary and recommended intakes might be important factors underlying the aetiology of common Western diseases. Data on Paleolithic diets and lifestyle, rather than the investigation of single nutrients, might be useful for the rational design of clinical trials.