Research On Substance Abuse And Social Rank Hierarchy

A major problem for psychiatry's basic sciences is a clear need for a comprehensive integration of proximal to ultimate phenomena—from organ and cell levels on through to the level of individual and group behavior. Research efforts often assume that clinical phenomena "empirically" are best studied in individual subjects—as though they existed in isolation. This has worked against pathophysiological formulations. Addiction research has recently provided encouraging data, however. It studies the human propensity to seek and use reinforcing drugs with consequent drug craving. Society finds drug addiction pervasively troubling. Behaviorally, addicts go to great lengths to acquire drugs. While a "communicational problem" may seem counterintuitive because the person seems to act out a "personal need," drugs stimulate feelings that relate to social roles, such as enhanced sense of power after imbibing alcohol (Newlin, 2002). Twelve-step and other social programs play integral roles in reversing maladaptive drinking and other drug use, suggesting social processes are innately involved in the tendency to develop addictions. More specific evolved sociophysiological foundations may underlie the epigenetic risk of substance abuse (Wilson, 1988). The "abuse" may have arisen not as addiction per se but from adaptive qualities (Nesse and Berridge, 1997). Addiction ubiquitously requires culture for its realization, although its mechanisms predate culture. Therefore, addicts may have latent but important genomically selected sociophysiological attributes. This aspect of addiction may repay careful proximate investigations.

A variety of neuropharmacological systems subserve this sociophysiology. For example, opiates operate in the central nervous system by stimulating endogenous opiate receptors to effect subjective well-being, and alcohol facilitates GABA receptor activity as do benzodiazepines and hypnotic-sedatives (though alcohol, uniquely among sedative-hypnotics, also blocks a glutamate receptor thereby causing greater intoxication). Cocaine increases synaptic levels of dopamine, serotonin, and norepinephrine via inhibition of presynaptic reuptake transporters to induce arousal while amphetamine action is primarily via direct cell entry that causes monoamine release and synaptic availability. Nestler (1999) unites these diverse receptor actions within an overarching model as the pathways extend up the neuroaxis from the pontine brainstem to include hypothalamic nuclei and converge on the mesolimbic dopamine system with resultant reinforcement for continued drug usage.

In addition to the more accepted dopamine systems, Newlin (2002) implicates the pontine locus coeruleus in addiction mechanisms. He suggests addicts evolutionarily pursue a self-perceived survival fitness strategy. Acute intoxication causes the person to feel psychologically engaged with the world but fosters chronic psychopathology as it both habituates and sensitizes a neural system vulnerable to temporary, artificial activation by drugs of abuse.

Electrostimulation of this system causes individuals to seek restimulation. In some rodent models the switch is self-activated many times per second. Panksepp (1998) has argued that this should not be labeled "reward" as earlier investigators did because the reward in fact involves the appetitive arc of an appetite-satiation cycle. As this appetitive engagement process differs considerably from the reward associated with sexual or food satisfaction, he labeled the overall neurophysiological system as SEEKING and emphasized how it enhances individual interest in and exploration and mastery of the environment.

Additional complimentary data stems from substance abuse research. Morgan et al. (2002) linked dopamine systems to social rank hierarchy. Using positron emission tomography (PET) investigators evaluated the self-administration of cocaine on D2 receptor occupancy in Rhesus monkeys with different ranks of social dominance. High dominance produced evidence of heightened dopamine activity in the basal ganglia compared to when the same animals were socially isolated or in contrast to subordinate status. Indeed, dominant animals (top rankers in groups of four) showed no interest in cocaine (for them it had no reinforcement value). This was not true of the lowest-ranking subordinates, however, who universally showed great interest. The negative correlation for drug use and status accounted for 55 percent of the variance.

Human social rank hierarchies can be examined by the manifest behaviors of other psychiatric conditions, for example, mood disorder. Mania seems to caricature charismatic leadership. On the other hand, normal leaders exemplify "alpha" behavior, presumably via a phylogenetically sustained apparatus of social rank modulation. President Lyndon Johnson, though not functionally nor technically "manic," displayed core characteristics of mania—extraordinary energy, sociability, planning behavior, strong humor, and a dominating manner (Caro, 2002). In this he reflected activation of an alpha communicational propensity state keyed to effective leadership. The neuroregu-latory apparatus can become dysmodulated, however, particularly as to threshold, rate, and reversal factors that influence triggering, exhibition, and/or undue social persistence (Gardner, 1982). Thus, clinical presentation can be recast into syndromal and subsyndromal components that may lend greater understanding to clinical problems as well as naturally adaptive features.

A related study compared manic patients and normals (Gardner, 1998) according to features of their communicational propensity state. That is, acutely ill manic patients were assessed using an "alpha scale" derived from the core social dominance characteristics of mania as listed in the form of a 13-item checklist in a training manual for the Diagnostic and Statistical Manual. Third Edition (DSM-III). Their scores did not differ statistically from those of healthy community leaders matched for age and sex; the two groups did differ, however, from two other matched groups: healthy low-profile community citizens and bipolar patients euthymic from lithium treatment. Members of the two latter groups did not differ from each other on the alpha scale nor from a large introductory psychology class. This can be understood as reflecting a system for alpha communications (human dominance). Dominants in most animal groups have more mating privileges. This and related phenomena are often seen in high-ranking humans, as well (Wrangham and Peterson, 1996). Such propensities evolved initially to mediate proximal competition for mating and other resources, only later influencing other functions, such as parenting in mammals, and ultimately in humans, such roles as teaching and political positions.

To date, commentators have poorly appreciated the biology of social rank hierarchies. Some male fish, for example, change sex in response to social subordination. From the standpoint of evolutionary genetics, "her" genes may then be transmitted to progeny after "she" mates with the dominant male (Keenleyside, 1979). Social insect drones, naked mole rats, and New World monkeys also directly suppress sexual reproductive physiology when occupying subordinate positions in the social structure (Abbott et al., 1989). Sapolsky (1990) distinguished between dominant and subordinate baboons by measuring stress hormones linked to the pathophysiology of affective and anxiety disorders. Biological profiles of subordinates differ from those of more dominant animals in many species (Sapolsky, 1993). Moreover, hormone levels in both dominant and subordinate animals vary as a function of group stability, but social rank instability affects individuals differently, both with respect to directional trends in rank (going up versus down) as well as basic temperament (Sapolsky, 1994). Sociophysiological feedback in the natural environment largely determines dominance-subordination relationships. Moreover, pharmacological probes emphasize differences between dominant and subordinate animals. For example, rhesus monkeys given amphetamine react according to rank. Dominants show augmented threat, chase, and attack behaviors, but subordinates increased submissive behaviors, for example, fear grimaces and turning away (D.R. Wilson, 2002). A female rhesus monkey given amphetamine showed marked differences as she moved from one group to another. A low ranker in the first group, she behaved in an isolated fearful way; and amphetamine dramatically accentuated this. But when in the new group, where the alpha male favored her thereby elevating her status, she changed behavior accordingly and under the influence of amphetamine she threatened even more effectively and repeatedly.

In caged vervet monkey colonies of both sexes, serotonin levels reflect rank in males (Raleigh et al., 1984). Serotonin blood levels persistently measure twice higher in dominants compared to their subordinates (the same effect exists in humans but less dramatically, perhaps because human social rank represents a more complicated state). When removed from the cage and alone, the alpha vervet's serotonin blood levels fell over time while that of one of the subordinates remaining behind rises, as he newly assumes alpha status. Restoration of the formerly dominant male to the colony results in renewed increase in serotonin levels correlated with his renewed stature as dominant (this doesn't happen with a sufficiently delayed reunion, which diminishes rank continuity). Use of the serotonin reuptake inhibitor, fluoxetine, caused subordinates to achieve elevated alpha status (Raleigh et al., 1991).

Interestingly, discussions of basal ganglia physiology characteristically focus on movement disorders from the untoward effects of neuroleptic drugs. Yet such discussions may benefit from MacLean's focus (1990) on these structures that function in part to mediate ancient communicational repertoires that developed in deep time as part of the R-complex. Postural effects with communicational impact stem from increased dopamine in the basal ganglia; thus, the precursor molecule levodopa used as a treatment for parkinsonism may produce an expanded posture when the dose exceeds therapeutic levels (Crane and Gardner, 1969). Ethological observations in many species show that dominance correlates with the animal exhibiting larger posture and submissive yielding with a smaller pose. The levodopa-induced arms-torso extension resulting in a body expansion resembles that assumed by a person exerting dominance. In contrast, people with parkinsonism exhibit abnormally low levels of dopamine in these structures and typically show a flexed shrunken posture similar to a person submitting. Of course, these social rank postures are normally deployed in more distinct, socially communciative forms, that is, throwing the shoulders back and raising the arms when showing authority versus bowing and kneeling when submitting or supplicating.

Sex hormones also reflect social context and rank, in many species including humans. Androgen levels in both men and women vary depending on their degree of social competition or cooperation and also with success in competitive games (Kemper, 1984). Increases occur in even nonphysical competition such as chess. Thus neurotrans-mitter and endocrine parameters not only reflect features of social status, affect, and mood but link directly to reproductive biology itself.

D.R. Wilson (2002) integrates social dominance research within the triune hierarchy in a review that summarizes current knowledge of the phylo-ontogeny of neuro-mentation and neurotransmission. Notably, atavistic reptilian algorithms for dominance and submission remain active amid more affable mammalian complexes such as thermoregulation, motherhood, parenting, pair bonding, support of kin, play, and eusocial affiliation (MacLean, 1990). Vertebrate brains, notably those of humans, seem able to integrate a sense of self-esteem from various sources. Illustrating a theme underlined elsewhere in this chapter, self-esteem not unsurprisingly rises and falls on the basis of reciprocated signals (Eibl-Eibesfeldt, 1989), self-esteem being linked to the rank the individual possesses in the eyes of conspecifics. Expression and registration of such signals originate from phylogenetically old, deeply canalized sociophysiological systems bequeathed to any individual from inherited genomic elements that organize behavior. Subsequent mammalian and primate evolution greatly elaborate these sociophysio-logical repertoires; novel elements overlay but do not wholly replace more primitive features. Retentions themselves often modify and integrate rising primato-mammalian sociophysiology, for example, later limbic, cortical, neocortical tissues (and neuroendocrine innovations) intermesh with simpler functions that arose earlier.

Despite the tyranny sometimes of ancient forms, however, the human capacity for experiencing communicational states can be quite plastic. Thus, if one deliberately chooses to be subordinate, then interestingly one becomes "in charge" of that new position so that it can be assumed "conflict free." This can be distinguished from "resentful" submission, for instance, that may represent cognitive appreciation of the necessity to submit, but another level still holds out for winning. This, of course, is hardly unique to humans (e.g., dogs seem very satisfied with subordinate roles, though they also exert control over masters). And of course, the use of language in fostering more comfortable submissive states demonstrates part of the power of this human "invention."

Table 20.1 illustrates how MacLean's (1990) demonstration of the triune hierarchy of brain levels helps organize much complex sociophysiology. Simply rendering these three levels in matrix form across the two social modes (modeled by game

TABLE 20.1. Evolutionary Sociophysiology: "Hawk" and "Dove" Game Theory Models at Three Brain Levels

Three Brain Levels,

Social Mode, and Repertoires and

Cognitive-Behavioral and

Neurobiological Aspects Two Social Modes

Neomammalian Cortex SAHP

"Hawk" Attractive

"Dove" Avoidant

Sociotropic - Cognitive/SAHP

Optimistic charmer

Pessimistic and

Cognition » affect

Manic sociopathy

shamed

Sj > Sj ~ D3, 4 > Dj

S2, D3, 4, and NE

Depressed and

Advanced neurohormones &

high

obsessive

peptides

S2 low D3, 4 and NE?

Paleomammalian Submissive

Limbic RHP

Dominant

Acquisative-emotive/RHP

Roused winner

Downcast loser

Affect > cognition

Aggressive and

Morbid and

S1 > S2, D2, 3,4 > D1

sadistic

masochistic

Primitive neurohormones and

Sj, D3, 4 and NE

S1, D3, 4 and NE low

peptides

high

Reptilian Midbrain RAB

Fighting

Fleeing

Territorial-instinctive/RAB

Strident and strong

Cowering and weak

Instinct » affect » cognition

Violent and

Frightful, abulic

S1 » S2 << D1 » D2, 3, 4

solipsist

D1 and NE low S?

Few neurohormones and peptides

Dj and NE high S?

Hawk = evolutionarily stable strategy (ESS) sociophysiological repertoires—dominant.

Dove = evolutionarily stable strategy (ESS) sociophysiological repertoires—submissive.

RAB = ritualized agonistic behavior.

RHP = resource holding potential.

SAHP = social attention holding potential.

S = serotonin subreceptors (by numbered type, if applicable).

D = dopamine subreceptors (by numbered type, if applicable).

NE = norepinephrine subreceptors (by numbered type, if applicable).

Hawk = evolutionarily stable strategy (ESS) sociophysiological repertoires—dominant.

Dove = evolutionarily stable strategy (ESS) sociophysiological repertoires—submissive.

RAB = ritualized agonistic behavior.

RHP = resource holding potential.

SAHP = social attention holding potential.

S = serotonin subreceptors (by numbered type, if applicable).

D = dopamine subreceptors (by numbered type, if applicable).

NE = norepinephrine subreceptors (by numbered type, if applicable).

theory) yields an illustrative template in which a variety of neurobiological, cognitive-behavioral, and other sociophysiological information can be correlated. For example, the three levels each display a different evolutionarily stable strategy that entails varying ratios of instinctive, emotive, and rational behavioral repertoires that may be presumed to have evolved in serial assemblages. These begin with the more primitive ritualized agonistic behavior (RAB) of the reptilian midbrain, resource holding potential (RHP) in the paleomammalian paleolimbic system and social-attention holding potential (SAHP) in the eusocial neomammalian, neolimbic, and neocortical regions (Gilbert, 1992). Likewise, as a working hypothesis based on an array of existing data, the three levels may exhibit unique variations—phylogenies really—of peptidergic and neurotransmitter receptor subtypes, normative and pathological expressions, and other heuristics for evolutionary selective attainment (Wilson, 2002a). Moreover, these serial levels each modulate sociophysiological communications in a bimodal fashion with characteristic expressions of phylogenetic repertoires for dominance and submission and associated neurobiological or behavioral markers and clinical phenomenology.

The above summarizes research illustrating how levels of analysis can be socio-physiologically integrated. Of course, the field of neuroscience labels so vast an arena that it almost defies coherent conceptual modeling. But a precisely focused basic science rubric for psychiatry may foster research creativity and levels of integration. In particular, the application of evolutionary science with its basic tools of Darwinian analysis should promote a comprehensive genomics beyond the current inductive program of "micro-Mendelism," and additionally, lend foundational depth and comprehensive breadth to human behavioral capacities and dysfunctions.

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