Mental health clinicians are more than five times more likely to think that an evolutionary explanation of anxiety is beneficial to patients than the genetic approach currently taught to trainees and psychiatrists in the UK and US, a new study has shown.
The University of Cambridge-led study also found that clinicians in the UK and Ireland were three times more likely to rate a human evolutionary perspective on anxiety as useful for their practice and understanding compared to genetic explanations.
The researchers argue that explaining how anxiety has helped our species survive and thrive (essentially, a naturally evolved defense response that is easily triggered) provides more important context and a more positive outlook than explaining that anxiety may be “hardwired” into a person’s DNA.
Insecurity, they say, is related to “ancestral threats,” ranging from food shortages to social rejection from early hunter-gatherer tribes. Aspects of the modern world, such as online interactions and constant exposure to the news, can “amplify anxiety responses and push some people into pathological territory.”
“Anxiety and fear are adaptive responses that have evolved to help organisms, including humans, detect and avoid potential threats,” said Dr Adam Hunt, an evolutionary researcher at the Department of Archaeology, Cambridge, who led the study. British Journal of Psychiatry.
“Understanding anxiety as a deep-seated survival function that goes beyond the norm helps patients understand their symptoms as exaggerated versions of positive mechanisms rather than evidence of brain damage or abnormality.”
In an accompanying report from the Evolution and Mental Health Foundation, chaired by Hunt, experts call for hours of evolutionary instruction to be added to psychiatry and mental health training, along with public resources outlining the evolutionary utility of anxiety.
“With the increase in mental health diagnoses in recent years, the question of why these conditions exist has become increasingly pressing,” Hunt said.
“Neuroscientists are spending billions of dollars enlarging genes and rat brains. The assumption that we’ll get the answer at the right level of magnification doesn’t work. Evolution, the fundamental theory that explains all biology, is clearly the place to look.”
“When doctors are overwhelmed with anxiety-related appointments, evolutionary thinking may help treat people with health concerns that don’t necessarily require medical care.”
According to the World Health Organization, 359 million people worldwide will be living with an anxiety disorder in 2021, an increase of more than 55% since 1990. A quarter of 16-24 year olds in the UK report having a common mental health condition such as anxiety.
In the latest study, an international team of anthropologists and psychiatrists randomly assigned 171 practicing mental health clinicians from across the UK and Ireland to 30-minute sessions on either evolutionary or genetic explanations of anxiety, based on the latest scientific thinking in both fields.
Pre- and post-session questionnaires assessed clinicians’ optimism about how effective they thought each “psychoeducational” intervention would be, and their patients’ anticipated willingness to seek help as a result.
Clinicians overwhelmingly favored an evolutionary explanation. They were more than five times as likely to believe that evolution rather than genetics is beneficial to patients, and more than three times as likely to believe that it improves treatment approaches.
Clinicians also believed that people would be more willing to seek psychiatric help if evolutionary explanations were widely known (about 80% more likely than genetic explanations) and about 60% more likely to believe that anxiety patients could recover if they were helped from an evolutionary perspective.
“We found there was a lot of enthusiasm among psychiatrists about the potential of evolutionary ideas to promote a more hopeful and therapeutically empowering attitude,” said study co-author Dr Tom Carpenter, registrar of psychiatry at NHS Greater Glasgow and Clyde.
Importantly, the differences between the two groups of clinicians were driven by both the positive effects of evolutionary education and the negative effects of genetic education.
This genetics presentation highlights research showing that anxiety disorders are moderately heritable (approximately 20-60%), which may help explain familial patterns of anxiety and how “polygenic scores,” risk factors resulting from thousands of small genetic differences, may ultimately help identify and guide prevention strategies.
“Genetic framing actively worsened the attitudes of some clinicians, reinforcing the idea that patients would be pessimistic about their recovery,” Professor Hunt said.
The evolutionary presentation uses the “smoke alarm principle” to explain why anxiety has evolved to be biased toward false alarms. Deep in human history, existential threats from predators, starvation, and ostracism made it safer to react frequently than to overlook real danger.
Hunt points out that different types of anxiety evolved to cope with specific ancestral threats, producing distinct physiological and behavioral responses.
For example, anxiety related to predators or life-threatening danger can help explain the hypersensitivity seen in panic disorder and agoraphobia. Agoraphobia can make you vulnerable to signals in open spaces and situations where escape is difficult.
Specific phobias reflect exaggerated fear responses to stimuli such as animals, heights, and enclosed spaces. Social anxiety can be understood in relation to the risk of loss of status and abandonment by the group, which has, and still does, have profound implications for survival and reproductive success.
“Social anxiety has evolved as a tool for inclusion. It makes a lot of sense to have highly neurotic people in your tribe. We see it in our friend and family groups as well. Anxious people often think ahead and pick up on social cues to prevent disharmony,” Hunt said.
“But now, when people spend long hours or even days alone or using only the internet, they lack consistent feedback of acceptance. Some people instinctively go for a breakup.”
Hunt said he’s heard from psychiatrists who say that while young people are leaning toward diagnosing anxiety as a reason to stop socializing, young people should aim for the exact opposite.
“All organisms have to learn which parts of their environment are dangerous and which parts are not. This is one of the oldest learning mechanisms in biology and an example of successful adaptation,” Hunt said.
“Exposure therapy targets these evolved learning systems by repeating safe experiences that teach the brain that stimuli are not a threat. Belonging to a tribe is a type of continuous exposure therapy for social anxiety. Humans and our lineage have been among each other for millions of years,” he said.
“The goal is not to replace existing psychiatry with evolutionary slogans; it is to enrich front-line mental health work with a deeper understanding of human nature.”
He points out that Cambridge University graduate Charles Darwin predicted that his work on evolution would eventually help understand the spectrum of neurodiversity that underpins human communities.
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Reference magazines:
Hunt, A.D., et al. (2026) Clinicians’ attitudes toward evolutionary and genetic explanations for anxiety: A cluster-randomized study of stigmatization. British Journal of Psychiatry. DOI: 10.1192/bjp.2026.10615. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/clinicians-attitudes-to-evolutionary-versus-genetic-explanations-for-anxiety-clusterrandomized-study-of-stigmatization/3A637EBB58DBADAA2C2147DE6CA3AAFA
