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Objective There are numerous reports of people substituting medical cannabis (MC) for medications. Our obejctive was to investigate the degree to which this substitution occurs among people with rheumatic conditions. Methods In a secondary analysis from a cross‐sectional survey conducted with patient advocacy groups in the US and Canada, we investigated MC use and medication substitution among people with rheumatic conditions. We subgrouped by whether participants substituted MC for medications and investigated differences in perceived symptom changes and use patterns, including methods of ingestion, cannabinoid content (cannabidiol vs delta‐9‐tetrahydrocannabinol [THC]), and use frequency. Results Among 763 participants, 62.5% reported substituting MC products for medications, including nonsteroidal anti‐inflammatory drugs (54.7%), opioids (48.6%), sleep aids (29.6%), and muscle relaxants (25.2%). Following substitution, most participants reported decreases or cessation in medication use. The primary reasons for substitution were fewer adverse effects, better symptom management, and concerns about withdrawal symptoms. Substitution was associated with THC use and significantly higher symptom improvements (including pain, sleep, anxiety, and joint stiffness) than nonsubstitution, and a higher proportion of substitutors used inhalation routes than those who did not. Conclusion Although the determination of causality is limited by our cross‐sectional design, these findings suggest that an appreciable number of people with rheumatic diseases substitute medications with MC for symptom management. Inhalation of MC products containing some THC was most commonly identified among those substituting, and disease characteristics did not differ by substitution status. Further study is needed to better understand the role of MC for symptom management in rheumatic conditions.

Abstract Introduction The Department of Health and Human Services recently recommended rescheduling cannabis from Schedule I to Schedule III, which might have broad effects on public health outcomes related to cannabis. In this changing environment, understanding national patterns in how people obtain information about cannabis is critical to informing public health outreach and education. Methods We surveyed American adults (≥ 18 years) between June 22nd-26th, 2023 using the AmeriSpeak panel. We assessed past year cannabis use, intentions for cannabis use, and where participants got their information about cannabis. We investigated differences by past year use and explored associations between demographic and cannabis use characteristics with information sources using logistic regression. Results Participants (n = 1,161) were 48.3±27.3 years of age (mean±standard deviation), 51% female, and 27% reported past year cannabis use. The most common information sources used were friends/family (35.6%) and websites (33.7%), while the least common information sources were health/medical care providers (9.3%), employees at place of purchase (8.6%), and government agencies (4.7%). Past year cannabis use was positively associated with all information sources except government agencies and popular media articles. A higher proportion of those using cannabis medically (with or without recreational use) obtained information from a healthcare provider (16.4% vs. 5.2%, p = 0.006). Conclusions As cannabis accessibility increases and legality continues changing, there is a strong need for better clinician education, improved public health outreach, and improved communication between patients and clinicians about cannabis.

Abstract Background Drug overdose is a leading cause of death and opioid-related deaths increased by more than 300% from 2010 to 2020 in New York State. Experts holding a range of senior leadership positions from across New York State were asked to identify the greatest challenges in substance misuse prevention, harm reduction, and treatment continuum of care. Expert input was used to shape funding priorities. Method Individual semi-structured interviews of sixteen experts were conducted in April and May 2023. Experts included academics, medical directors, leaders of substance misuse service agencies, administrators of a state agency, a county mental health commissioner, the president of a pharmacy chain, and a senior vice president of an addiction-related national non-profit. Zoom interviews were conducted individually by an experienced qualitative interviewer and were recorded, transcribed, and coded for content. An initial report, with the results of the interviews organized by thematic content, was reviewed by the research team and emailed to the expert interviewees for feedback. Results The research team identified five major themes: 1. Siloed and fragmented care delivery systems; 2. Need for a skilled workforce; 3. Attitudes towards addiction (stigma); 4. Limitations in treatment access; and 5. Social and drug related environmental factors. Most experts identified challenges in each major theme; over three-quarters identified issues related to siloed and fragmented systems and the need for a skilled workforce. Each expert mentioned more than one theme, three experts mentioned all five themes and six experts mentioned four themes. Conclusions Research, educational, and programmatic agendas should focus on identified topics as a means of improving the lives of patients at risk for or suffering from substance use-related disorders. The results of this project informed funding of pilot interventions designed to address the identified care challenges.

Objective Understanding how medical cannabis (MC) use is integrated into medical practice for rheumatic disease management is essential. We characterized rationale for MC use, patient–physician interactions around MC, and MC use patterns among people with rheumatic conditions in the US and Canada. Methods We surveyed 3406 participants with rheumatic conditions in the US and Canada, with 1727 completing the survey (50.7% response rate). We assessed disclosure of MC use to health care providers, MC authorization by health care providers, and MC use patterns and investigated factors associated with MC disclosure to health care providers in the US versus Canada. Results Overall, 54.9% of US respondents and 78.0% of Canadians reported past or current MC use, typically because of inadequate symptom relief from other medications. Compared to those in Canada, fewer US participants obtained MC licenses, disclosed MC use to their health care providers, or asked advice on how to use MC (all P values

IntroductionThere is substantial public interest in psychedelics as potential treatments for psychiatric conditions. However, most psychedelics are criminalized under federal law in the USA, so it is unclear whether use occurs with clinical support. Our objective was to assess whether naturalistic psychedelic use occurs with clinical support, interactions between those using psychedelics and healthcare providers (psychiatrist, therapist, or primary physicians), and use characteristics.MethodsWe conducted an online, anonymous, confidential, cross-sectional survey of adults reporting psychedelic use (N = 1221) through a psychedelics advocacy event and social media between 9/18/2022 and 11/5/2022. We assessed participant disclosure of psychedelic use with their psychiatric care provider (PsyCP) and/or primary care provider (PCP), desire for provider support, access to support, and rate of taking prescribed psychoactive medications alongside psychedelics.ResultsAmong participants with such care providers, 22% disclosed psychedelic use to their PCP vs. 58% to their PsyCP. Participants were less confident in PCP vs. PsyCP ability to integrate psychedelics into treatment. Common reasons for nondisclosure included stigma, inadequate provider knowledge, and legal concerns. 23% reported taking psychedelics on the same day as potentially interacting psychiatric medications (e.g., anxiolytics, antidepressants). Despite 81% of participants desiring therapist support during psychedelic experiences, only 15% had received such support.DiscussionOur results show that psychedelic use is generally disconnected from primary and psychiatric clinical care. This disconnection may result in safety issues, including inadequate screening for contraindicated conditions, lack of support during emergent adverse events, and drug interactions. Enhanced clinical education and orienting drug policy towards known harms and benefits of psychedelics is needed.

Abstract Background Patients use medical cannabis for a wide array of illnesses and symptoms, and many substitute cannabis for pharmaceuticals. This substitution often occurs without physician oversight, raising patient safety concerns. We aimed to characterize substitution and doctor-patient communication patterns in Canada, where there is a mature market and national regulatory system for medical cannabis. Methods We conducted an anonymous, cross-sectional online survey in May 2021 for seven days with adult Canadian federally-authorized medical cannabis patients (N = 2697) registered with two global cannabis companies to evaluate patient perceptions of Primary Care Provider (PCP) knowledge of medical cannabis and communication regarding medical cannabis with PCPs, including PCP authorization of licensure and substitution of cannabis for other medications. Results Most participants (62.7%, n = 1390) obtained medical cannabis authorization from their PCP. Of those who spoke with their PCP about medical cannabis (82.2%, n = 2217), 38.6% (n = 857) reported that their PCP had “very good” or “excellent” knowledge of medical cannabis and, on average, were moderately confident in their PCP’s ability to integrate medical cannabis into treatment. Participants generally reported higher ratings for secondary care providers, with 82.8% (n = 808) of participants rating their secondary care provider’s knowledge about medical cannabis as “very good” or “excellent.” Overall, 47.1% (n = 1269) of participants reported substituting cannabis for pharmaceuticals or other substances (e.g., alcohol, tobacco/nicotine). Of these, 31.3% (n = 397) reported a delay in informing their PCP of up to 6 months or more, and 34.8% (n = 441) reported that their PCP was still not aware of their substitution. Older, female participants had higher odds of disclosing cannabis substitution to their PCPs. Conclusion Most of the surveyed Canadian medical cannabis patients considered their PCPs knowledgeable about cannabis and were confident in their PCPs’ ability to integrate cannabis into treatment plans. However, many surveyed patients substituted cannabis for other medications without consulting their PCPs. These results suggest a lack of integration between mainstream healthcare and medical cannabis that may be improved through physician education and clinical experience.

Abstract Background Products containing delta-8-THC became widely available in most of the USA following the 2018 Farm Bill and by late 2020 were core products of hemp processing companies, especially where delta-9-THC use remained illegal or required medical authorization. Research on experiences with delta-8-THC is scarce, some state governments have prohibited it because of this lack of knowledge. Objective We conducted an exploratory study addressing a broad range of issues regarding delta-8-THC to inform policy discussions and provide directions for future systematic research. Methods We developed an online survey for delta-8-THC consumers, including qualities of delta-8-THC experiences, comparisons with delta-9-THC, and open-ended feedback. The survey included quantitative and qualitative aspects to provide a rich description and content for future hypothesis testing. Invitations to participate were distributed by a manufacturer of delta-8-THC products via social media accounts, email contact list, and the Delta8 Reddit.com discussion board. Participants (N = 521) mostly identified as White/European American (90%) and male (57%). Pairwise t tests compared delta-8-THC effect rating items; one-sample t tests examined responses to delta-9-THC comparison items. Results Most delta-8-THC users experienced a lot or a great deal of relaxation (71%); euphoria (68%) and pain relief (55%); a moderate amount or a lot of cognitive distortions such as difficulty concentrating (81%), difficulties with short-term memory (80%), and alerted sense of time (74%); and did not experience anxiety (74%) or paranoia (83%). Participants generally compared delta-8-THC favorably with both delta-9-THC and pharmaceutical drugs, with most participants reporting substitution for delta-9-THC (57%) and pharmaceutical drugs (59%). Participant concerns regarding delta-8-THC were generally focused on continued legal access. Conclusions Delta-8-THC may provide much of the experiential benefits of delta-9-THC with lesser adverse effects. Future systematic research is needed to confirm participant reports, although these studies are hindered by the legal statuses of both delta-8-THC and delta-9-THC. Cross-sector collaborations among academics, government officials, and representatives from the cannabis industry may accelerate the generation of knowledge regarding delta-8-THC and other cannabinoids. A strength of this study is that it is the first large survey of delta-8 users, limitations include self-report data from a self-selected convenience sample.

Abstract Background People report using cannabis as a substitute for prescription medications but may be doing so without the knowledge of their primary health care providers (PCPs). This lack of integration creates serious concerns, e.g., using cannabis to treat medical conditions that have established treatment options. Methods We conducted an anonymous, cross-sectional online survey among patrons of a medical cannabis dispensary in Michigan (n = 275) to examine aspects of their relationship with their PCP and their perceptions of PCP knowledge related to cannabis. Results Overall, 64% of participants initiated medical cannabis use based on their own experiences vs. 24% citing advice from their PCP. Although 80% reported that their PCP knew they currently used medical cannabis, 41% reported that their PCP had not always known. Only 14% obtained their medical cannabis authorization from their PCP. Only 18% of participants rated their PCP’s knowledge about medical cannabis as very good or excellent and only 21% were very or completely confident in their PCP’s ability to integrate medical cannabis into their treatment. Although 86% had substituted cannabis for pharmaceutical medications, 69% (n = 134) of those who substituted reported some gap in their PCP’s knowledge of their substitution, and 44% (n = 86) reported that their PCP was currently unaware of their substitution. Conclusions Patients frequently substitute cannabis for prescription drugs, often without PCP knowledge. Although most participants disclosed cannabis use to their PCP, their perceptions of PCP knowledge ranged widely and many obtained medical cannabis licensure from an outside physician. Our results highlight the need for standardized physician education around appropriate medical cannabis use.

Abstract Background Medical cannabis users report that their knowledge regarding cannabis is predominantly from their own personal experiences and the Internet. Objective We summarize and describe information found through Internet searches on medical cannabis in English language websites. Methods We used terms related to medical cannabis in the Google search engine between November and December 2019. Resulting websites were catalogued and coded for content, including mentions of health and medical conditions, pharmacology, dosage, harmful or adverse effects, harm reduction techniques, cautions or warnings, products for sale, and credentials. Results We coded 344 web pages on 179 unique websites. Cannabis was mentioned for the treatment of 151 different medical and health conditions, only four of the twenty most frequently mentioned conditions have received substantial empirical support for cannabis or cannabinoid treatment. Information content varied widely across sites, only a small proportion of sites included information on pharmacology, dosage, risks, and other aspects that are requirements for pharmaceutical drugs. Information provided was only moderately related to conclusions in the emerging scientific literature. Conclusions Given the rise in cannabis use within the U.S. and the reliance on the Internet as a source of information, considerable efforts are needed to provide accurate on-line cannabis education to minimize harms and maximize benefits for individuals and society.

Evolutionary definitions of altruism are only concerned with reproductive consequences and not motives or other psychological mechanisms, making them ideal for generalization to all forms of organisms. Hamilton’s inclusive fitness theory explains altruistic behavior toward genetic relatives and has generated extensive empirical support. Trivers’ theory of reciprocal altruism helps explain patterns of helping among non-kin, and other research has demonstrated that human helping intentions follow fitness consequences from age-based reproductive value on altruism. The current study examines a novel psychological factor, belief in the afterlife, which may influence altruistic helping intentions. Belief in the afterlife was incorporated into a previous study design assessing the effects of a target’s genetic relatedness and age-based reproductive value. The influences of inclusive fitness and target age were reproduced in a non-Western sample of participants ( N = 300) in Iran. Belief in the afterlife predicted the overall confidence of risking one’s life to save another across all targets, and also moderated the effects of genetic relatedness and target age. Rather than promoting altruism equitably or advantaging those favored by adaptive tendencies, higher belief in an afterlife aligned with these tendencies in promoting further favoritism toward close kin and younger targets with higher reproductive value.

Life History Theory is a powerful framework that can help promote understanding of variation in health-related behavioral patterns and why they vary consistent with environmental conditions. An organism's life history reflects tradeoffs made in the allocation of effort towards specific aspects of survival and reproduction across the lifespan. This study examines the relationship between psychological indicators of life history strategy and health related behaviors in a demographically representative sample in the Midwestern USA. Slower life histories predicted higher levels of health promoting behaviors and lower levels of health adverse behaviors, even when controlling for relevant socio-demographic factors. The analyses provide a strong test of the hypothesized relationship between life history and health behavior indicators, as life history variation co-varies with these socio-demographic factors. Traditional public health efforts may be reaching their limits of effectiveness in encouraging health-promoting behaviors. Integrating an evolutionary framework may revitalize behavioral health promotion efforts.

Life history theory (LHT) is a powerful evolutionary framework for understanding physiological, psychological, and behavioral variation both between and within species. Researchers and theorists are increasingly integrating LHT into evolutionary psychology, as it provides a strong foundation for research across many topical areas. Human life history variation has been represented in psychological and behavioral research in several ways, including indicators of conditions in the developmental environment, indicators of conditions in the current environment, and indicators of maturation and life milestones (e.g., menarche, initial sexual activity, first pregnancy), and in self-report survey scale measures. Survey scale measures have included constructs such as time perspective and future discounting, although the most widely used index is a constellation of indicators assessing the K -factor, thought to index general life history speed (from fast to slow). The current project examined the utility of two brief self-report survey measures assessing the life history dimensions of mating effort and parenting effort with a large undergraduate sample in the United States. Consistent with the theory, items reflected two inversely related dimensions. In regressions including the K -factor, the Mating Effort Scale proved to be a powerful predictor of other constructs and indicators related to life history variation. The Parenting Effort Scale had less predictive power overall, although it explained unique variance across several constructs and was the only unique predictor of the number of long-term (serious and committed) relationships. These scales may be valuable additions to self-report survey research projects examining life history variation.

This article attends to recent discussions of validity in psychometric research on human life history strategy (LHS), provides a constructive critique of the extant literature, and describes strategies for improving construct validity. To place the psychometric study of human LHS on more solid ground, our review indicates that researchers should (a) use approaches to psychometric modeling that are consistent with their philosophies of measurement, (b) confirm the dimensionality of life history indicators, and (c) establish measurement invariance for at least a subset of indicators. Because we see confirming the dimensionality of life history indicators as the next step toward placing the psychometrics of human LHS on more solid ground, we use nationally representative data and structural equation modeling to test the structure of middle adult life history indicators. We found statistically independent mating competition and Super-K dimensions and the effects of parental harshness and childhood unpredictability on Super-K were consistent with past research. However, childhood socioeconomic status had a moderate positive effect on mating competition and no effect on Super-K, while unpredictability did not predict mating competition. We conclude that human LHS is more complex than previously suggested—there does not seem to be a single dimension of human LHS among Western adults and the effects of environmental components seem to vary between mating competition and Super-K.

There is a growing interest in the unification of health research in a biopsychosocial framework. However, increasing specialization and advancement in instrumentation makes it more difficult to bridge understanding across areas. It would be very useful to ground biopsychosocial research in the most powerful explanatory framework in the life sciences, evolution by natural and sexual selection. This would require and explanation of the functional significance of the phenomena related to the area of study, in addition to descriptions of the mechanism. The application of an integrative evolutionary framework will be illustrated with the example of sex differences in human mortality rates, which are related to endocrine, psychological, and socio-environmental factors. The integrative evolutionary model will be contrasted with a theoretical model that acknowledges physiological and social influences, but artificially separates them.

Being male is the strongest demographic predictor of early mortality in Croatia. For every woman who dies between the ages of 15 and 34, three men die. Between the ages of 15 and 54, men are four times as likely as women to die from behavioral causes of death, such as accidents, homicides, and suicides. A causal explanation for sex differences in mortality must be based on an understanding of how sex differences were shaped by natural selection, and how those differences interact with environmental factors to create observed patterns and variations. In brief, males have been selected for riskier behavioral and physiological strategies than women, because of the greater variance and skew in male reproductive success. This paper examines the sex difference in Croatian mortality in three parts. First, we quantify the Croatian Male to Female Mortality Ratio (M:F MR) for 9 major causes of death across age group to provide a richer understanding of the sex difference in mortality from a life history framework. Second, we compare the Croatian M:F MR from behavioral, internal, and all causes with that of the available world population to demonstrate how Croatian mortality can be understood as part of a universal pattern that is influenced by unique environmental context. Third, we investigate how the War of Independence in 1991-1995 affected mortality patterns though its impact on behavioral strategies and the physical embodiment of distress.

We generated an inventory of 27 interpersonal behaviors and examined the extent to which participants judged each behavior as cheating on a long-term partner. We predicted variation in these judgments based on participant sex and attachment insecurity. Ratings for items ranged considerably; participants rated sexual behaviors as most indicative of cheating, then erotic behaviors, followed by behaviors consistent with a romantic relationship, and then behaviors related to financial support. Women rated ten items higher than did men, and men's ratings were higher on a minor financial support item. Higher attachment anxiety was associated with higher ratings for 18 of 27 behaviors; higher attachment avoidance was associated with lower scores on five items and higher scores on one item. Principle Axis Factoring identified three dimensions; sexual interaction, behaviors indicating close relationships, and casual social interaction. We discuss these results using the framework of attachment theory and sex-specific mating strategies.

When women are scarce in a population relative to men, they have greater bargaining power in romantic relationships and thus may be able to secure male commitment at earlier ages. Male motivation for long-term relationship commitment may also be higher, in conjunction with the motivation to secure a prospective partner before another male retains her. However, men may also need to acquire greater social status and resources to be considered marriageable. This could increase the variance in male marital age, as well as the average male marital age. We calculated the Operational Sex Ratio, and means, medians, and standard deviations in marital ages for women and men for the 50 largest Metropolitan Statistical Areas in the United States with 2000 U.S Census data. As predicted, where women are scarce they marry earlier on average. However, there was no significant relationship with mean male marital ages. The variance in male marital age increased with higher female scarcity, contrasting with a non-significant inverse trend for female marital age variation. These findings advance the understanding of the relationship between the OSR and marital patterns. We believe that these results are best accounted for by sex specific attributes of reproductive value and associated mate selection criteria, demonstrating the power of an evolutionary framework for understanding human relationships and demographic patterns.

Sex differences in mortality rates stem from a complex set of genetic, physiological, psychological, and social causes whose influences and interconnections are best understood in an integrative evolutionary life history framework. Although there are multiple levels of mechanisms contributing to sex based disparities in mortality rates, the intensity of male mating competition in a population may have a crucial role in shaping the level of excess male mortality. The degree of variation and skew in male reproductive success may shape the intensity of male mating competition, leading to riskier behavioral and physiological strategies. This study examines three socio-demographic factors related to variation in human male reproductive success; polygyny, economic inequality, and the population ratio of reproductively viable men to women across nations with available data. The degrees of economic inequality and polygyny explained unique portions in the sex difference in mortality rates, these predictors accounted for 53% of the variance. The population ratio of reproductively viable men to women did not explain any additional variance. These results demonstrate the association between social conditions and health outcomes in modern nations, as well as the power of an evolutionary life history framework for understanding important social issues.

If marriage markets were only subject to the influences of numerical supply and demand, one would expect that the scarcer sex in a population would have a greater proportion married. Previous research has demonstrated that when males are scarce, they are actually less likely to be married, presumably because their market scarcity enhances their short term mating success and decreases incentives for commitment. However, males in modern societies appear to shift from mating effort to parental investment across the life course. Also, women preferentially value indicators of phenotypic quality for short term relationships, and these signals may be increasingly difficult to display with progressive physiological senescence. We predicted that men in low sex ratio populations would use market scarcity to their advantage for mating effort when young, but would shift towards commitment strategies when older. Data from the 50 largest Metropolitan Statistical Areas in the USA confirmed that a female biased sex ratio was associated with a lower proportion of men married between ages 20 and 29, but a higher proportion of men married between ages 35 and 74.

Cross-culturally, male economic power is directly related to reproductive success. Displays of wealth and social status are an important part of human male mating effort. The degree of male financial consumption may be related to variance in life history strategies, as differences in life history patterns are fundamentally differences in the allocation of effort and/or resources. Males who have higher mating intentions may maximize their economic displays, saving little and even spending beyond their capacity through the use of credit. These men may seek and possibly obtain a greater number of sexual partners. This hypothesis was tested in a randomly selected community sample of men aged 18–45 included in a telephone health interview. The degree of financial consumption was directly related to future mating intentions and past mating success, even when accounting for age, years of education completed, and marital status. The degree of financial consumption was not related to future mating intentions or past mating success for women in the same sample.

Life history theory (LHT) is a powerful framework for examining relationship choices and other behavioral strategies which integrates evolutionary, ecological, and socio-developmental perspectives. We examine the relationship between psychological and behavioral indicators of women's life history attributes and hypothetical relationship choices with characters representing short-term and long-term male sexual strategies. We demonstrate that psychological indicators of women's life history strategies are related to predicted and actual behaviors in mating relationships. Women with insecure attachment styles, especially those with negative evaluations of both themselves and others (fearful attachment), were more likely to consider men with attributes indicating short-term mating strategies for short-term and long-term relationships than women with a secure attachment style. Women with relatively unrestricted sociosexuality were more likely to predict they would have sexual affairs with men in general, with the tendency being generally stronger when considering men with attributes indicating short-term mating strategies. Those who scored high on self-monitoring were also more likely to predict having sexual affairs and short-term relationships with these men. These and other findings demonstrate the usefulness of a life history approach for understanding women's relationship choices.

Adults in many species exhibit exchanges in reproductively relevant currencies, where males trade resources for sexual relations with females, and females have sex with males in exchange for provisioning. These exchanges can occur outside of a long-term partnership, which itself could be considered a commitment to the accessibility of reproductive currencies provided by each partner. The current study investigated whether young adults who are not in acute need of resources intentionally attempt reproductive currency exchanges outside of dating relationships or formal committed relationships such as marriage; and whether young adults have awareness of being the target of such attempts made by others. College students ( N = 475) completed a brief survey assessing their own attempts to exchange reproductively relevant currencies, as well as others' attempts to make these exchanges with them. Men were more likely to report making attempts to trade investment for sex and women were more likely to report attempted trades of sex for investment. Participants' experiences of exchange attempts initiated by other individuals mirrored these patterns. Men were more likely to report another individual trying to trade sex for their investment, and women were more likely to report another individual trying to trade investment for sex with them. The vast majority of these attempted exchanges took place outside of existing relationships, although a small portion did lead to short or long-term relationships.

From an evolutionary perspective, human risk-taking behaviors should be viewed in relation to evolutionarily recurrent survival and reproductive problems. In response to recent calls for domain-specific measures of risk-taking, we emphasize the need of evolutionarily valid domains. We report on two studies designed to validate a scale of risky behaviors in domains selected from research and theory in evolutionary psychology and biology, corresponding to reoccurring challenges in the ancestral environment. Behaviors were framed in situations which people would have some chance of encountering in modern times. We identify five domains of risk-taking: between-group competition, within-group competition, mating and resource allocation for mate attraction, environmental risks, and fertility risks.

Sex differences in mortality rates stem from a complex set of genetic, physiological, psychological, and social causes whose interconnections are best understood in an integrative evolutionary framework. We predicted that the transition from centrally planned to market economies in Eastern Europe inflated the discrepancy between male and female mortality rates, because economic uncertainty and increasing variation and skew in social status and resources should increase risky male behavior and the impact of stress on physiological susceptibility to internal causes of death. We computed the ratio of the male mortality rate to the female mortality rate separately for 14 Eastern European countries and for the combined population of 12 Western European countries in the pre-transition (1985–1989), transition (1990–1994), and post-transition (1995–1999) periods. We found that the Male to Female Mortality Ratio (M:F MR) for 14 Eastern European nations increased during the years of economic transition, most prominently during early adulthood. Larger sex differences in mortality rates occurred in both young adulthood, reflecting a shift towards riskier behavioral strategies, and middle adulthood, indicating greater physiological susceptibility to stress. For 12 of the 14 Eastern European nations, the increase was substantially larger than the slight increase in the overall Western European M:F MR. The impact of the transition on the magnitude of mortality discrepancy across countries varies considerably and likely reflects conditions particular to each country. These findings illustrate how traits shaped by natural selection interact with environmental conditions to influence male psychology and ultimately mortality patterns.

More frequent risk taking among young men than women has been explained as a sexually selected trait, perhaps advertising male quality. We investigated this hypothesis in three studies. (1) Young men and women rated how attractive they would find it if a potential partner took various specific risks. A domain-specific risk inventory allowed us to distinguish whether risk taking is attractive generally or only in certain domains. Both sexes reported social and recreational risk taking as attractive (the latter not always significantly so), but other domains of risk taking as unattractive (ethics, gambling, and health) or neutral (investment). The sexes differed markedly little. Parallel studies in Germany and the United States yielded very similar results. (2) We asked subjects to predict how attractive the other sex would find it if the subject performed each risky behavior. Both sexes were rather accurate (which could be merely because they assume that the other sex feels as they do) and sex differences in attractive risk taking are not explicable by sex differences either in attraction or in beliefs about what others find attractive. However, our data could explain why unattractive risks are more often taken by men than women (men slightly underestimated the degree of unattractiveness of such risks, whereas U.S. women overestimated it, perhaps because they themselves found such risk taking more unattractive than did U.S. men). (3) Both members of 25 couples reported their likelihood of engaging in specific risky behaviors, their perception of these risks, and how attractive they would have found these behaviors in their partner. One hypothesis was that, for instance, a woman afraid of heights would be particularly impressed by a man oblivious to such risks. Instead we found positive assortment for risk taking, which might be explained by a greater likelihood of encountering people with similar risk attitudes (e.g. members of the same clubs) or a greater compatibility between such mates. Finally, contrary to the assumption that taking a low risk is likely to be less revealing of an individual's quality than taking a high risk, we found a strong negative relationship between the perceived riskiness of a behavior and how attractive it was judged.

This paper extends the evolutionary understanding of sex differences in mortality rates by quantifying and graphically examining the overall Male to Female Mortality Ratio (M:F MR) for 11 specific leading causes of death across age groups in the USA, over the course of the lifespan in 20 different countries, and across the past 70 years in 5 countries. The resulting quantitative descriptions of rates, trends, and the relative contributions of various proximate causes of death to the M:F MR provide an initial exploration of the risks associated with being male. This analysis also illustrates how sex differences shaped by sexual selection interact in complex ways with multiple aspects of culture and environment to yield a pattern that has some consistency across decades and societies, but also has variations arising from differences among cohorts and cultures. The results confirmed our expectations of higher mortality rates for men than for women, especially in early adulthood, where three men died for every woman who died. For external causes the ratios were even higher. Historical mortality data reflect an epidemiological transition in which discrepancies between male and female mortality rates increase as general mortality rates fall. Cross-national variation in the modern M:F MR further suggests a universal pattern that is influenced by cultural and environmental context. Being male is now the single largest demographic risk factor for early mortality in developed countries.

There appears to be a common belief among evolutionary psychologists that academic positions may be difficult to obtain. Similar to many contemporary students involved in Evolutionary Psychology (EP), we were concerned as to our academic job prospects. This worry seems to be frequently shared by academic supervisors, as a training in EP may make a student undesirable for future academic positions. As recent students in EP who now possess academic positions, we have reflected upon our experiences to provide advice as to what students and their supervisors can do to improve their employment prospects. We begin by individually discussing our backgrounds, including the details of our current positions, and then come together in the discussion section to offer some suggestions to students and supervisors.