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1. 00:02 So nature or nurture? This is the millennia old debate. Are we
2. 00:10 born with some kind of template, some kind of predisposition or proclivity that predispose us to develop mental health disorders?
3. 00:21 Or do we acquire psychopathologies along the way? Do we become mentally ill
4. 00:29 by being exposed to highly specific environments, abusive, traumatizing,
5. 00:35 dysfunctional environments, and to highly specific people, narcissists, psychopaths, as parents, as role models,
6. 00:42 as peers? Which is it? The wishy-washy answer is both. We are born with a
7. 00:50 template or a predisposition, but these are not triggered. These genes are not expressed and not triggered unless and until we are exposed to an environment
8. 01:02 which is less than optimal, suboptimal, an environment which pushes us over the
9. 01:10 genetic hereditary edge into the territory of mental illness. That is a
10. 01:17 common answer. However, and and even though I subscribe to this view, um sometimes I come across
11. 01:28 issues in mental health and mental illness, issues in psychology that seem to challenge the very foundations of
12. 01:35 this wellaccepted paradigm. And today I’m going to discuss one of these
13. 01:41 issues, spousal correlation. And how it seems to indicate that mental
14. 01:48 health or mental illness actually is to a large degree determined by the
15. 01:54 environment, by who you live with, who you work with,
16. 02:00 who you study with, who you interact with. And in short, your interpersonal relationships seem to determine who you
17. 02:08 are as far as mental health and mental disorder or mental dysfunction.
18. 02:15 Where genetics enters all this is an open question and spousal correlation
19. 02:23 raises serious problems with this model of nature plus nurture equals mental
20. 02:30 health problems. serious serious serious challenges to this view.
21. 02:38 My name is Sambaknne and I’m the author of malignant self- loveve narcissism revisited. I’m in I’m a professor of
22. 02:44 psychology. I’m in Paris right now. If you want to talk to me with a paid consultation or if you want to organize
23. 02:51 a free lecture or a free seminar in this city of lights, I’m all at your disposal, write to me sambakin@gmail.com. Let’s get straight into the subject. I
24. 03:05 have I have dealt with the diiathesis stress model, the diiathesis stress
25. 03:11 model. I’ve dealt with it in another video. You can find the link in the description.
26. 03:17 The diiathesis stress or the stress vulnerability model says that we are born with vulnerabilities and then we are exposed to specific
27. 03:30 environments, specific people, specific relationships which are stressful. They induce anxiety
28. 03:37 and tension and these trigger the vulnerability, trigger the susceptibility. And this is how mental
29. 03:44 illness or mental disorder, a mental health disorder or mental dysfunction,
30. 03:50 how they’re born. They’re born from the interplay between vulnerability and
31. 03:56 stress. I would like to expand the diiathesis stress model a bit and to suggest that
32. 04:05 having a psychological need is in itself by definition a vulnerability
33. 04:12 and when this need is frustrated what we have is stress.
34. 04:19 Whereas the classic, the currently acceptable, the mainstream diiathesis stress model regards vulnerabilities and
35. 04:27 susceptibilities as mostly hereditary. I suggest that our psychological needs
36. 04:35 constitutes they constitute weaknesses, frailties,
37. 04:41 chinks in the armor. And so whenever our needs are not met,
38. 04:47 whenever we are not seen, whenever we are not catered to, this creates frustr frustration which could lead to
39. 04:54 aggression according to Donald. But the frustration itself is stress inducing.
40. 05:01 The stress is secondary. The stress is not primary. The fact that our
41. 05:08 psychological needs are not met, this fact creates the stress creates the
42. 05:14 dissonance which then gives rise to anxiety. So this is an expanded diaphysis stress model and it would
43. 05:22 explain many many mental health issues especially personality disorders.
44. 05:29 Consider for example paranoid ideiation. The paranoid person is grandiose. The
45. 05:36 paranoid person regards himself or herself as the center of the universe. Oh, definitely the center of malign
46. 05:43 intention, the butt of a conspiracy. This places the paranoid person smack in
47. 05:50 the middle of everything. And so this focus of attention is self- agrantizing.
48. 05:57 So the paranoid has a fantastic grandiose self-concept. But this is not
49. 06:04 the main feature of paranoia in my view. Although I consider paranoia, paranoid
50. 06:10 personality disorder and paranoid ideiation as features of narcissism,
51. 06:16 narcissistic disorder of the self. I still believe that in paranoia there’s an added layer and that’s the layer of
52. 06:24 looking for meaning. There’s a psychological need, psychological dependency on meaning. The paranoid
53. 06:33 looks for meaning. Once paranoid wants to make sense of his or her world.
54. 06:41 So this quest for meaning generates theories about the world. Some of these
55. 06:48 theories are known as conspiracy theories. And these theories about the world place
56. 06:54 the paranoid at the center. Of course, that’s the grandiose part. But at the same time, they have a hermeneutic
57. 07:01 value. These theories make sense of the world, explain to the paranoid his life
58. 07:08 and the lives of others around him. Make um um a an explicatory have an
59. 07:16 explicatory power when it comes to the paranoid’s mind and to the minds of others. In other words, the this the
60. 07:23 paranoia generates on the fly a theory of mind. It also creates an internal
61. 07:30 working model in that it explains why people behave the way they do in interpersonal relationships. And so paranoia is mostly about finding
62. 07:42 meaning. Whereas reality is perceived as completely meaningless,
63. 07:50 random, inexplicable, mysterious, hence the conspiracy. So in
64. 07:56 paranoid ideation, we have a conflict between a psychological need for meaning that is being frustrated by reality.
65. 08:06 Reality does not sit well with the paranoid paranoid’s need for meaning. Reality refuses to succumb and surrender its secrets. In that point, the paranoid
66. 08:19 chooses meaning. However counterfactual, however fantastic,
67. 08:25 however conspiratorial, however crazy, but paranoid chooses
68. 08:31 meaning over reality in order to avoid the frustration.
69. 08:37 Let’s talk about avoidant people including for example borderline people with borderline personality disorder in
70. 08:43 the engulfment phase or reactive to the to engulfment anxiety. Border lines tend
71. 08:49 to become avoidant in these situations. People with avoidant um avoidant
72. 08:55 relationships or avoidant attachment styles. Avoidance in general. Avoidance
73. 09:01 is a pathology in the sense that it is widely considered to be unhealthy
74. 09:08 and it involves again a conflict between a psychological need that is frustrated
75. 09:14 and not met and the alternative which would never satisfy this need. The need
76. 09:21 is to not be hurt, to avoid harm, to avoid hurt, to avoid pain. There’s pain
77. 09:28 aversion which translates into conflict aversion and sometimes people pleasing but there’s pain aversion whereas socializing always involves a modiccom of hurt and
78. 09:40 pain and humiliation and insults and so on so forth. Interact with other people other people are unpredictable. Many of
79. 09:47 them are insensitive, tactless and rude even or even sadistic. So interacting
80. 09:54 with people carries the risk of frustrating the need of not being hurt.
81. 10:01 So the solution is to avoid people and that is avoidance.
82. 10:08 Um another example and the last one before I move on to spousal correlation is narcissism. The narcissism need
83. 10:16 narcissist need is to maintain inflated fantastic selfworth.
84. 10:23 to stabilize a sense of selfworth, explicit self-esteem, a self-concept
85. 10:29 which are completely counterfactual, unreal, not grounded in in anything.
86. 10:36 And so this is a psychological need. But the only way to meet this need, the only way to cater to this need, the only way to gratify and satisfy this need is to avoid the truth.
87. 10:48 And so the narcissist be avoids the truth. is not truthful but not because the narcissist is a inveterate liar or because he’s a manipulator
88. 11:00 or because he’s cunning and scheming and so on. This is the psychopath. The narcissist avoids the truth because the
89. 11:08 truth guarantees the narcissist’s inability and the environment’s
90. 11:14 inability to satisfy the narcissist’s need to be embedded in fantasy.
91. 11:20 These are three examples. The problem with psychology, there’s a double problem with current thinking in
92. 11:27 psychology. Number one, we often attribute all these things to a hereditary
93. 11:33 genetic template. As I said, some predisposition, some proclivity that is
94. 11:39 mysteriously coded in unknown very often genes. And while this hypothesis may yet pan
95. 11:47 out to be true in the future, at this stage we have no proof of this.
96. 11:53 So there’s the first problem. And we do have a mountain of evidence that many
97. 11:59 mental health issues emerge from adverse childhood experiences and in contagion settings when you are
98. 12:06 exposed to other people with mental health issues. Of course such
99. 12:12 information such data which is overwhelming um the data are over overwhelming. So
100. 12:19 the data would tend to contradict the idea that somehow mental illness mental
101. 12:25 illnesses deterministically uh emanate deterministically flows from
102. 12:31 and emanates from some kind of genetic arrangements of gene arrays.
103. 12:37 Um that’s the first problem. The second problem is that we tend to pathize
104. 12:43 when whenever a need is not met and the response to the frustration is less than
105. 12:49 optimal hampers social functioning for example or interpersonal relationships
106. 12:56 we tend to pathize the response. So we pathize narcissism we pathize avoidance.
107. 13:02 We pathize paranoia because we say the these people are sick. they need
108. 13:08 treatment. This is the medical model of psychology and psychiatrist, therapists
109. 13:14 and so on like to think of themselves as medical doctors which when the with the exception of the psychiatrist, they’re
110. 13:20 not. And so there’s this perception, this medicalization of of the of the human
111. 13:27 soul or the human psyche. Um there’s a need, the need is not met.
112. 13:33 If you react to the frustration in certain ways, you’re healthy. If you react to the frustration in other way other ways you’re not healthy and the predominant the predominant differential
113. 13:44 clinical features feature is your impact on other people
114. 13:50 your social behavior. In other words you would be deemed mentally unhealthy,
115. 13:56 mentally unwell, mentally ill by adjudicating and observing your
116. 14:02 impact on other people, your adverse impacts on other people. So it’s relational. It’s not about the
117. 14:08 individual but it’s about the individual’s functioning when embedded in social settings. So for example, most
118. 14:15 of the criteria in the diagnosis of narcissistic personality disorder,
119. 14:21 antisocial personality disorder as the name implies and even to to a large extent borderline personality disorder.
120. 14:27 Most of the criteria are actually relational. They’re social criteria. They’re not clinical. And that’s a major
121. 14:35 major problem. I would rather look at this at the whole
122. 14:41 range of responses as a strong proof of the diversity of
123. 14:47 human nature. When we are faced with an unmet psychological need, psychological
124. 14:53 need that is frustrated. Uh we can react in a variety of ways. We
125. 14:59 could become aggressive. We could become narcissistic. Could become avoidant or even psychopathic. who can be they’re paranoid skittles. I mean there are numerous ways to react to frustrated
126. 15:10 needs. I don’t think we should pathize these reactive patterns.
127. 15:17 I think we we could classify them as socially unacceptable or socially
128. 15:23 acceptable. We could even criminalize some of these reactive patterns. But I don’t think pathologizing them adds any
129. 15:30 knowledge or any meaning um to the to the field. It definitely doesn’t help in developing treatment modalities. And so today I would like to discuss
130. 15:42 um the phenomenon of spousal correlation. In a previous video, uh, I
131. 15:48 dealt with a study that has shown that if you’re in a classroom and you’re
132. 15:54 exposed to to classmates who are mentally unwell by our current definitions, you would tend to acquire these characteristic. You would tend to become also mentally unwell. This is a
133. 16:07 contagion phenomenon which I’ve been talking about for more than 40 years. And this contagion phenomenon raises
134. 16:15 very serious questions. If we say that mentally ill or mentally unwell people are genetically
135. 16:23 determined, if we say that mental illness is gen a genetic thing, a hereditary thing, how come other people
136. 16:30 in the class the classmates acquired exactly the same mental health disorder?
137. 16:36 Are we are we to say that all of them have identical gene arrays, identical
138. 16:42 genes, identical heredity? Of course not. That would be a preposterous proposition. But then if the genetics is
139. 16:51 different, if each child in the class has a different genetic arrangement, if
140. 16:57 each each child is exposed to different hereditary influences and so on so forth, how come all of them begin to behave identically? in the pres presence of a single individual who is by current
141. 17:11 standards mentally ill or mentally unwell. The contagion is strongly is a strong
142. 17:17 indication that mental illness is mostly behavioral
143. 17:23 relational and is communicated by what was called or is still called object
144. 17:29 relations is communicated via social interpersonal interactions. Mental illness therefore is not a psychological phenomenon. Definitely not a genetic phenomenon.
145. 17:41 Mental illness is a social phenomenon. Nothing proves this more than spousal correlation. Spousal correlation is the most studied
146. 17:55 seriously studied um phenomenon of contagion. The
147. 18:01 contagion of mental illness. We are talking about millions of people who participated in dozens of studies across
148. 18:09 cultures, societies, periods in history and so on so forth. As you will see in this literature review, there is no
149. 18:15 doubt that spousal correlation is 100% objective happens. There’s no question
150. 18:23 about it. There’s no debate about it. But if spousal correlation is real, if one spouse can infect the other spouse with mental illness, this is a really really strong proof that mental illness is not genetic or
151. 18:39 not hereditary. Um
152. 18:45 this year there’s a study published the authors are the hodi border
153. 18:51 um fan and the article is titled spousal correlations for nine psychiatric
154. 18:57 disorders are consistent across cultures and persistent across generations. It was published in the magazine natural human behavior 2005. You can find the
155. 19:08 article in the literature. And what the what the study um shows is
156. 19:17 that when you’re a partner, an intimate partner, romantic partner, when you’re in short a spouse in a committed
157. 19:24 relationship, and the relationship is long-term, various health characteristics
158. 19:32 converge. They become shared across the two members of the couple.
159. 19:38 And this applies and extends to psychiatric disorders as well. In other words, if you spend a long time with a narcissist, you are likely to become a
160. 19:49 narcissist. If you spend a long time with a psychopath, you will acquire psychopathic traits and behaviors.
161. 19:57 And even if you spend time with someone with anxiety and or depression, you’re likely to become anxious and depressed. But this is not so surprising. What is much more surprising is that this
162. 20:08 applies to schizophrenia to autism which is to anorexia nervosa which is
163. 20:15 pretty shocking because schizophrenia autism they’re considered to be
164. 20:21 neurodedevelopmental disorders more medical than psychological premised on brain abnormalities and a genetic template a hereditary pronounced hereditary component and yet if you
165. 20:34 spend time with a schizophrenic In a committed relationship in a couple, you’re likely to develop in effect
166. 20:41 schizophrenia light. This applies to autism and this is pretty shocking.
167. 20:48 The analysis is beyond beyond certain. This is the kind
168. 20:56 of rigorous heavyduty study and research that leaves you
169. 21:03 convinced and becomes the new norm. Which we cannot say for example about studies
170. 21:10 with regards to brain abnormalities in narcissistic personality disorder or studies with regards to genetics uh
171. 21:18 genetic load and hereditary dimensions in narcissistic personality disorders. studies are puny and pretty meaningless statistically speaking and also badly
172. 21:29 designed. This is not the case with spousal correlation.
173. 21:35 This study that has just been published as I mentioned earlier was based on an analysis of hold your breath six million
174. 21:44 couples. Six million couples. How can you dispute this? How can you how can you argue with
175. 21:51 this? The couples were based in Taiwan, Denmark, Sweden.
176. 21:57 So, while Denmark and Sweden have affinities, they wouldn’t like me saying it. Uh, still they have affinities.
177. 22:04 They’re both in Scandinavia. Taiwan of course is across the known universe. And
178. 22:10 so, we’re talking about different cultures and different societies. And there was an international team of researchers. And what they found is that
179. 22:17 people were significantly more likely to have the same psychiatric conditions as
180. 22:23 their partners than would be expected by chance. I mean dramatically more likely.
181. 22:31 And what conditions are we talking about? I mentioned schizophrenia at ADHD, attention deficit hyperactivity
182. 22:37 disorder, depression, autism disorders, anxiety, bipolar disorder,
183. 22:44 obsessivecompulsive disorder, substance abuse, and anorexia nervosa. In all
184. 22:50 these nine conditions, if you spend time with someone who has them, you become like them. Genetics and heredity be damned.
185. 23:02 The authors say, “We found that a majority of psychiatric disorders have consistent spousal correlations across
186. 23:09 nations and over generations indicating their importance in the population dynamics of psychiatric disorders.
187. 23:17 So this spousal correlation um
188. 23:24 this aspect of spousal correlation the contagion of mental health issues, contagion of psychiatric conditions
189. 23:31 adds onto an edifice of previous studies which have demonstrated for example that
190. 23:37 people adopt the same religious beliefs, the same political views. um they adjust
191. 23:44 their education levels they abuse substances similarly
192. 23:50 and there’s a question of course why do people do that when they are in a committed relationships
193. 23:56 well the first assumption is we typically pick partners that are very much like ourselves assortative
194. 24:03 mating well I’ll discuss it a bit later um the second assumption is that maybe
195. 24:10 we are limited in our choice choice. Our choice of partners is limited by a variety of constraints. And the third
196. 24:17 assumption is that couples that spend a long time together, live together in the same environment, tend to become more alike. Grandmothers would tell you that when a couple spend a lot of time together,
197. 24:28 they even begin to resemble each other facially. Now that’s that maybe is a
198. 24:34 superstition but it’s a very entrenched superstition across continents across cultures
199. 24:41 societies periods in history. People insist that members of a couple become very similar visually. It’s even attributed to to pets. If you
200. 24:52 have a pet you would resemble the pet somehow. Okay. These these uh these
201. 24:58 tales these folk tales aside the reality is that we do come to resemble our
202. 25:04 partners and when we live with someone when you sh we share quarters with someone living together is very crucial. The physical space seems to be the medium through
203. 25:16 which the contagion is communicated. Same applies to the study about classmates in a classroom. So
204. 25:24 um it seems that there is some modus of contagion.
205. 25:30 Is it imitation? Is it an attempt to gratify the partner by becoming more similar to him or to
206. 25:36 her to forall abandonment to cement the relationship? We are alike. Is it in
207. 25:44 other words a kind of fad? Is it a kind of shared psychosis or what is now called massyogenic illness? In other words, is one of the members of the couple trying on purpose deliberately to imitate the other member
208. 26:00 or are we talking about real contagion which is essentially unconscious?
209. 26:06 Studies tend to show that it’s the latter. Contagion does have conscious
210. 26:12 elements, but most of it is submerged. Most of it happens willy with no
211. 26:18 voluntary decision making or choices. Despite different cultures and different
212. 26:25 health care systems, the results are statistically identical across countries, societies, cultures,
213. 26:32 periods in history. The only minor differences were in were in OCD, bipolar
214. 26:38 disorder, and anorexia. The authors wrote, “As our results show, spousal
215. 26:45 resemblance within and between psychiatric disorder pairs is consistent across cries and persistent across
216. 26:53 generations, indicating a universal phenomenon.” Remember, these are six million couples. The typical study of narcissistic personality disorder is, hold your
217. 27:05 breath, fewer than three people. You understand why I’m mocking these studies and why I’m completely ignoring them? They’re not even statistically significant. You need a minimum of eight
218. 27:16 to begin to generate a glimmer of statistical significance. Whereas this study is a survey of 6
219. 27:23 million couples. Now
220. 27:29 there are open questions of course. For example, we need to map the dynamic of the relationship. Uh this diagnosis,
221. 27:40 this diagnostic contagion, did it occur before the members of the couple have met? In other words, did like attract like or did they occur after the couple has become a have
222. 27:52 become a couple has become a couple. Um it seems from the data set
223. 28:00 that the there was an emergence of the psychiatric disorders after the couple
224. 28:08 have has become a couple. Now the the authors analyze successive
225. 28:15 generations not only in Taiwan but in in Sweden in Denmark and uh so they have a huge data set not all of it has been analyzed and included
226. 28:26 in the study but they found for example that having two parents with the same disorder increase the risk of a disorder
227. 28:33 showing up in children as well. So that’s a strong indication of genetics or hereditary component.
228. 28:40 Uh genetic analysis studies largely assume that our mating patterns are mostly random. But maybe this is an indication that like is attracted to
229. 28:51 like and that we do um engage in discriminatory mating mate selection. I
230. 28:59 will discuss assortative mating uh shortly. If people with psychiatric disorders such as the ones studied here
231. 29:06 are more likely to get together there uh it reopens the question of a
232. 29:14 genetic risk and how mental illnesses start.
233. 29:20 But again I must say while the data set is not fully analyzed what has been analyzed until now and published is that
234. 29:28 there is a contagion effect that preceded the that did not precede the formation of the couple. The emergence
235. 29:35 of the psychiatric disorders followed the creation of the couple did not precede it which it would indicate very
236. 29:43 strongly a contagion which is not contagion that is not genetically or
237. 29:49 hereditarily determined. Uh the authors qualify this finding and
238. 29:57 say that given the ubiquitousness of spousal correlation, it is important to take non-random mating patterns into
239. 30:03 consideration when designing genetic studies of psychiatric disorders.
240. 30:09 So yes, the question is still open, but spousal correlation of this magnitude,
241. 30:15 most of which happens after you have met your partner, is a strong indication
242. 30:21 that there is behavioral contagion or modeling contagion or imit
243. 30:27 imi imitatory mimicry contagion of some kind. I’ll read to you the abstract of the study and we’ll go on to other studies. Abstract trait similarities between spouses are a
244. 30:39 key factor that shapes the landscape of complex human traits. The driving force behind the spousal correlations can increase the overall prevalence of disorders influence occurrences of
245. 30:50 coorbidities and bias estimations of genetic architectures.
246. 30:56 However, there is a lack of largecale studies examining cultural differences and generational trends in spousal
247. 31:04 correlations for psychiatric disorders. Focusing on three national registries, we performed a large-scale analysis on spousal correlations across nine psychiatric disorders. We obtained the trade correlations from
248. 31:20 5 million spousal pairs in Taiwan and then compared them with estimates from the Danish National Registry and with
249. 31:28 published results from the Swedish National Registry altogether 1.2 million couples 1.3 million couples.
250. 31:35 Generational changes in Taiwan for people born after the 1930s were investigated as well. We found that a
251. 31:42 majority of psychiatric disorders have consistent spousal correlations across nations and over generations indicating their importance in the population dynamics of psychiatric disorders. What
252. 31:55 else do we know about spousal correlation?
253. 32:01 In 2023 there was an article published. The authors were hoitz balona powich and
254. 32:07 others. The author uh article was titled evidence of correlations between human partners based on systematic reviews and
255. 32:14 meta analysis of 22 trades and UK bioank analysis of 133 trades. So it’s a it’s a
256. 32:23 mega study. It was published in um nature human behavior. So here is the uh
257. 32:32 abstract. Positive correlations between mates can increase trait variation and prevalence
258. 32:38 as well as bias estimates from genetically informed study designs.
259. 32:44 While past studies of similarity between human mating part partners have largely found evidence of positive correlations,
260. 32:51 to our knowledge, no formal meta analysis has examined human partner correlations across multiple categories
261. 32:59 of traits. Remember this article was written in 2023. The first article I’ve mentioned
262. 33:05 published in 2025 did exactly this. So say the authors. We conducted
263. 33:11 systematic reviews and random effects meta analysis of human male female partner correlations across 22 traits commonly studied by psychologists,
264. 33:22 economists, sociologists, anthropologists, epidemiologists, and geneticists.
265. 33:28 So the authors use this that they they mention all the sources they’ve used and so on so forth across analysis political
266. 33:36 and religious attitudes educational attainment and some substance use traits
267. 33:42 showed the highest correlations. So we’re talking about behavior behaviors
268. 33:48 converged. We’re not quite sure whether it’s through imitation or modeling or whatever. The authors continue,
269. 33:54 psychological, that is psychiatric personality and anthropometric traits generally yielded lower but positive correlations. We observed high levels of between
270. 34:06 sample heterogeneity for most metaanalyzed traits probably because of both systematic differences between samples and true differences in partner correlations across populations. In
271. 34:19 short, this study that preceded the first study that I mentioned already found positive correlations in terms of
272. 34:27 psychological traits, not disorders, not illnesses, but traits. Now, we know
273. 34:34 or we believe that we know that human psychological traits are genetically
274. 34:40 determined. They’re hereditary. And yet this study found contagion.
275. 34:46 Traits, not behaviors, not disorders. Traits seem to have changed in the
276. 34:53 presence of another person. Long-term exposure to a spouse or girlfriend or a boyfriend in a committed relationship.
277. 35:02 Another study 2024, as you can see, this is a hot topic. Tovi Sunday Chisman and others study was titled non-random mating patterns within
278. 35:14 and across education and mental and somatic health uh somatic somatic health. It was published in nature communication. So here’s the abstract.
279. 35:26 Partners resemble each other in health and education, but studies usually examine one trait at a time in established couples. Using data from all
280. 35:37 Norwegian firsttime parents about 200,000 between 19 uh 2016 and 2020 we
281. 35:44 analyze grade point average at age 16 educational attainment and medical
282. 35:50 records of 10 mental and 10 somatic health conditions measured 10 to 5 years
283. 35:56 before childbirth. We find say the authors stronger partner
284. 36:02 similarity in mental than in somatic health conditions. By the way, massively
285. 36:09 stronger, dramatically strong with ubiquitous crossrade correlations in mental health. High grade point average or education is associated with better partner mental health and somatic health. Elevated mental health correlations in established couples indicate convergence.
286. 36:30 Analysis of siblings and in-laws suggest that health similarity is influenced by
287. 36:36 indirect assortment based on related traits. Adjusting for grade point
288. 36:42 average or education reduces partner health correlations by 30 to 40%.
289. 36:48 These findings have implications for the distribution of risk factors among children, genetic studies, and
290. 36:54 intergenerational transmission. In conclusion, this study provides evidence
291. 37:00 for assortative mating patterns in 20 health conditions up to 10 years before
292. 37:07 partners have had their first child in data without participation bias.
293. 37:14 Among the health conditions, mental health conditions were particularly strongly related to partner selection.
294. 37:21 We observed vast crossstrait assortment for mental health conditions indicating that individuals match on overall mental health rather than on specific health conditions. The link with education
295. 37:35 might indicate trade-offs for overall attractiveness. I want to stop here for a minute, take a
296. 37:42 pause and and and elucidate one very important point.
297. 37:48 It seems that we do pick up partners who are as mentally healthy or as mentally
298. 37:54 ill as we are. But we do not pick up partners with identical mental health issues. So
299. 38:03 if you are gen if your mental health is generally compromised, you would tend to pick up a partner whose mental health is
300. 38:09 generally pro compromised. But you are not going to have the same conditions.
301. 38:15 In majority, overwhelming majority of cases, you’re not going to have the same conditions. The amazing thing is spending years together, you’re going to converge on the same conditions. Even you, if you start off as members of a couple with different conditions,
302. 38:34 you end up having the same conditions. It is true that your the general index
303. 38:41 of mental well-being or general index of mental illness in both cases would tend to match but not the content of the mental illness. Not which exact mental
304. 38:52 health disorder. These are communicated and mediated via contagion effect. These
305. 39:00 you do acquire from your partner. So the propensity if you wish the template the
306. 39:07 readiness the predisposition the proclivity is there your mentally mentally unhealthy maybe
307. 39:14 but then the content of this basket is determined by your partner your partner determines which kind of mental
308. 39:21 illnesses you will develop if you are ready to develop mental illnesses that
309. 39:27 is a study in 2024 what we found in 2025 is that even if If you’re completely
310. 39:33 mentally healthy, you would still develop mental health conditions. And this is the shocking thing. Contagion seems to be impervious
311. 39:44 to susceptibility or vulnerability. In other words, it challenges the diiathesis stress model. the
312. 39:52 vulnerability stress model. It challenges it and it challenges head on all the genetic hereditary models. Uh the authors continue the questions
313. 40:05 assumptions in genetic designs and the these questions these issues that
314. 40:12 I’ve just mentioned question assumptions in genetic designs. They undermine genetic the genetic explanation the genetic paradigm and could have consequences for the distribution of risk factors among children. In general, partner
315. 40:28 resemblance could not be explained with direct assortment. Uh all this information
316. 40:39 could only to a moderate degree account for partner similarity and mental health. In other words,
317. 40:47 prior to the exposure to the couple, all the information we have cannot explain the development of mental health
318. 40:54 conditions later. The only explanation is the presence of a partner.
319. 41:00 The use of prospective data ensured that partner resemblance was not merely due to convergence and the comparison with cross-sectional data indicates that studies without prospective data do not
320. 41:13 precisely reflect assortative mating. Indirect assortment appears the best explanation for partner similarity, raising important questions on mate choice and complicating models of
321. 41:24 partner similarity. So what these authors are proposing is that we tend to
322. 41:30 choose partners who would be aminable, susceptible, vulnerable to the contagion. They are not disputing the
323. 41:38 existence of a contagion. They’re just saying it’s the outcome of assortative mating. We select people who would be
324. 41:47 there to be infected. We It’s like we are like I mean when someone is mentally ill, they’re like a virus. They’re looking for a for a cell to infect and and they’re looking for cells to infect
325. 41:59 which are already wide open, which are already vulnerable and susceptible. Assortative mating, continue the
326. 42:06 authors. The non-random ma matching of partners is commonly studied from the perspective of social inequalities.
327. 42:13 Strong assortment for educational attainment is well documented across disciplines and partners often resemble
328. 42:19 each other in mental and somatic health. Recently, there’s been a revived interest in matching across traits. This is important because people do not choose
329. 42:31 their partners based on one phenotype phenotype at a time, but holistically. We build upon the wellestablished links between educational attainment and health and investigate assortative
330. 42:41 mating patterns within and between these interconnected phenomena in populationwide data. This provides
331. 42:48 insight into the clustering of education and health within families. A comprehensive catalog of partner
332. 42:55 correlations based on the UK bioank presented partner similarity in 133
333. 43:01 phenotypes including educational attainment and symptoms of mental disorders. However, previous studies are
334. 43:09 with few exceptions limited to cohort samples with healthy volunteer selection bias. Issues related to selective non-participation are amplified in studies of couples as both partners need
335. 43:21 to participate. In addition, partner correlations are usually assessed as at arbitrary relationship stages and may therefore reflect convergence in addition to initial matching leaving it
336. 43:34 unclear to what degree partners are similar in mental health at the time of couple formation.
337. 43:40 Another line of research investigates correlations between partners’ genetic risk for mental disorders. Assortment
338. 43:47 based on heritable mental disorders should lead to genetic correlations between partners and since the genes are
339. 43:55 determined before the couples are formed, correlations should be independent of convergence. These studies report null findings for mental disorders except for schizophrenia.
340. 44:06 Such findings could imply that mental health does not influence partner selection. Despite a century of research
341. 44:13 on assortative mating, it is still questioned whether there is really assortative mating on the liability to
342. 44:20 psychiatric disorders. Even less is known about assortment for somatic health. Good somatic health is desire is
343. 44:27 a desired trait in partners, but it is unclear how similar partners are in somatic compared to mental health. Our
344. 44:35 first aim say the authors were was therefore to assess partner similarity in education and mental and somatic
345. 44:42 health using populationwide prospective data. Crossstrait assortment refers to
346. 44:48 non-random matching across different traits in the two partners. Due to the
347. 44:54 competition for mates and attractiveness trade-offs, one should expect partner correlations to arise across different
348. 45:01 generally attractive traits such as income and body mass. The econometric research on cross trait
349. 45:07 assortment has centered on such trade-offs. Whereas the genetic research has been has seen cross trait assortment
350. 45:14 as a source of genetic correlations. Assortment across traits can lead to correlations between genetic and environmental influences on different traits which in turn can contribute to
351. 45:25 coorbidity and familial clustering of multiple disorders. Beyond genuine increases in correlations
352. 45:33 between genetic liabilities, cross trait assortment can also violate assumptions and bias genomewide association and mandelian randomization studies.
353. 45:45 However, we are not aware of any studies examining cross trait assortment for education and health phenotypes in
354. 45:52 representative samples. Addressing this gap, our second aim was to determine the degree of crossstrait assortment for education and a broad selection of health conditions.
355. 46:03 Partner similarity can arise from several potentially co-occurring processes. We outlined these processes
356. 46:10 in figure one and the role they play in this paper. First
357. 46:16 the first um process that may affect partner similarity direct assortment or
358. 46:23 primary phenotypic assortment means that partners resemble each other in trait in traits because the observed trait
359. 46:30 influence partner selection. You choose other people because they’re similar to you. Direct assortment is a sufficient
360. 46:38 explanation for partner similarity when it comes to height for example. Second, indirect assortment, also called
361. 46:46 secondary assortment, refers to similarity in a trait resulting from selection on a correlated trait which
362. 46:52 may be unknown or known. For instance, similarity in a specific mental disorder
363. 46:58 could arise from assortment on psychiatric vulnerabilities. If one trait, such as attractiveness
364. 47:05 underlies assortment for multiple other traits, cross-trait assortment can be observed for these other traits as well.
365. 47:13 Direct assortment on an imperfectly measured phenotype can statistically resemble indirect assortment on an
366. 47:20 unobserved phen phenotype. In such cases, assortment may be said to
367. 47:26 be direct for the trait of interest but indirect for the indicator. The third
368. 47:32 process which may impact partner similarity is social stratification or social homogamy. It refers to individuals selecting each other based on environmental proximity which
369. 47:44 incidentally makes make them similar in the phenotype of interest. Social stratification has been found to play a small to moderate role in partner similarity. The fourth process is
370. 47:57 convergence. It refers to partners becoming more similar over time either because they
371. 48:03 influence each other or because they share the same environments. Convergence has been found for lifestyle
372. 48:10 choices such as alcohol consumption and exercise. Convergence is not a form of assortment but an alternative
373. 48:16 explanation of partner similarity. And so
374. 48:23 this these are the processes that may affect ultimate partner similarity.
375. 48:30 Each mechanism say the authors has different genetic and environmental consequences and can bias genetic and
376. 48:36 intergeneral studies in different ways. The optimal adjustment for assortative mating depends on the underlying process
377. 48:43 which is often unknown. Direct assortment on the observed variable is typically assumed although several studies have found deviations from direct assortment for educational
378. 48:54 attainment for example. and one study found deviations from direct assortment in n in 29 of 51 studied traits.
379. 49:03 We have previously shown that adding sibling data can inform on mechanisms.
380. 49:10 The third aim in the study was therefore to determine whether partner resemblance across a range of health phenotypes is
381. 49:17 consistent with direct assortment. And so this is these are the debates
382. 49:24 that are taking place right now. Having read all these studies and many
383. 49:30 others, I think the correct picture is this.
384. 49:37 We tend to select people who are consciously or unconsciously, visibly or invisibly
385. 49:45 similar to us in profound ways. in in ways which are not
386. 49:54 uh superficial but reflect who we are reflect our
387. 50:00 essence and identity. We would therefore tend to select mentally ill people or mentally disordered people if we are mentally ill and disordered.
388. 50:11 There is therefore assortative ma mating in my view or and from the studies
389. 50:17 people who are predisposed to mental illness or already affect afflicted with
390. 50:23 mental illness would tend to select as partners people who have a predisposition for mental illness or
391. 50:31 already are afflicted with mental illness. Like attracts like.
392. 50:37 Couples are similar to start with. There is an assortative mechanism.
393. 50:43 There’s a mechanism of filtering out mates which are not like us. Mates,
394. 50:53 partners, spouses, boyfriends, girlfriends which are dramatically different to us.
395. 51:01 So the ground is set when in these couples
396. 51:07 where one of the members of the couple is mentally ill, afflicted with a psychiatric condition including severe
397. 51:13 psychiatric conditions such as personality disorders and schizophrenia, bipolar disorder and so on. This per
398. 51:21 this kind of person would select as a mate as a spouse in a committed
399. 51:27 relationship someone who has the capacity to develop mental illness
400. 51:35 that I believe has been established in multiple studies. However,
401. 51:41 which type of psychiatric disorders would emerge in the partner
402. 51:47 depend crucially on the other partner. I think that has been established as well. There is a contagion effect regarding the specificity of the of the
403. 51:59 mental health condition. Not the general propensity but the specificity. I may be inclined to
404. 52:06 develop mental illness, but whether I become a narcissist or um someone with a
405. 52:12 mood disorder depends on my partner. If my partner is a narcissist, I’m much
406. 52:18 more likely to become a narcissist. If my partner has a mood disorder, I’m much more likely to develop a mood disorder.
407. 52:25 Partners determine the specific mental health conditions of their partners. This is
408. 52:32 the shocking news. because it means that there is no
409. 52:39 genetic hereditary predis predisposition or proclivity for any one specific
410. 52:46 mental illness. There is a genetic there is genetic determinism to some
411. 52:53 extent. there’s a genetic contribution hereditary determination with regards to the general
412. 53:01 vulnerability or susceptibility to mental illness. In other words, I think the only thing
413. 53:07 the genetics that one’s genes determine is whether you are likely to develop
414. 53:14 mental illness or not. You’re likely to acquire a psychiatric condition or disorder or not. This is determined by
415. 53:23 genetics. This is hereditary. What type of mental illness you will
416. 53:29 develop? Exactly. Would it be a personality disorder, a mood disorder,
417. 53:35 some other type of disorder, including autism, including ADHD? This is
418. 53:41 determined by the environment, and most crucially by other people in your environment to which you’re exposed in
419. 53:48 the long term. This is the amazing outcome which
420. 53:54 emanates from uh studies of spousal correlation,
421. 54:00 convergence and in my language contagion.