Altered White-Matter Microstructure in Conduct Disorder Is Specifically Associated with Elevated Callous-Unemotional Traits

Adolescents with conduct disorder (CD) and elevated callous-unemotional (CU) traits have been reported to present with a more severe and persistent pattern of antisocial behaviour than those with low levels of CU traits. However, relatively few studies have investigated whether there are differences in brain structure between these subgroups.We acquired diffusion tensor imaging data and used tract-based spatial statistics (TBSS) to compare adolescents with CD and high levels of CU traits (CD/CU+; n?=?18, CD and low levels of CU traits (CD/CU-; n?=?17) and healthy controls (HC; n?=?32) on measures of fractional anisotropy (FA), axial (AD), radial (RD) and mean (MD) diffusivity. Compared to CD/CU- adolescents, those with CD/CU+ presented increased FA and reduced RD and MD (lower diffusivity) in several tracts including: body and splenium of the corpus callosum, right inferior longitudinal fasciculus, ILF; right inferior fronto-occipital fasciculus, IFOF; left superior longitudinal fasciculus, SLF; left cerebral peduncle, bilateral internal capsule, left superior and posterior corona radiata, bilateral thalamic radiation and left external capsule. In addition, relative to CD/CU- individuals, adolescents with CD/CU+ showed lower diffusivity (indexed by reduced RD and MD) in left uncinate fasciculus and bilateral fornix. Finally, relative to healthy controls, CD/CU+ individuals showed lower diffusivity (reduced RD) in the genu and body of the corpus callosum and left anterior corona radiata. These results suggest that CD/CU+ individuals present with white-matter microstructural abnormalities compared to both CD/CU- individuals and age-matched healthy controls. This finding is consistent with emerging evidence suggesting that CD/CU+ represents a distinct subtype of CD, and illustrates the importance of accounting for heterogeneity within CD populations.     

The Effects of Spirituality and Religion on Outcomes in Patients with Chronic Heart Failure

Heart failure (HF) is a chronic progressive disease with marked morbidity and mortality. Patients enduring this condition suffer from fluctuations in symptom burden such as fatigue, shortness of breath, chest pain, sexual dysfunction, dramatic changes in body image and depression. As physicians, we often ask patients to trust in our ability to ameliorate their symptoms, but oftentimes we do not hold all of the answers, and our best efforts are only modestly effective. The suffering endured by these individuals and their families may even call into question one??s faith in a higher power and portends to significant spiritual struggle. In the face of incurable and chronic physical conditions, it seems logical that patients would seek alternative or ancillary methods, notably spiritual ones, to improve their ability to deal with their condition. Although difficult to study, spirituality has been evaluated and deemed to have a beneficial effect on multiple measures including global quality of life, depression and medical compliance in the treatment of patients with HF. The model of HF treatment incorporates a multidisciplinary approach. This should involve coordination between primary care, cardiology, palliative care, nursing, patients and, importantly, individuals providing psychosocial as well as spiritual support. This review intends to outline the current understanding and necessity of spirituality??s influence on those suffering from HF.     

Children's responses to social atypicality among group members – advantages of a contextualized social developmental account

Abrams, Rutland, Palmer, Ferrell, and Pelletier (2014) showed that better second‐order mental state understanding facilitates 6–7‐year‐olds' ability to link a partially disloyal child's atypicality to inclusive or exclusive reactions by in‐group or outgroup members. This finding is interpreted in terms of predictions from the developmental subjective group dynamics model. We respond to thoughtful commentaries by Rhodes and Chalik, Patterson, and Rakoczy. Children face a significant developmental challenge in becoming able to recognize and interpret social atypicality in intergroup contexts. Researching that ability to contextualize judgements raises new questions about the nature of peer inclusion and exclusion, about children's social cognition, and about the way that social cognitive development and social experience combine. Rather than individual‐focused cognition taking priority over category‐based cognition, we argue the two become more systematically integrated during development. We note that loyalty is but one example of typicality, and we also consider the role of more advanced perspective taking among older children, and the role of multiple classification skill among younger children, as well as potential implications for intervention to reduce peer victimization and prejudice.