The impact of prolonged disorders of consciousness on family caregivers’ quality of life – a scoping review

Providing long-term care for a family member diagnosed with a Prolonged Disorder of Consciousness (PDoC) can have a significant impact on the lives of family caregivers. This scoping review aimed to explore the current literature investigating the impact of caring for a person in a PDoC on family caregivers’ Quality of Life (QOL), as categorized using the WHOQOL-BREF model. We observed that articles employing quantitative methodologies mostly reported QOL outcomes relating to negative feelings, thinking, learning, memory and concentration, and personal relationships. Articles employing qualitative methodologies mostly reported QOL outcomes relating to negative feelings, personal relationships, positive feelings, and health and social care accessibility and quality. A descriptive content analysis of the QOL outcomes highlighted the limitations of the current literature base in representing the complexities of the experiences of family members providing care for a person in a PDoC. To provide valuable and personalized support to caregivers, without pathologizing or medicalizing their distress, it is vital to characterize more accurately the contextual subtleties of each person’s situation

Distinguishing between conduct disorder with high versus low levels of callous-unemotional traits

The aim of this thesis was to investigate differences between conduct disorder with high versus low levels of callous-unemotional traits. Differences in parenting, grey matter volume and facial emotion recognition ability were investigated using univariate and machine learning methods. In Chapter 3, youths with conduct disorder experienced more negative and less positive parenting than typically developing youths. The high callous-unemotional group also experienced less positive parenting than the low callous-unemotional group. All groups were classified with above-chance accuracy. In Chapter 4, when controlling for ADHD, youths with conduct disorder exhibited reduced grey matter volume in the insulae relative to typically developing youths. Youths with conduct disorder and high callous-unemotional traits exhibited additional reductions in the left orbitofrontal cortex. All groups were classified with above-chance accuracies. In Chapter 5, youths with conduct disorder – regardless of callous-unemotional traits – were poorer at recognising emotions than typically developing youths. Youths with conduct disorder were classified against typically developing youths at above-chance levels, but the classifier did not exceed chance when distinguishing between high and low callous-unemotional groups. Together, these findings indicate both similarities and differences in conduct disorder with high versus low levels of callous-unemotional traits, consistent with different developmental pathways to similar outcomes