Lack of Remorse in Antisocial Personality Disorder Among Drug Abusers in Residential Treatment

The antisocial personality disorder (ASPD) diagnosis has generated controversy because of its emphasis on antisocial behaviors and its limited attention to psychological traits of psychopathy, such as lack of loyalty, remorse, and anxiety. We examined the relationships between one psychological trait of psychopathy, lack of remorse, and phenomenology of ASPD, drug history, preadmission psychosocial functioning, and characteristics of index episode of treatment among 140 drug abusers with DSM-III-R ASPD enrolled in residential addictions treatment. Lack of remorse was associated with a more severe and more violent form of ASPD and increased comorbidity with mood and anxiety disorders. Implications for tailoring addictions treatment to antisocial clients who lack remorse include the need to identify and treat comorbid emotional disorders

Gestational cytokine concentrations and neurocognitive development at 7 years

Gestational inflammation may contribute to brain abnormalities associated with childhood neuropsychiatric disorders. Limited knowledge exists regarding the associations of maternal cytokine levels during pregnancy with offspring neurocognitive development. We assayed the concentrations of five cytokines (interleukin (IL)-6, IL-1β, IL-8, tumor necrosis factor alpha (TNF-α), and IL-10) up to four times in the 2nd and 3rd trimesters of pregnancy using stored prenatal sera from 1366 participants in the New England Family Study (enrollment 1959–1966). Intelligence (IQ), academic achievement, and neuropsychological functioning of singleton offspring were assessed at age 7 years using standardized tests. We used linear mixed models with random effects to estimate the cumulative exposure to each cytokine during 2nd and 3rd trimesters, and then related cumulative cytokine exposure to a wide range of offspring neurocognitive outcomes. We found that children of women with higher levels of the pro-inflammatory cytokine, TNF-α, in the 2nd and 3rd trimesters had lower IQ (B = −2.51, 99% CI: −4.84,−0.18), higher problem scores in visual-motor maturity (B = 0.12, 99% CI: 0.001,0.24), and lower Draw-a-Person test scores (B = −1.28, 99% CI: −2.49,−0.07). Higher gestational levels of IL-8, another pro-inflammatory molecule, were associated with better Draw-a-Person test scores and tactile finger recognition scores. Other cytokines were not associated with our outcome of interest. The opposing directions of associations observed between TNF-α and IL-8 with childhood outcomes suggest pleiotropic effects of gestational inflammation across the domains of neurocognitive functioning. Although the path to psychopathological disturbances in children is no doubt multifactorial, our findings point to a potential role for immune processes in the neurocognitive development of children