Prosocial apathy for helping others when effort is required

Prosocial acts—those that are costly to ourselves but benefit others—are a central component of human coexistence1,2,3. While the financial and moral costs of prosocial behaviours are well understood4,5,6, everyday prosocial acts do not typically come at such costs. Instead, they require effort. Here, using computational modelling of an effort-based task, we show that people are prosocially apathetic. They are less willing to choose to initiate highly effortful acts that benefit others compared with those benefitting themselves. Moreover, even when choosing to initiate effortful prosocial acts, people exhibit superficiality, exerting less force into the actions that benefit others than those that benefit themselves. These findings were replicated, and were present whether the other person was anonymous or not, and when choices were made to earn rewards or avoid losses. Importantly, the least prosocially motivated people had higher subclinical levels of psychopathy and social apathy. Thus, although people sometimes ‘help out’, they are less willing to benefit others and are sometimes ‘superficially prosocial’, which may characterize everyday prosociality and its disruption in social disorders

Conduct Disorder

Decades of research has shown that youths with conduct disorder (CD) represent a highly heterogeneous population. Over the past 20 years, most of the research and clinical work have focused on two sub-typing approaches to characterize the heterogeneity within CD: (1) the age of onset distinction introduced in DSM-IV and (2) the presence of callous-unemotional traits included as the ``limited prosocial emotion'' specifier within DSM-5. Considering these sub-typing approaches to characterize youths with CD, this chapter selectively reviews the literature on the prevalence and diagnosis of CD, as well as the evidence base on the neurobiological correlates of the disorder identified through genetics, epigenetics, autonomic nervous system responsivity, levels of neurotransmitters, neuropsychological performance, and structural and functional neuroimaging. Next, we highlight the pressing need to further investigate females and the role of sex differences in this population. We conclude the chapter with a discussion of clinical interventions and the long-term outcomes associated with the disorder

Treatment consideration and manifest complexity in comorbid neuropsychiatric disorders

Psychiatric disorders may co-occur in the same individual. These include, for example, substance abuse or obsessive-compulsive disorder with schizophrenia, and movement disorders or epilepsy with affective dysfunctional states. Medications may produce iatrogenic effects, for example cognitive impairments that co-occur with the residual symptoms of the primary disorder being treated. The observation of comorbid disorders in some cases may reflect diagnostic overlap. Impulsivity, impulsiveness or impulsive behaviour is implicated in a range of diagnostic conditions including substance abuse, affective disorder and obsessive-compulsive disorder. These observations suggest a need to re-evaluate established diagnostic criteria and disorder definitions, focusing instead on symptoms and symptom-profiles