Commentary: Conduct disorder and perceiving harm to others - a reflection on Michalska etal. (2016).

Abstract

The study by Michalska etal. () reported in this issue of JCPP focused on how children with conduct disorder (CD) process harm to other people. Many children with CD lack empathy for their victims and this behavioural profile has encouraged the investigation of potential underpinnings of atypical empathy in this group. Michalska etal. () administered an fMRI task depicting harm to other people to a large sample of children with CD and typically developing peers. The authors found that CD symptom severity and degree of callousness were negatively associated with right posterior insula response to other people experiencing harm. Furthermore, CD and callousness ratings were negatively associated with anterior insula, anterior midcingulate cortex and posterior superior temporal sulcus response to intentional harm. Reactive aggression scores, in contrast, were associated with increased positive insula reactivity when processing harm to others. Finally, the authors reported a sex difference in the engagement of brain areas associated with computations of intentionality when children processed intentional harm. In females (but not males) with CD, higher CD symptomatology was associated with lower activity in pSTS and middle frontal gyrus (MFG). This study is novel in focusing on a preadolescent sample of children and testing for sex differences in the neural underpinnings of conduct disorder (CD) symptomatology. We look forward to further work in this area and are certain that the important study by Michalska etal. () will motivate a host of new investigations that help us uncover the neural underpinnings of CD.