There is converging evidence that certain subpopulations of smokers, such as smokers with a serious mental illness like schizophrenia (SCZ), are more likely to become addicted to tobacco and are less likely to quit smoking. This review focuses on the unique risk factors that may increase vulnerability to the initiation and maintenance of nicotine addiction in persons with schizophrenia and other psychotic disorders and also reviews the latest approaches to treating nicotine addiction and schizophrenia based on our neurobiological understanding of central nicotinic receptor systems and related neurotransmitters. In addition, suggestions for future lines of research to better understand reasons for the comorbidity of nicotine addiction in schizophrenia are discussed.

Children with fetal alcohol spectrum disorder show executive function (EF) deficits, particularly in self-regulation skills, and abnormalities in brain regions critical for these skills. None of the validated EF interventions for these children has been evaluated with regards to impacts on brain structure. Twenty-nine children with FASD were assigned to either an immediate-treatment (TX) or delayed-treatment control (DTC) group (DTC). Nineteen typically developing children served as healthy controls (CT). All received a structural MRI scan and baseline neuropsychological testing, following which the TX group underwent 12 weekly 1.5-h sessions of the Alert Program for Self-Regulation®. After treatment or a period of ~14 weeks, all received a repeat scan and post-intervention testing. Whole-brain and region-of-interest analyses using voxel-based morphometry evaluated group differences and changes over time in gray matter (GM). Exploratory analyses revealed significant group changes: (1) At baseline, combined TX and DTC groups demonstrated global GM reductions compared with the CT group. (2) Region-of-interest analysis using a frontal mask, comparing post-intervention to pre-intervention results, showed significantly increased GM in the left middle frontal gyrus (BA10), right frontal pole (BA11), and right anterior cingulate (BA32) in the TX group. Similar results were not found in the DTC or CT groups. (3) At post-intervention, both TX and CT groups showed larger GM volumes than the DTC group in the left superior frontal gyrus (BA9), which was smaller in the FASD group at baseline. These results suggested that Alert led to improvements in post-intervention testing of self-regulation skills and typical brain development in treated children.

Pedophilia is a principal motivator of child molestation, incurring great emotional and financial burdens on victims and society. Even among pedophiles who never commit any offense,the condition requires lifelong suppression and control. Previous comparison using voxel-based morphometry (VBM)of MR images from a large sample of pedophiles and controls revealed group differences in white matter. The present study therefore sought to verify and characterize white matter involvement using diffusion tensor imaging (DTI), which better captures the microstructure of white matter than does VBM. Pedophilics ex offenders (n=24) were compared with healthy, age-matched controls with no criminal record and no indication of pedophilia (n=32). White matter microstructure was analyzed with Tract-Based Spatial Statistics, and the trajectories of implicated fiber bundles were identified by probabilistic tractography. Groups showed significant, highly focused differences in DTI parameters which related to participants’ genital responses to sexual depictions of children, but not to measures of psychopathy or to childhood histories of physical abuse, sexual abuse, or neglect. Some previously reported gray matter differences were suggested under highly liberal statistical conditions (p(uncorrected)<.005), but did not survive ordinary statistical correction (whole brain per voxel false discovery rate of 5%). These results confirm that pedophilia is characterized by neuroanatomical differences in white matter microstructure, over and above any neural characteristics attributable to psychopathy and childhood adversity, which show neuroanatomic footprints of their own. Although some gray matter structures were implicated previously, only few have emerged reliably.

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Introduction Neuroimaging and other studies have changed the common view that pedophilia is a result of childhood sexual abuse and instead is a neurologic phenomenon with prenatal origins. Previous research has identified differences in the structural connectivity of the brain in pedophilia. Aim To identify analogous differences in functional connectivity. Methods Functional magnetic resonance images were recorded from three groups of participants while they were at rest: pedophilic men with a history of sexual offenses against children (n = 37) and two control groups: non-pedophilic men who committed non-sexual offenses (n = 28) and non-pedophilic men with no criminal history (n = 39). Main Outcome Measure Functional magnetic resonance imaging data were subjected to independent component analysis to identify known functional networks of the brain, and groups were compared to identify differences in connectivity with those networks (or “components”). Results The pedophilic group demonstrated wide-ranging increases in functional connectivity with the default mode network compared with controls and regional differences (increases and decreases) with the frontoparietal network. Of these brain regions (total = 23), 20 have been identified by meta-analytic studies to respond to sexually relevant stimuli. Conversely, of the brain areas known to be those that respond to sexual stimuli, nearly all emerged in the present data as significantly different in pedophiles. Conclusion This study confirms the presence of significant differences in the functional connectivity of the brain in pedophilia consistent with previously reported differences in structural connectivity. The connectivity differences detected here and elsewhere are opposite in direction from those associated with anti-sociality, arguing against anti-sociality and for pedophilia as the source of the neuroanatomic differences detected.

Decision making under risk has been intensively studied; however, little is understood about how decision making under risk changes with increased ecological validity. The current study investigated whether increased ecological validity resulted in greater decision quality and a minimization of the description-experience gap. Whether presenting items as abstract monetary gambles or framed within a meaningful context, decision quality was higher for loss items when presented as a description, and for gain items when experienced. When the rare event was a nonzero gain or loss, decision quality was increased when abstract monetary gambles were presented as a description. When the rate event was a zero gain, higher decision quality resulted if the gamble was experienced. When the rare event was a zero loss, higher decision quality resulted if the gamble was presented as a description. Implications for future research are discussed, with regard to improving understanding of decision making under uncertainty.

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Decision making under risk has been intensively studied; however, little is understood about how decision making under risk changes with increased ecological validity. The current study investigated whether increased ecological validity resulted in greater decision quality and a minimization of the description-experience gap. Whether presenting items as abstract monetary gambles or framed within a meaningful context, decision quality was higher for loss items when presented as a description, and for gain items when experienced. When the rare event was a nonzero gain or loss, decision quality was increased when abstract monetary gambles were presented as a description. When the rate event was a zero gain, higher decision quality resulted if the gamble was experienced. When the rare event was a zero loss, higher decision quality resulted if the gamble was presented as a description. Implications for future research are discussed, with regard to improving understanding of decision making under uncertainty.