This study tested whether inattentive-impulsive-overactive (I/O) and oppositional-defiant (O/D) behaviors were associated with peer problems and whether these associations were moderated by callous-unemotional (CU) traits in clinically referred children with disruptive behaviors. Parents of 135 children aged 6-12 years (M = 9.09, SD = 1.62) completed measures to assess their child's I/O, O/D, and CU behaviors, and peer functioning problems. Findings showed that I/O and O/D behaviors were associated with greater peer problems, and CU traits significantly moderated the I/O behaviors and peer problems association. Children with relatively more CU traits and I/O behaviors showed greater peer problems. However, those with more CU traits and fewer I/O behaviors showed less peer problems. I/O behaviors and CU traits have an important influence on peer functioning that varies according to the severities of each.

Psychiatry, psychoanalysis and infant mental health research of the last decades have led to intervention concepts for pre- and postnatal stages of human development. Such concepts reach from how parents-to-be can be prepared for parenthood to how to intervene in support of relation and attachment in infants, toddlers and older children. Especially the postnatal relation of infant and parents has been examined extensively, as have parental competencies. The expression of intuitive parental competencies (according to Papousek and Papousek) may be compromised by diverse factors, thus putting the infant's psychic development at risk in general. Early intervention concepts may help out to some extent. In German-speaking countries, there are intervention programs focusing on bonding as there are on handling, processing of and coping with trauma, on promoting secure attachment between infant and parents, on relational issues, on bodily contact, on understanding the infant's signals, including those of the preterm infant, as well as on educational practices. From prenatal period onwards up to kindergarten age there are structured interventions, including the involvement of parents and parents-to-be. Yet, some factors of psychic development and of pathology may not necessarily be reached by these. Whereas concepts on an individual level of personality education do exist, nevertheless there might have to be collective measures. There seems to be a need to augment the agenda as there is good reason to assume that in the last decades there has been a motion toward new social deprivation stemming from societal depravation processes, which might potentiate future deprivation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The development of novel therapeutics for rare “orphan” diseases has brought a growing tension between the desire to accelerate access to these breakthrough therapies and the need to generate quality evidence regarding their safety and efficacy. Accelerating the pace of drug development and approval may facilitate the rapid delivery of benefits to patients and cost savings for research and development, which theoretically improves affordability of drugs for the health system. However, several ethical challenges arise with expedited approval, compassionate release of drugs, and subsequent study of drugs in “real-world” settings. In this article, we explore the changing landscape of drug approval and the ethical challenges expedited approval creates for patients, caregivers, clinicians, and institutions, and propose tangible strategies to maximize the benefits of “real-world” data acquisition while mitigating risks to patients, clinicians, and institutions.