The road forward for research on callous-unemotional traits: reply to Lahey (2014)

Lahey (2014) provides a thoughtful and scholarly discussion of our review of the research on the potential utility of callous-unemotional (CU) traits for designating a distinct subgroup of children and adolescents with severe conduct problems. In this reply, we attempt to clarify several issues raised in Lahey's commentary. Specifically, by focusing largely on only 1 part of the research review (i.e., implications for evaluating the new specifier included for the diagnosis of conduct disorder in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders; American Psychiatric Association, 2013), the commentary underestimates the available empirical support for the utility of these traits for designating an important subgroup of children and adolescents with severe conduct problems. Furthermore, we highlight a number of studies that provide data inconsistent with the model proposed by Lahey in which CU traits are best considered as solely a marker of more severe conduct problems. Finally, we highlight limitations in estimating the stability of CU traits based solely on the number of individuals who continue to fall above and below a diagnostic cutoff at 2 points in time.