Variants of limited prosocial emotions among adolescent boys with conduct disorder

Studies that used complex statistical analyses provided some evidence to support the utility of differentiating between variants of callous-unemotional (CU) traits. Yet, no study has tried to identify these variants using a method that closely resembles applied clinical work. This study, therefore, tested if these variants can be found in individuals with DSM-5 defined conduct disorder (CD) and DSM-5 defined CU traits.

Participants were 288 male adolescents (M_age = 16.94) with a CD diagnosis. Using a diagnostic interview to assess the DSM-5 CU specifier ("with limited prosocial emotions (LPE)") and a well-established self-report anxiety questionnaire, participants were assigned to mutually exclusive groups, including groups that were low in anxiety (CD + LPE - ANX or "primary variant"; n = 145) or high in anxiety (CD + LPE + ANX or "secondary variant"; n = 27). These two groups were compared in individual and environmental characteristics as measured via questionnaire measures and experimental tasks.

Relative to the CD + LPE - ANX group, the CD + LPE + ANX group scored higher on psychopathic trait dimensions, affective empathy, depressive symptoms, negative urgency, bodily awareness of emotions, emotional maltreatment, and sexual abuse. No group differences emerged in antisocial behavior, aggression, emotion recognition accuracy, and treatment engagement.

Findings tentatively suggest that self-reported anxiety can be used to identify variants of youth who have CD and LPE diagnoses and that the CD + LPE + ANX captures a group of youth with multiple and complex needs.