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Conduct Disorder, Empathy, and Callous-Unemotional Traits

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Handbook of Anger, Aggression, and Violence

Abstract

The Diagnostic and Statistical Manual of Mental Disorders – fifth edition (DSM-5) proposed a new specifier for conduct disorders (CD), that is “with limited prosocial emotions” (LPE). The aim is to identify children and adolescents who meet full CD criteria and persistently and pervasively show two or more out of four criteria: (1) lack of remorse or guilt, (2) callous lack of empathy, (3) unconcerned about performance, and (4) shallow or deficient affect. The inclusion of the LPE specifier was based on a robust literature that enucleated a specific subgroup of CD children and adolescents characterized by severe maladaptive and antisocial behaviors and high developmental risk for adult antisocial personality disorder and global negative outcome. This subgroup of CD youths has been associated with the presence of specific temperamental traits, described primarily in adult psychopathy, named callous-unemotional (CU) traits, and characterized by reduced emotional responsiveness to others’ distress, low sensitivity to punishment cues, impairment in empathic concerns, and scarce capacity to generate prosocial attitudes. This chapter will describe the symptomatologic correlates and developmental trajectories of CU traits from childhood through adolescence to adulthood and will try to elucidate the international literature of the past 15 years’ contributions with respect to the identification of genetic, temperamental, and socio-environmental factors in the genesis of CU traits as well as with respect to their neurobiological and psychophysiological underpinnings. With the aim to facilitate the early identification of children and adolescents with CD and CU traits with preventive purposes, assessment strategies will be proposed, and validated assessment tools will be described in clinical and nonclinical populations, for different age groups and from various informants (self-reports, parents, teachers, clinicians). Finally, major therapeutic intervention models will be described that have shown evidence of effectiveness in CD with CU traits by reducing aggressive and antisocial behaviors and preventing negative outcomes.

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Abbreviations

ADHD:

Attention-deficit/hyperactivity disorder

APSD:

Antisocial process screening device

BDNF:

Brain-derived neurotrophic factor

BES:

Basic Empathy Scale

CAPE:

Clinical Assessment of Prosocial Emotions

CD:

Conduct disorders

COMT:

Catechol-O-methyltransferase

CP:

Conduct problems

CPP:

Coping power program

CPS:

Childhood Psychopathy Scale

CPTI:

Child Problematic Traits Inventory

CU:

Callous-unemotional

DSM:

Diagnostic and Statistical Manual of Mental Disorders

DTI:

Diffusion tensor imaging

FFT:

Functional Family Therapy

HTR:

5-Hydroxytryptamine receptor

ICD:

International Classification of Diseases

ICU:

Inventory for Callous-Unemotional Traits

IRI:

Interpersonal Reactivity Index

K-SADS-PL:

Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version

LPE:

Limited prosocial emotions

MAOA:

Monoamine oxidase A

MPH:

Methylphenidate

MRI:

Magnetic resonance imaging

MST:

Multisystemic Therapy

ODD:

Oppositional defiant disorder

PCL:YV:

Youth Version of the Psychopathy Checklist

PSCD:

Proposed Specifiers for Conduct Disorder

TriPM:

Triarchic Psychopathy Measure

UNSW:

University of New South Wale

YPI:

Youth Psychopathic Traits Inventory

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Correspondence to Annarita Milone .

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Sesso, G., Milone, A. (2023). Conduct Disorder, Empathy, and Callous-Unemotional Traits. In: Martin, C.R., Preedy, V.R., Patel, V.B. (eds) Handbook of Anger, Aggression, and Violence. Springer, Cham. https://doi.org/10.1007/978-3-031-31547-3_28

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