Skip to main content
SpringerLink
Log in

The significance of limited prosocial emotions among externalizing disorders in children

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Limited Prosocial Emotion (LPE) specifier of conduct disorder (CD) includes lack of remorse or guilt, callousness/lack of empathy, unconcern about performance, and shallow/deficient affect. Given the relatively recent inclusion of the LPE specifier in the Diagnostic and Statistical Manual, fundamental information is still unknown about LPE, such as how common the different domains are, how much they overlap with one another, whether they predict unique variance from each other, and the potential for the LPE specifier as a transdiagnostic facet of externalizing problems. Caregivers (n = 1,50) of children (Mage = 8.42, SD = 2.31) completed a questionnaire assessing individual LPE domains and measures of externalizing symptoms. Results showed that LPE specifier domains were highly related but separable. All LPEs were uniquely associated with oppositional defiant disorder (ODD), CD, and overall impairment after controlling for other LPE items, child sex, and ADHD symptoms. Being unconcerned about performance, emotionally manipulative, and having shallow/deficient affect were uniquely associated with ADHD while controlling for ODD and CD symptomatology. Our findings fit with the historical conceptualization of LPE as a unidimensional construct and contributes to the growing evidence of the potential utility of assessing LPE across externalizing disorders in children. Future research should look to replicate and extend our findings in clinical samples of youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. Author, Arlington

    Book  Google Scholar 

  2. Anderson SL, Zheng Y, McMahon RJ (2018) Do callous-unemotional traits and conduct disorder symptoms predict the onset and development of adolescent substance use? Child Psychiatry Hum Dev 49(5):688–698

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ansel LL, Barry CT, Gillen CT, Herrington LL (2015) An analysis of four self-report measures of adolescent callous-unemotional traits: exploring unique prediction of delinquency, aggression, and conduct problems. J Psychopathol Behav Assess 37(2):207–216

    Article  Google Scholar 

  4. Barker ED, Oliver BR, Viding E, Salekin RT, Maughan B (2011) The impact of prenatal maternal risk, fearless temperament and early parenting on adolescent callous- unemotional traits: a 14-year longitudinal investigation. J Child Psychol Psychiatry 52(8):878–888

    Article  PubMed  Google Scholar 

  5. Berg JM, Lilienfeld SO, Reddy SD, Latzman RD, Roose A, Craighead LW, Raison CL (2013) The Inventory of Callous and Unemotional Traits: a construct validational analysis in an at-risk sample. Assessment 20:532–544

    Article  PubMed  Google Scholar 

  6. Blair RJR, Mitchell D, Blair K (2005) The psychopath: emotion and the brain. Blackwell Publishing, Malden

    Google Scholar 

  7. Buitelaar JK, Smeets KC, Herpers P, Scheepers F, Glennon J, Rommelse NN (2013) Conduct disorders. Eur Child Adolesc Psychiatry 22(1):49–54

    Article  Google Scholar 

  8. Bunford N, Evans SW, Wymbs F (2015) ADHD and emotion dysregulation among children and adolescents. Clin Child Fam Psychol Rev 18(3):185–217

    Article  PubMed  Google Scholar 

  9. Cardinale EM, Marsh AA (2020) The reliability and validity of the Inventory of Callous Unemotional Traits: a meta-analytic review. Assessment 27(1):57–71

    Article  PubMed  Google Scholar 

  10. Castagna PJ, Babinski DE, Pearl AM, Waxmonsky JG, Waschbusch DA (2020) Initial investigation of the psychometric properties of the limited prosocial emotions questionnaire (LPEQ). Assessment

  11. Cima M, Raine A, Meesters C, Popma A (2013) Validation of the Dutch Reactive Proactive Questionnaire (RPQ): differential correlates of reactive and proactive aggression from childhood to adulthood. Aggressive Behav 39(2):99–113

    Article  Google Scholar 

  12. Ciucci E, Baroncelli A, Franchi M, Golmaryami FN, Frick PJ (2014) The association between callous-unemotional traits and behavioral and academic adjustment in children: further validation of the Inventory of Callous-Unemotional Traits. J Psychopathol Behav Assess 36(2):189–200

    Article  Google Scholar 

  13. Christian RE, Frick PJ, Hill NL, Tyler L, Frazer DR (1997) Psychopathy and conduct problems in children: II. Implications for subtyping children with conduct problems. J Am Acad Child Adolesc Psychiatry 36(2):233–241

    Article  CAS  PubMed  Google Scholar 

  14. Connor DF, Doerfler LA (2008) ADHD with comorbid oppositional defiant disorder or conduct disorder: discrete or nondistinct disruptive behavior disorders? J Atten Disord 12(2):126–134

    Article  PubMed  Google Scholar 

  15. Dadds MR, Whiting C, Hawes DJ (2006) Associations among cruelty to animals, family conflict, and psychopathic traits in childhood. J Interpers Viol 21(3):411–429

    Article  Google Scholar 

  16. Déry M, Bégin V, Toupin J, Temcheff C (2019) Clinical utility of the limited Prosocial emotions Specifier in the childhood-onset subtype of conduct disorder. Can J Psychiatry 64(12):838–845

    Article  PubMed  PubMed Central  Google Scholar 

  17. Essau CA, Sasagawa S, Frick PJ (2006) Callous-unemotional traits in a community sample of adolescents. Assessment 13(4):454–469

    Article  PubMed  Google Scholar 

  18. Fabiano GA, Pelham WE Jr, Waschbusch DA, Gnagy EM, Lahey BB, Chronis AM, MacLean-Burrows L (2006) A practical measure of impairment: psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. J Clin Child Adolesc Psychol 35(3):369–385

    Article  PubMed  Google Scholar 

  19. Fanti KA, Panayiotou G, Lazarou C, Michael R, Georgiou G (2016) The better of two evils? Evidence that children exhibiting continuous conduct problems high or low on callous–unemotional traits score on opposite directions on physiological and behavioral measures of fear. Dev Psychopathol 28(1):185–198

    Article  PubMed  Google Scholar 

  20. Frick PJ (July, 2013) Clinical assessment of prosocial emotions (CAPE). Unpublished test manual

  21. Frick PJ (2004) Inventory of Callous-Unemotional Traits. http://labs.uno.edu/developmentalpsychopathology/ICU.html. Accessed 20 Aug 2019

  22. Frick PJ, Cornell AH, Barry CT, Bodin SD, Dane HE (2003) Callous- unemotional traits and conduct problems in the prediction of conduct problem severity, aggression, and self-report of delinquency. J Abnorm Child Psychol 31(4):457–470

    Article  PubMed  Google Scholar 

  23. Frick PJ, Dickens C (2006) Current perspectives on conduct disorder. Curr Psychiatry Rep 8:59–72

    Article  PubMed  Google Scholar 

  24. Frick PJ, Moffitt TE (2010) A proposal to the DSM-V childhood disorders and the ADHD and disruptive behavior disorders work groups to include a specifier to the diagnosis of conduct disorder based on the presence of callous-unemotional traits. In: American Psychiatric Association, Washington, DC pp 1–36

  25. Frick PJ, Nigg JT (2012) Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Annu Rev Clin Psychol 8:77–107

    Article  PubMed  Google Scholar 

  26. Frick PJ, Ray JV, Thornton LC, Kahn RE (2014a) Annual research review: a developmental psychopathology approach to understanding callous-unemotional traits in children and adolescents with serious conduct problems. J Child Psychol Psychiatry 55(6):532–548

    Article  PubMed  Google Scholar 

  27. Frick PJ, Ray JV, Thornton LC, Kahn RE (2014b) Can callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review. Psychol Bull 140(1):1–57

    Article  PubMed  Google Scholar 

  28. Frick PJ, Stickle TR, Dandreaux DM, Farrell JM, Kimonis ER (2005) Callous-unemotional traits in predicting the severity and stability of conduct problems and delinquency. J Abnorm Child Psychol 33(4):471–487

    Article  PubMed  Google Scholar 

  29. Frick PJ, White SF (2008) Research review: the importance of callous-unemotional traits for developmental models of aggressive and antisocial behavior. J Child Psychol Psychiatry 49:359–375

    Article  PubMed  Google Scholar 

  30. Fusar-Poli P, Solmi M, Brondino N, Davies C, Chae C, Politi P, McGuire P (2019) Transdiagnostic psychiatry: a systematic review. World Psychiatry 18(2):192–207

    Article  PubMed  PubMed Central  Google Scholar 

  31. Graziano PA, Garcia A (2016) Attention-deficit hyperactivity disorder and children’s emotion dysregulation: a meta-analysis. Clin Psychol Rev 46:106–123

    Article  PubMed  Google Scholar 

  32. Hawes DJ (2014) Disruptive behaviour disorders and DSM-5. Asian J Psychiatry 11:102–105

    Article  Google Scholar 

  33. Hawes DJ, Dadds MR (2005) The treatment of conduct problems in children with callous-unemotional traits. J Consult Clin Psychol 73(4):737–741

    Article  PubMed  Google Scholar 

  34. Helseth SA, Waschbusch DA, King S, Willoughby MT (2015) Aggression in children with conduct problems and callous-unemotional traits: social information processing and response to peer provocation. J Abnorm Child Psychol 43(8):1503–1514

    Article  PubMed  Google Scholar 

  35. Henry J, Pingault JB, Boivin M, Rijsdijk F, Viding E (2016) Genetic and environmental aetiology of the dimensions of Callous-Unemotional traits. Psychol Med 46(2):405–414

    Article  CAS  PubMed  Google Scholar 

  36. Herpers PCM, Klip H, Rommelse NNJ, Taylor MJ, Greven CU, Buitelaar JK (2017) Taxometric analyses and predictive accuracy of callous-unemotional traits regarding quality of life and behavior problems in non-conduct disorder diagnoses. Psychiatry Res 253:351–359

    Article  PubMed  Google Scholar 

  37. Hodgins S, De Brito SA, Simonoff E, Vloet T, Viding E (2009) Getting the phenotypes right: an essential ingredient for understanding aetiological mechanisms underlying persistent violence and developing effective treatments. Front Behav Neurosci 3:44

    Article  PubMed  PubMed Central  Google Scholar 

  38. Houghton S, Hunter SC, Crow J (2013) Assessing callous unemotional traits in children aged 7-to 12-years: a confirmatory factor analysis of the inventory of callous unemotional traits. J Psychopathol Behav Assess 35(2):215–222

    Article  Google Scholar 

  39. Kahn RE, Byrd AL, Pardini DA (2013) Callous-unemotional traits robustly predict future criminal offending in young men. Law Hum Behav 37(2):87

    Article  PubMed  Google Scholar 

  40. Kimonis ER, Fanti KA, Frick PJ, Moffitt TE, Essau C, Bijttebier P, Marsee MA (2015) Using self-reported callous-unemotional traits to cross-nationally assess the DSM-5 “With Limited Prosocial Emotions” specifier. J Child Psychol Psychiatry 56(11):1249–1261

    Article  PubMed  Google Scholar 

  41. Kimonis ER, Frick PJ, Skeem JL, Marsee MA, Cruise K, Munoz LC, Morris AS (2008) Assessing callous–unemotional traits in adolescent offenders: Validation of the Inventory of Callous-Unemotional Traits. Int J Law Psychiatry 31(3):241–252

    Article  PubMed  Google Scholar 

  42. Koutsogiorgi CC, Lordos A, Fanti KA, Michaelides MP (2020) Factorial structure and nomological network of the inventory of callous-unemotional traits accounting for item keying variance. J Pers Assess 4:1–12. https://doi.org/10.1080/00223891.2020.1769112

    Article  Google Scholar 

  43. Kumsta R, Sonuga-Barke E, Rutter M (2012) Adolescent callous–unemotional traits and conduct disorder in adoptees exposed to severe early deprivation. Br J Psychiatry 200(3):197–201

    Article  PubMed  Google Scholar 

  44. Martel MM (2009) Research review: a new perspective on attention-deficit/hyperactivity disorder: emotion dysregulation and trait models. J Child Psychol Psychiatry 50(9):1042–1051

    Article  PubMed  Google Scholar 

  45. Masi G, Pisano S, Brovedani P, Maccaferri G, Manfredi A, Milone A, Muratori P (2018) Trajectories of callous–unemotional traits from childhood to adolescence in referred youth with a disruptive behavior disorder who received intensive multimodal therapy in childhood. Neuropsychiatr Dis Treat 14:2287–2296

    Article  PubMed  PubMed Central  Google Scholar 

  46. Masi G, Milone A, Brovedani P, Pisano S, Muratori P (2018) Psychiatric evaluation of youths with disruptive behavior disorders and psychopathic traits: a critical review of assessment measures. Neurosci Biobehav Rev 91:21–33

    Article  PubMed  Google Scholar 

  47. Moffitt TE, Arseneault L, Jaffee SR, Kim-Cohen J, Koenen KC, Viding E (2008) Research review: DSM-V conduct disorder: Research needs for an evidence base. J Child Psychol Psychiatry 49(1):3–33 (in alphabetical order)

    Article  PubMed  PubMed Central  Google Scholar 

  48. Pardini D, Stepp S, Hipwell A, Stouthamer-Loeber M, Loeber R (2012) The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls. J Am Acad Child Adolesc Psychiatry 51(1):62–73

    Article  PubMed  PubMed Central  Google Scholar 

  49. Pelham WE Jr, Gnagy EM, Greenslade KE, Milich R (1992) Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. J Am Acad Child Adolesc Psychiatry 31(2):210–218

    Article  PubMed  Google Scholar 

  50. Pelham WE Jr, Evans SW, Gnagy EM, Greenslade KE (1992) Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders - Prevalence, factor-analyses, and conditional probabilities in a special-education sample. Sch Psychol Rev 21(2):285–299

    Article  Google Scholar 

  51. Pisano S, Muratori P, Gorga C, Levantini V, Iuliano R, Catone G, Masi G (2017) Conduct disorders and psychopathy in children and adolescents: aetiology, clinical presentation and treatment strategies of callous-unemotional traits. Ital J Pediatrics 43(1):1–11

    Article  Google Scholar 

  52. Rowe R, Maughan B, Moran P, Ford T, Briskman J, Goodman R (2010) The role of callous and unemotional traits in the diagnosis of conduct disorder. J Child Psychol Psychiatry 51(6):688–695

    Article  PubMed  Google Scholar 

  53. Schachar R, Tannock R (1995) Test of four hypotheses for the comorbidity of attention-deficit hyperactivity disorder and conduct disorder. J Am Acad Child Adolesc Psychiatry 34(5):639–648

    Article  CAS  PubMed  Google Scholar 

  54. Seijas R, Servera M, García-Banda G, Barry CT, Burns GL (2018) Evaluation of a four-item DSM–5 Limited Prosocial Emotions specifier scale within and across settings with Spanish children. Psychol Assess 30(4):474–485

    Article  PubMed  Google Scholar 

  55. Shaw P, Stringaris A, Nigg J, Leibenluft E (2014) Emotion dysregulation in attention deficit hyperactivity disorder. Am J Psychiatry 171(3):276–293

    Article  PubMed  PubMed Central  Google Scholar 

  56. Smith ZR, Langberg JM, Cusick CN, Green CD, Becker SP (2020) Academic motivation deficits in adolescents with ADHD and associations with academic functioning. J Abnorm Child Psychol 48(2):237–249

    Article  PubMed  Google Scholar 

  57. Stadler C, Poustka F, Sterzer P (2010) The heterogeneity of disruptive behavior disorders–implications for neurobiological research and treatment. Front Psychiatry 1:21

    Article  PubMed  PubMed Central  Google Scholar 

  58. Viding E, McCrory EJ (2012) Why should we care about measuring callous-unemotional traits in children? Br J Psychiatry 200(3):177–178

    Article  PubMed  Google Scholar 

  59. Walker TM, Frick PJ, Matlasz TM, Robertson EL, Mikolajewski AJ, Mitchell C, Hyde LW (2020) Psychometric properties of a semistructured interview to assess limited prosocial emotions. Assess. https://doi.org/10.1177/1073191120947796

    Article  Google Scholar 

  60. Waschbusch DA (2002) A meta-analytic examination of comorbid hyperactive-impulsive-attention problems and conduct problems. Psychol Bull 128(1):118–150

    Article  PubMed  Google Scholar 

  61. Waschbusch DA, Baweja R, Babinksi DE, Mayes SD, Waxmonsky JG (2019) Irritability and limited prosocial emotions/callous-unemotional traits in elementary-school-age children. Behavior Ther 51:223–237 (Advance online publication)

    Article  Google Scholar 

  62. Waschbusch DA, Willoughby MT (2008) Attention-deficit/hyperactivity disorder and callous-unemotional traits as moderators of conduct problems when examining impairment and aggression in elementary school children. Aggressive Behav 34(2):139–153

    Article  Google Scholar 

  63. Waschbusch DA, Willoughby MT, Haas SM, Ridenour TA, Crum KI, Helseth SA, Altszuler AR, Ross JM, Coles EK, Pelham WE Jr (2019) Effects of behavioral treatment modified to fit children with conduct problems and callous-unemotional traits. J Clin Child Adolesc Psychol 49:639–650 (Advance online publication)

    Article  PubMed  PubMed Central  Google Scholar 

  64. Willoughby MT, Mills-Koonce WR, Waschbusch DA, Gottfredson NC, Family Life Project Investigators (2015) An examination of the parent report version of the Inventory of Callous-Unemotional Traits in a community sample of first-grade children. Assessment 22(1):76–85

    Article  PubMed  Google Scholar 

  65. Wright KD, Waschbusch DA, Frankland BW (2007) Combining data from parent ratings and parent interview when assessing ADHD. J Psychopathol Behav Assess 29(3):141–148

    Article  Google Scholar 

  66. Wymbs BT, McCarty CA, King KM, McCauley E, Vander Stoep A, Baer JS, Waschbusch DA (2012) Callous-unemotional traits as unique prospective risk factors for substance use in early adolescent boys and girls. J Abnorm Child Psychol 40(7):1099–1110

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

There was no funding source for this project.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Health, Penn State Hershey Medical Centre, Penn State College of Medicine, 500 University Drive, Office: C5635, Hershey, PA, 17033, USA

    Peter J. Castagna, Dara E. Babinski, James G. Waxmonsky & Daniel A. Waschbusch

Authors
  1. Peter J. Castagna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dara E. Babinski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James G. Waxmonsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel A. Waschbusch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter J. Castagna.

Ethics declarations

Conflict of interest

None of the authors declare a conflict of interest.

Ethical approval

All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The questionnaire and methodology for this study were approved by the institutional review board at Penn State College of Medicine.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Castagna, P.J., Babinski, D.E., Waxmonsky, J.G. et al. The significance of limited prosocial emotions among externalizing disorders in children. Eur Child Adolesc Psychiatry 31, 589–600 (2022). https://doi.org/10.1007/s00787-020-01696-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-020-01696-0

Keywords

Search

Navigation