Conflict of interest statement: Dr. Findling receives or has received research support, acted as a consultant and/or served on a speaker’s bureau for Abbott, Addrenex, Alexza, AstraZeneca, Biovail, Bristol-Myers Squibb, Forest, GlaxoSmithKline, Johnson & Johnson, KemPharm Lilly, Lundbeck, Merck, Neuropharm, Novartis, Noven, Organon, Otsuka, Pfizer, Rhodes Pharmaceuticals, Sanofi-Aventis, Schering-Plough, Seaside Therapeutics, Sepracore,Shire, Solvay, Sunovion, Supernus Pharmaceuticals, Transcept Pharmaceuticals, Validus, and Wyeth. Dr. Eric Youngstrom has received travel support from Bristol Meyers Squibb to attend the Annual Meeting of the American College of Neuropsychopharmacology. Dr. Paul Frick, Dr. Jennifer Kogos-Youngstrom, and Ms. Rachel Kahn have no biomedical, financial interests or potential conflicts of interest.
The effects of including a callous–unemotional specifier for the diagnosis of conduct disorder
Article first published online: 26 SEP 2011
© 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health
Journal of Child Psychology and Psychiatry
Volume 53, Issue 3, pages 271–282, March 2012
How to Cite
Kahn, R. E., Frick, P. J., Youngstrom, E., Findling, R. L. and Youngstrom, J. K. (2012), The effects of including a callous–unemotional specifier for the diagnosis of conduct disorder. Journal of Child Psychology and Psychiatry, 53: 271–282. doi: 10.1111/j.1469-7610.2011.02463.x
- Issue published online: 3 FEB 2012
- Article first published online: 26 SEP 2011
- Accepted for publication: 22 July 2011 Published online: 26 September 2011
- Callous–unemotional traits;
- conduct disorder;
Background: ‘With Significant Callous–Unemotional Traits’ has been proposed as a specifier for conduct disorder (CD) in the upcoming revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The impact of this specifier on children diagnosed with CD should be considered.
Methods: A multi-site cross-sectional design with volunteers (n = 1136) in the third–seventh grades and 566 consecutive referrals (ages 5–18) to a community mental health center were used to estimate the prevalence rates of CD with and without the proposed specifier. In addition, the degree of emotional and behavioral (especially physical aggression) disturbance and level of impairment in youth with and without CD and with and without the specifier was evaluated.
Results: In the community sample, 10%–32% of those with CD and 2%–7% of those without CD met the callous–unemotional (CU) specifier threshold depending on informant. In the clinic-referred sample, 21%–50% of those with CD and 14%–32% without CD met the CU specifier threshold depending on informant. Those with CD and the specifier showed higher rates of aggression in both samples and higher rates of cruelty in the clinic-referred sample.
Conclusions: Results indicate between 10% and 50% of youth with CD would be designated with the proposed CU specifier. Those with CD and the specifier appear to be more severe on a number of indices, including aggression and cruelty.