Conduct Disorder

Decades of research has shown that youths with conduct disorder (CD) represent a highly heterogeneous population. Over the past 20 years, most of the research and clinical work have focused on two sub-typing approaches to characterize the heterogeneity within CD: (1) the age of onset distinction introduced in DSM-IV and (2) the presence of callous-unemotional traits included as the ``limited prosocial emotion'' specifier within DSM-5. Considering these sub-typing approaches to characterize youths with CD, this chapter selectively reviews the literature on the prevalence and diagnosis of CD, as well as the evidence base on the neurobiological correlates of the disorder identified through genetics, epigenetics, autonomic nervous system responsivity, levels of neurotransmitters, neuropsychological performance, and structural and functional neuroimaging. Next, we highlight the pressing need to further investigate females and the role of sex differences in this population. We conclude the chapter with a discussion of clinical interventions and the long-term outcomes associated with the disorder

Callous-unemotional traits as a cross-disorders construct

Item does not contain fulltextPURPOSE: Callous-unemotional (CU) traits are currently viewed as the defining signs and symptoms of juvenile psychopathy. It is unclear, however, whether CU traits have validity only in the context of conduct disorder (CD) as proposed by Frick and Moffitt (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, American Psychiatric Association, Washington, DC, 2010), or also outside CD, either in combination with other forms of psychopathology or as a stand-alone construct. METHODS: The current review systematically studied the existent literature on CU traits in juveniles to examine their validity inside and outside CD according to the framework regarding the validity of a psychiatric diagnosis provided by Robins and Guze (Am J Psychiatry 126:983-987, 1970). RESULTS: Inside youth with conduct problems, and CD specifically, it seems that CU traits meet the Robins and Guze criteria. As many of the reviewed studies included youth with ODD and ADHD as well, there are indications the same might be true for ODD and ADHD, although probably to a lesser extent. In other disorders, CU traits may be present as well, but their role is not firmly established. As stand-alone construct, data are lacking or are scarce on all of the above-mentioned criteria. CONCLUSIONS: CU traits are a useful specifier in CD, and possibly also in disruptive behaviour disorders (DBDs) more generally. High CU traits outside DBDs exist but it is as yet unknown if there is a clinical need for defining CU traits as a stand-alone construct