Utility of the Limited Prosocial Emotions Specifier in Preschoolers With Conduct Problems

This study examined the clinical utility of the “Limited Prosocial Emotions” (LPE) specifier (i.e., prevalence rates, group differences, and predictive utility) in a high-risk preschool sample ( N = 109, M age = 4.77) presenting with conduct problems (CPs; n = 59). First, LPE prevalence rates ranged from 7.7% to 89.8%. Next, few group differences were observed between with CP-only and CP+LPE; youth with CP+LPE differed from youth with CP-only on callous-unemotional (CU) traits and verbal ability, but not on externalizing or internalizing psychopathology, nor on parenting experiences. In the full sample, youth with LPE differed from youth without LPE on externalizing and internalizing psychopathology, parenting, and verbal ability. Finally, LPE predicted greater baseline CP but did not predict trajectories of CP. Findings highlight the clinical utility of the LPE specifier during early childhood and call for a refinement of the LPE specifier to improve its clinical value.

Limited Prosocial Emotions in a Clinical Population of Children and Adolescents: Proposal for Core and Ancillary Characteristics: Émotions prosociales limitées dans une population clinique d’enfants et d’adolescents; Proposition de caractéristiques essentielles et accessoires

Objective: Limited prosocial emotions (LPE) has been recently incorporated into international classifications as a specifier for conduct disorder in the DSM-5 and for all disruptive behavioural disorders in the ICD-11. The aims of the current work were to determine (a) the accuracy of each of the characteristics used to assess the LPE specifier and (b) whether the manner in which symptoms group together supports the idea of LPE having core characteristics. Method: Trained clinicians conducted interviews and determined LPE characteristics using responses from 74 parent/guardian and child/adolescent participants. Results: The distribution of LPE characteristics among those participants with LPE ( n = 13) was compared to those with only one LPE characteristic ( n = 11). The proposal of callous lack of empathy (CLE) and shallow deficient affect (SDA) as core characteristics was supported by strong associations with the presence of the LPE specifier, larger specificity, and sensitivity indices than those for unconcerned about performance and lack of remorse or guilt, as well as by a robust aggregation in a latent class analysis. Conclusions: CLE and SDA could be considered as core characteristics of LPE in children and adolescents.

Psychometric Properties of a Semistructured Interview to Assess Limited Prosocial Emotions

Callous-unemotional (CU) traits have recently been added to the diagnostic criteria of Conduct Disorder in the Diagnostic and Statistical Manual of Mental Disorders–Fifth edition and of conduct–dissocial and oppositional defiant disorders in the International Classification of Disease–Eleventh edition as the limited prosocial emotions specifier. This change necessitates the assessment of these traits with validated measures in both research and clinical contexts. The current study sought to validate a semi-structured diagnostic interview method, the Michigan Limited Prosocial Emotion Addendum (M-LPE) to the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version, of assessing CU traits based on a recently developed clinician rating system (Clinical Assessment of Prosocial Emotions, Version 1.1) in a sample of at-risk youth. Results supported the interrater reliability of the M-LPE with moderate agreement and high reliability between raters. The M-LPE demonstrated convergent and incremental validity with CU traits and various measures of antisocial behavior. The results provide preliminary evidence for the use of a semi-structured interview assessment of CU traits in research contexts and build the foundation for further validation.

Initial Investigation of the Psychometric Properties of the Limited Prosocial Emotions Questionnaire (LPEQ)

Callous–unemotional traits, which include lack of remorse or guilt, callousness/lack of empathy, unconcern about performance, and shallow/deficient affect, were included as a specifier of conduct disorder in the current (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders under the rubric Limited Prosocial Emotions (LPEs). The purpose of this study was to examine the psychometric properties of a new rating scale, the Limited Prosocial Emotions Questionnaire (LPEQ). Caregivers ( n = 1,050) of children ( Mage = 8.42, SD = 2.31) completed the LPEQ and other measures. Results provide support for a single factor model of the LPEQ, with measurement invariance supported across child and informant sex. Both the reliability and validity of the LPEQ as a measure of LPEs were also well supported. Children identified with LPE had significantly greater average impairment and need for treatment relative to children without LPE. Children with conduct problems (i.e., conduct disorder or oppositional defiant disorder), as well those without conduct problems, had significantly more impairment if they were identified as having LPE. Our findings fit with the mounting evidence of the clinical utility of assessing LPEs in children. Future research should look to replicate our findings in clinical samples of youth.