title: Exploring the clinical utility of the DSM-5 conduct disorder specifier of 'with limited prosocial emotions' in an adolescent inpatient sample.
abstract: BACKGROUND
  With the recent addition of a callous-unemotional (CU) specifier to the diagnosis of conduct disorder (CD) in the DSM-5, studies are needed to evaluate the clinical utility of this specifier and the best ways to identify youth meeting criteria for this specifier in clinical samples.
  
  
  METHODS
  To this end, the current study examined cross-sectional correlates and treatment response across four groups of inpatient adolescents (N=382, ages 12-17): those with CD without the specifier, with CD and the CU specifier, CU alone, and a group of psychiatric controls. We used two different measures to identify adolescents with high levels of CU traits: the Antisocial Process Screening Device (APSD) [1] and the Inventory of Callous-Unemotional Traits (ICU) [2]. Questionnaires and structured interviews were used to evaluate a range of outcomes including presence of baseline levels and treatment outcomes of both externalizing and internalizing problems.
  
  
  RESULTS
  Results indicated that the ICU, but not the APSD differentiated between conduct disordered youth with and without the specifier on externalizing behaviors in both cross-sectional relations and treatment response.
  
  
  CONCLUSIONS
  The results of the current study caution the use of the most frequently used measure to identify the CU specifier, and make suggestions about alternatives.
authors.affiliation: University of Houston, 126 Heyne Building, Houston, TX 77204, USA.
authors.forename: Salome
authors.initials: S
authors.lastname: Vanwoerden
authors.affiliation: University of Houston, 126 Heyne Building, Houston, TX 77204, USA.
authors.forename: Tyson
authors.initials: T
authors.lastname: Reuter
authors.affiliation: University of Houston, 126 Heyne Building, Houston, TX 77204, USA; The Menninger Clinic, 12301 Main Street, Houston, TX 77035, USA; Centre for Development Support, University of the Free State, South Africa. Electronic address: csharp2@central.uh.edu.
authors.forename: Carla
authors.initials: C
authors.lastname: Sharp
mesh_terms: D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000523:psychology; D019955:Conduct Disorder / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D000066498:Emotional Adjustment; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome