The early onset of Conduct Disorder (CD) is considered a precursor of serious psychiatric problems in adulthood, and its primary and secondary prevention is challenging for clinicians and researchers. The concomitant presence of CD and traits of Callous-Unemotional define a subgroup of children with more severe and stable forms of CD, more significant psychiatric morbidity, and greater emotional and cognitive deficits than children presenting with BT alone.

Recently, the DSM-5 has included the new specifier “with limited prosocial emotions” (LPE) in the diagnosis of CD to clinically distinguish individuals with CD who present Callous-Unemotional traits, are considered precursors of adult psychopathy, and who show resistance to conventional treatments aimed at the child and adolescent population with behavioral problems. However, given the recent appearance of the LPE specifier, there is still no validated method for its clinical diagnosis. Various etiological models of psychopathy highlight the existence of attentional abnormalities and deficits in emotional processing, such as recognizing certain emotions and learning about fear. Such deficits could be linked to abnormal amygdala functioning. However, although there is some consensus in considering psychopathy as a neurodevelopmental disorder, research on them in children with CD and Callous-Unemotional traits is scarce, inconsistent, or non-existent.

Aims

The general aim of the project is to contribute to the analysis of the usefulness of the LPE specifier of the DSM-5 CD by adapting a new diagnostic instrument and studying attentional, emotional, and neuroendocrine correlates in a clinical population of children aged 5 to 12 years in elementary school.

The specific aims are:

  1. Sociolinguistic adaptation in Spanish of the semi-structured interview Clinical Assessment of Prosocial Emotions: Version 1.1 (CAPE 1.1) and study of its psychometric properties.
  2. To study whether the concomitant presence of CD and the LPE specifier is related to deficits in emotion recognition in visual stimuli (human faces).
  3. To analyze whether the concomitant presence of CD and the LPE specifier is related to reduced attention to the eye region to human face stimuli and whether emotion recognition improves under indications of altered attentional focus in the CD+ LPE+, in subgroup of children.
  4. To evaluate the existence of deficits in fear conditioning in children with CD and to analyze to what extent these are common to all children with a such diagnosis or, on the contrary, specific to those with CD and the LPE specifier.
  5. To study whether hair cortisol levels of HPA axis activity under chronic stress are different in children with CD and the LPE specifier compared to children with CD without the specifier.

What are we expecting?

It is expected that the LPE specifier will allow the detection of a subgroup of children with CD with specific cognitive, emotional, and hormonal characteristics that will guide the design of specific primary and secondary prevention programs.