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The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls.

ABSTRACT: A callous-unemotional (CU) subtype of conduct disorder (CD) has been proposed as an addition to the fifth edition of the Diagnostic and Statistic Manual of Mental Disorders (DSM-5). This study tested the hypothesis that young girls with the CU subtype of CD would exhibit more severe antisocial behavior and less severe internalizing problems over time relative to girls with CD alone. Second, the developmental outcomes of girls with CU traits in the absence of CD was examined because these girls would be overlooked by the proposed CU subtyping scheme.Theses issues were examined in a community sample of 1,862 girls 6 to 8 years of age at study onset. Outcomes included internalizing and externalizing problems, academic achievement, and global impairment assessed concurrently and at a 6-year follow-up.Girls with the CU subtype of CD had higher levels of externalizing disorder symptoms, bullying, relational aggression, and global impairment than girls with CD alone. Girls with CD alone tended to have more anxiety problems than girls with the CU subtype of CD. Girls with high CU traits without CD exhibited higher ODD and attention-deficit/hyperactivity disorder (ADHD) symptoms and lower academic achievement at the 6-year follow-up relative to girls without CU traits and CD. Group differences at the 6-year follow-up were primarily accounted for by baseline differences on the outcomes.The proposed DSM-5 CU subtype of CD identifies young girls who exhibit lower anxiety problems and more severe aggression, CD symptoms, academic problems and global impairment across time than girls with CD alone.

SUBMITTER: Pardini D

PROVIDER: S-EPMC3271440 | biostudies-literature | 2012 Jan

REPOSITORIES: biostudies-literature

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The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls.

Pardini Dustin D Stepp Stephanie S Hipwell Alison A Stouthamer-Loeber Magda M Loeber Rolf R

Journal of the American Academy of Child and Adolescent Psychiatry 20120101 1

<h4>Objective</h4>A callous-unemotional (CU) subtype of conduct disorder (CD) has been proposed as an addition to the fifth edition of the Diagnostic and Statistic Manual of Mental Disorders (DSM-5). This study tested the hypothesis that young girls with the CU subtype of CD would exhibit more severe antisocial behavior and less severe internalizing problems over time relative to girls with CD alone. Second, the developmental outcomes of girls with CU traits in the absence of CD was examined bec ...[more]

PMID: 22176940

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Project description:Previous studies have reported changes in gray matter volume in youths with conduct disorder (CD), although these differences are difficult to interpret as they may have been driven by alterations in cortical thickness, surface area (SA), or folding. The objective of this study was to use surface-based morphometry (SBM) methods to compare male youths with CD and age and sex-matched healthy controls (HCs) in cortical thickness, SA, and folding. We also tested for structural differences between the childhood-onset and adolescence-onset subtypes of CD and performed regression analyses to assess for relationships between CD symptoms and callous-unemotional (CU) traits and SBM-derived measures.We acquired structural neuroimaging data from 20 HCs and 36 CD participants (18 with childhood-onset CD and 18 with adolescence-onset CD) and analyzed the data using FreeSurfer.Relative to HCs, youths with CD showed reduced cortical thickness in the superior temporal gyrus, reduced SA in the orbitofrontal cortex (OFC), and increased cortical folding in the insula. There were no significant differences between the childhood-onset and adolescence-onset CD subgroups in cortical thickness or SA, but several frontal and temporal regions showed increased cortical folding in childhood-onset relative to adolescence-onset CD participants. Both CD subgroups also showed increased cortical folding relative to HCs. CD symptoms were negatively correlated with OFC SA whereas CU traits were positively correlated with insula folding.Cortical thinning in the superior temporal gyrus may contribute to the social cognitive impairments displayed by youths with CD, whereas reduced OFC SA may lead to impairments in emotion regulation and reward processing in youths with CD. The increased cortical folding observed in the insula may reflect a maturational delay in this region and could mediate the link between CU traits and empathy deficits. Altered cortical folding was observed in childhood-onset and adolescence-onset forms of CD.

Dataset Information

The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls.

Publications

The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls.

Similar Datasets

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