Vanwoerden Salome, Reuter Tyson, Sharp Carla
University of Houston, 126 Heyne Building, Houston, TX 77204, USA.
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.
Compr Psychiatry. 2016 Aug;69:116-31. doi: 10.1016/j.comppsych.2016.05.012. Epub 2016 May 19.
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.
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 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.
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.
随着《精神疾病诊断与统计手册》第5版（DSM - 5）中品行障碍（CD）诊断增加了冷酷无情（CU）特质说明符，需要开展研究来评估该说明符的临床实用性以及在临床样本中识别符合该说明符标准的青少年的最佳方法。
为此，本研究调查了四组住院青少年（N = 382，年龄12 - 17岁）的横断面相关性和治疗反应：无该说明符的品行障碍患者、有品行障碍及该CU说明符的患者、仅有CU特质的患者以及一组精神科对照。我们使用两种不同的测量方法来识别具有高水平CU特质的青少年：反社会过程筛查工具（APSD）[1]和冷酷无情特质量表（ICU）[2]。通过问卷调查和结构化访谈来评估一系列结果，包括外化问题和内化问题的基线水平及治疗结果。
结果表明，在横断面关系和治疗反应方面，ICU而非APSD能够区分有无该说明符的品行障碍青少年在外化行为上的差异。
本研究结果对使用最常用的测量方法来识别CU说明符提出了警示，并对替代方法提出了建议。
