Örebro University, Sweden; Ghent University, Belgium; and Curium-Leiden University Medical Centre, Oegstgeest, the Netherlands.
University of Cyprus, Greece.
J Am Acad Child Adolesc Psychiatry. 2021 Aug;60(8):1020-1029. doi: 10.1016/j.jaac.2020.09.022. Epub 2020 Oct 15.
A limited prosocial emotions (LPE) subtype of conduct disorder (CD) has been added to the DSM-5. Empirical studies on this categorically defined subtype are scarce, and existing work is predominantly cross-sectional. Hypotheses surrounding the LPE subtype that relate to comorbidity, prognosis, and developmental antecedents, and overlap with psychopathic personality, have received no or little scrutiny.
These knowledge gaps were addressed in a community sample of 1,839 children 8 to 10 years of age who were enrolled in the study in early childhood (age 3-5 years) and were followed up in early adolescence (age 11-13 years). Parents and teachers completed questionnaires that tap theoretically and clinically relevant features.
Children with the LPE subtype exhibited more CD symptoms and comorbid problems, including fearlessness, and symptoms of oppositional defiant disorder and attention-deficit/hyperactivity disorder. These children were also at higher risk for future CD symptoms at the 3-year follow-up. Additionally, fearlessness, callous-unemotional traits, interpersonal traits, and harsh parenting assessed in early childhood were identified as developmental antecedents of the LPE subtype. Findings tentatively suggest that the LPE subtype is a heterogeneous group differentiated on other psychopathic personality traits.
The LPE subtype appears to identify a troubled, etiologically distinct group of children with conduct problems who are at heightened risk for future maladjustment. Findings can inform the underlying mechanisms related to the LPE subtype, and can lead to the development and improvement of prevention and intervention programs for children with conduct problems.
DSM-5 中增加了一种有限亲社会情绪（LPE）的品行障碍（CD）亚型。关于这种分类定义的亚型的实证研究很少，现有的工作主要是横断面研究。与共病、预后和发展前因有关的、与精神病态人格重叠的 LPE 亚型的假设，尚未得到或很少得到审查。
在一个 1839 名 8 至 10 岁的儿童社区样本中，对这些知识空白进行了研究。这些儿童在儿童早期（3-5 岁）入组并在青少年早期（11-13 岁）进行随访。父母和教师完成了理论和临床相关特征的问卷。
LPE 亚型的儿童表现出更多的 CD 症状和共病问题，包括无所畏惧、对立违抗性障碍和注意缺陷/多动障碍的症状。这些儿童在 3 年随访时也更有可能出现未来的 CD 症状。此外，在儿童早期评估的无所畏惧、无情情感特质、人际关系特质和严厉的养育方式被确定为 LPE 亚型的发展前因。研究结果初步表明，LPE 亚型是一个异质的群体，在其他精神病态人格特质上有所不同。
LPE 亚型似乎确定了一个有问题的、病因学上不同的品行障碍儿童群体，他们未来适应不良的风险更高。研究结果可以为与 LPE 亚型相关的潜在机制提供信息，并为有品行障碍的儿童开发和改进预防和干预计划。
