The DSM-5 With Limited Prosocial Emotions Specifier for Conduct Disorder Among Detained Girls

new DSM-5 specifier 'with Limited Prosocial Emotions' (LPE) is expected to provide greater information about impairment of children and adolescents with conduct disorder (CD). This study examined the clinical utility of the LPE specifier symptom threshold among female adolescents being detained in Belgium (n = 191 girls; ages 12-17). Standardized questionnaires and a structured diagnostic interview were used to assess the LPE specifier, CD, and variables of interest. Approximately 62% (n = 118) of the girls met criteria for CD. Depending on the instrument that was used to assess the LPE specifier criteria, 26% to 37% of the girls with CD met criteria for the LPE specifier symptom threshold (CD + LPE). Overall, CD + LPE girls were not significantly different from CD-only girls regarding psychiatric morbidity (i.e., attention-deficit/hyperactivity disorder, oppositional defiant disorder, substance use disorder, major depression, and anxiety disorders). However, CD + LPE girls were more aggressive, rule-breaking, delinquent, and had higher levels of psychopathic traits than CD-only girls. This study supports the view that the LPE specifier identifies a group of seriously antisocial individuals, but could not replicate previous findings that the LPE specifier symptom threshold identifies CD individuals who exhibit more psychiatric morbidity than CD individuals who are without the specifier symptom threshold. These findings altogether suggest that the clinical usefulness of the DSM-5 specifier for the diagnosis of CD is restricted, at least in detained girls.