New insights into characteristics of Conduct Disorder with “limited prosocial emotions”

In a recent study, Dr. Moji Aghajani and colleagues show that adolescents with a severe form of Conduct Disorder (CD) -with limited prosocial emotions- require an unusually large amount of brain capacity to read emotional faces. These effects were found in comparison to CD youth without limited prosocial emotions and healthy control peers. It thus appears that these CD youth recruit additional cognitive processes to compensate for their social-emotional limitations.

Conduct Disorder (CD) is a serious mental disorder that is relatively common in children and adolescents but is notoriously difficult to treat. This transgressive behavioural disorder is characterised by aggressive and antisocial behaviours. However, the diagnosis of CD is associated with very different outcomes in terms of etiology, course, severity, and treatment responsiveness. As such, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) added a specifier for CD describing characteristics of “limited prosocial emotions”, meaning that a person shows little empathy, remorse, or guilt. Adolescents with CD who also meet this specifier demonstrate much more severe antisocial behaviours that often persist into adulthood.

No direct evidence until now

Several studies suggest that this more severe form of CD is the result of abnormalities in certain neurobiological systems governing socioemotional behaviour. Until now, however, no direct evidence has been put forward comparing CD adolescents with and without the DSM-5 specifier “limited prosocial emotions”.

In their recently published fMRI study, Aghajani et al. show that CD adolescents with limited prosocial emotions recruit much more brain capacity to process socioemotional information (emotional faces). These effects were found in comparison to CD youth without limited prosocial emotions and healthy control peers.

Distinctive pattern of social-emotional information processing

According to Aghajani, the findings tentatively suggest that CD adolescents with limited prosocial emotions employ highly controlled cognitive processes in order to compensate for their limitations within the socioemotional domain. Interestingly, this particular pattern of socioemotional information processing is also often seen in adults with psychopathic traits, and is often associated with deficient prosocial emotions. However, Aghajani stresses that the findings are still very much preliminary, and that further research is necessary.

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