Callous-unemotional traits (CU) are distinguished by a persistent pattern of behavior that reflects a disregard for others, and also a lack of empathy and generally deficient affect.
The interplay between genetic and environmental risk factors may play a role in the expression of these traits as a conduct disorder (CD).
[6] The provision of the CU specifier for CD youth is claimed to improve the diagnostic power, treatment options, and increase the understanding life-course outcomes.
[15] Primatologist Frans de Waal argues that evolutionary theory postulates that biological altruism in primates evolved for the return-benefits it bears the performer.
[23] Children with combined CD and ADHD are more likely to show features associated with psychopathy, but only in those who have high rates of CU traits.
[9] A systematic review found that CU traits were associated with poorer outcomes in family-based interventions for conduct problems.
[29] Similarly, different subtypes of aggressive and antisocial behaviors in youth may predict distinct problem-behaviors and risk factors.
Following the publication of DSM-III, these distinctions prompted research, but there were still issues with the terminology in diagnosing the core features of the undersocialized versus socialized subtype.
The word undersocialized was used in order to avoid the negative connotations of psychopathy, but was commonly misinterpreted to mean that the child was not well socialized by parents or lacked a peer group.
Also, the operational definition failed to include dimensions that could reliably predict the affective and interpersonal deficits in psychopathic-like youths.
Due to these issues, the American Psychiatric Association removed the undersocialized and socialized distinctions from the conduct disorder description in the DSM after the third edition.