“…Among adolescents whose externalizing behavior problems are severe enough to merit entry into substance use disorder treatment, very high prevalence of CD is generally seen (Dennis et al, 2004), with more than 80% of such youths having CD in some studies (Sakai, Hall, Mikulich-Gilbertson and Crowley, 2004). While a good deal of work has characterized SUD youths with CD in terms of their longitudinal course and associated co-morbid disorders (e.g., Crowley and Riggs, 1995; Walters, 2014; Hopfer et al, 2013), recent findings have suggested that CD is a relatively heterogeneous phenotype and that CD youth might be meaningfully divided based on callous-unemotional traits (e.g., Frick and White, 2008). After reviewing evidence showing that callous-unemotional traits are measurable in childhood (Frick and Ellis, 1999), stable (Frick and White, 2008), and predict worse outcomes (Frick and White, 2008; Frick, Cornell, Barry, Bodin and Dane, 2003; Frick and Dickens, 2006), the Diagnostic and Statistical Manual of Mental Disorders' (DSM-5) ADHD and Disruptive Behavior Disorders Work Group developed and described methods for categorical identification of callous-unemotional traits (Frick and Moffitt, 2012) and included a “limited prosocial emotions” (LPE) specifier for the CD diagnosis in DSM-5 (APA, 2013).…”