Empathy problems in youth with disruptive behavior disorders, with and without callous unemotional traits

This chapter first examines the nature of empathy problems in clinically referred disruptive behavior disorders (DBD) youth with callous unemotional (CU) traits. It then examines whether a lack of empathy contributes to a differentiation between DBD subtypes. The chapter also explores whether the empathy problems associated with CU traits are similar for those with pure DBD as for those with attention deficit-hyperactivity disorder (ADHD) comorbidity. Next, it considers the various components of empathy, using Davis' organizational model, which emphasizes the connections between all components. Later, it reflects on the Diagnostic Statistical Manual of Mental Disorders (DSM-5) classifications of oppositional defiant disorder (ODD) and conduct disorder (CD), and summarizes studies conducted with undifferentiated samples (not accounting for CU or psychopathic traits) of DBD youth followed by studies examining empathy problems in DBD children and adolescents with high versus low CU traits. The chapter concludes with clinical implications and suggestions for future research.