To Örebro University

Objectives: Better descriptions and treatment of children with conduct problems (CP) grandiose-manipulative (GM) and daring-impulsive (DI) traits are proposed for subtyping CP, instead of only using a callous-unemotional (CU) specifier. Unfortunately, the acclaimed benefits of having multiple specifiers for CP remain largely untested and, therefore, highly speculative. To fill this gap, we tested longitudinal relations between these 3 specifiers and developmental outcomes in childhood and adolescence, independent of early childhood CP.

Methods: We relied on longitudinal data from 2 community studies. Teacher-ratings were used to measure CP and the specifiers in 3- to 5-year-olds from Sweden (N = 2064) and Spain (N = 2055). Developmental outcomes were assessed by multiple informants (ie, teachers, parents, and children) 1 to 8 years later.

Results: Early childhood CP were predictive of all outcomes. CU traits predicted low levels of social competence and prosocial behavior, independent of CP (and age, gender, and socioeconomic status). GM and DI traits were predictive of aggression and violent delinquency, respectively, independent of CP, but also of higher levels of prosocial behavior or social competence.

Conclusions: The 3 specifiers are predictive of different outcomes, independent of CP, which is thought to form the basis for developing specifiers for CP. Findings tentatively challenge the centrality of CU traits for subtyping CP, but it is premature to conclude that GM and DI specifiers are needed in future revisions of the DSM and ICD. Efforts to systematically evaluate the utility of these specifiers should be welcomed to inform ongoing debates on this matter.