Some studies, for example, showed that children with CP and CU display higher levels of severe and stable antisocial behavior (e.g., criminality, aggression, and substance use problems), to exhibit a fearless temperament, to be impaired in their responsiveness to and recognition of cues to fear and sadness in others, and to display higher levels of interpersonal (e.g., grandiosity) and behavioral/lifestyle (e.g., thrill-seeking) psychopathic personality traits (Christian et al. Specifically, it is estimated that 20–50% of children with CP exhibit high levels of CU traits and there is evidence to suggest that these children differ from children with CP and low levels of CU traits in various theoretically and clinically relevant features (Frick et al. CU traits are increasingly used as a subtyping scheme to understand heterogeneity among children with conduct problems (CP), and to delineate a small but important subgroup of youth with severe CP (Dadds et al. 2014), and sometimes also by being unconcerned about poor performance (APA 2013 Frick 2003). Crucially, limitations that hallmark the few studies on the topic hamper any firm conclusion about the usefulness of the specifier.Ĭallous-unemotional (CU) traits are commonly characterized by deficient empathy and guilt, insensitivity to others’ feelings, shallow emotions (Andershed et al. Empirical work shows that this specifier should not be used for clinical decision-making when relying on items from measures that have been used in the development of the LPE specifier. Effect sizes typically were in the small to moderate range, suggesting that the practical usefulness of the group differences is limited. Available work altogether showed that CD + LPE youth displayed higher levels of past antisocial behaviour than CD Only youth, but failed to reveal other group differences that corroborate with expectations. The most commonly used features relate to severity of antisocial behavior, low neuroticism (or lack of anxiety and depression), and treatment responsiveness. The studies greatly varied in the features used to test the viability of the DSM-5 LPE specifier. The prevalence of youth with CD who met criteria for this novel LPE specifier (CD + LPE) ranged from 6.1% to 83.7%. All studies constructed an LPE measure by pulling the same items from the same rating scales that were used in the development of the DSM-5 LPE specifier. Eventually, nine papers were included in this review, referring to eight unique samples. Computer-assisted searches were executed and identified 181 potentially relevant papers. This paper systematically reviews the evidence base for this specifier in children and adolescents who are diagnosed with CD. DSM-5 added a categorically defined specifier (‘with Limited Prosocial Emotions’ LPE) for the diagnosis of conduct disorder (CD).