Psychometric Properties of the Clinical Assessment of Prosocial Emotions: Version 1.1 (CAPE 1.1) in Young Males Who Were Incarcerated

• Author: Rafael Torrubia,Albert Bonillo,Paul J. Frick,Noemí Torrent,Albert Requena,Vanessa Pera-Guardiola,Iolanda Batalla,Beatriz Molinuevo,Esther Martínez-Membrives
• DOI: 10.1177/0093854819892931
• Published date: 01 May 2020
• Date: 01 May 2020
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2020, Vol. 47, No. 5, May 2020, 547 –563.

DOI: https://doi.org/10.1177/0093854819892931

Article reuse guidelines: sagepub.com/journals-permissions

© 2019 International Association for Correctional and Forensic Psychology

547

PSYCHOMETRIC PROPERTIES OF THE CLINICAL

ASSESSMENT OF PROSOCIAL EMOTIONS

Version 1.1 (CAPE 1.1) in Young Males Who Were

Incarcerated

BEATRIZ MOLINUEVO

Universitat Autònoma de Barcelona

ESTHER MARTÍNEZ-MEMBRIVES

Government of Catalonia

VANESSA PERA-GUARDIOLA

Sant Joan de Deu Terres de Lleida

Biomedical Research Institute of Lleida

Universitat de Lleida

ALBERT REQUENA

Unit of Attention and Evaluation to Affected by Terrorism

NOEMÍ TORRENT

PsicoGarrigues

ALBERT BONILLO

Universitat Autònoma de Barcelona

IOLANDA BATALLA

Biomedical Research Institute of Lleida

Universitat de Lleida

Santa Maria University Hospital

RAFAEL TORRUBIA

Universitat Autònoma de Barcelona

PAUL J. FRICK

Louisiana State University

Learning Science Institute of Australia

AUTHORS’ NOTE: The authors are grateful to all the participating youths and juvenile justice professionals of the

detention centers L’Alzina (Barcelona) and El Segre (Lleida). They would like to recognize Xènia Blaya, BS, Juanjo

J. Martínez, BS, David Garreta, MS, Anna Camarasa, BS, Carmen Tello, PhD, and Manel Fortes, BS, for assistance

in data collection. This research was financially supported by the Centre d’Estudis Jurídics i Formació Especialitzada,

Government of Catalonia (DOGC Núm. 7024-23.12.05; DOGC DOGC Núm. 7274 – 27/12/16), by the Departament

d’Economia i Coneixement, Generalitat de Catalunya (2014SGR-1587), and by the Ministerio de Economía, Industria

y Competitividad, Spanish Government (PSI2015-67441-R). The funding organizations had no further role in the study

design; collection, analysis, and interpretation of data; writing of the report; and decision to submit the manuscript

for publication. The authors declare that Dr. Paul Frick is the creator of the CAPE 1.1 and they declare no other

conflicts of interest. Correspondence concerning this article should be addressed to Beatriz Molinuevo, Departament

de Psiquiatria i Medicina Legal, Facultat de Medicina, Universitat Autònoma de Barcelona, Avinguda de Can

Domènech, s/n, Bellaterra (Cerdanyola del Vallès), Barcelona 08193, Spain; e-mail: beatriz.molinuevo@uab.cat.

892931CJBXXX10.1177/0093854819892931Criminal Justice and BehaviorMolinuevo et al. / Psychometric Properties of the CAPE 1.1

research-article2019

548 CRIMINAL JUSTICE AND BEHAVIOR

The Clinical Assessment of Prosocial Emotions: Version 1.1 (CAPE 1.1) uses structured clinical judgments to diagnose the

“with limited prosocial emotions” specifier for Conduct Disorder. This study examined (a) the internal consistency and inter-

rater agreement, and (b) the convergent and divergent validity of the CAPE 1.1 in 72 young males who were incarcerated in

two Spanish juvenile detention centers (age range = 14–22 years). The CAPE 1.1 showed good interrater agreement for

making the diagnosis of the specifier and adequate internal consistency. The CAPE 1.1 was associated with other measures

of callous–unemotional traits, but less consistently associated with other dimensions of psychopathy. Youth who met diag-

nostic criteria for the specifier scored higher on externalizing problems, but did not differ from other youth who were incar-

cerated on internalizing problems. These results provide preliminary support for the psychometric properties of the CAPE

1.1 for the clinical assessment of the specifier.

Keywords: Clinical Assessment of Prosocial Emotions (CAPE 1.1); callous–unemotional traits; limited prosocial emotions;

juvenile delinquency

Callous–unemotional (CU) traits define the affective components of psychopathy in

adult samples (Hare & Neumann, 2008) and the affective components of conscience in

child samples (Frick et al., 2014a). Furthermore, there is now substantial evidence to sup-

port the importance of CU traits for designating a clinically important subgroup of antiso-

cial youth (Frick et al., 2005). That is, recent reviews of the available literature have shown

that the presence of elevated CU traits in children and adolescents with serious behavior

problems designates a group that is especially severe, violent, and difficult to treat (Blair

et al., 2014; Frick et al., 2014b; Herpers et al., 2012). These reviews have also indicated that

children and adolescents with elevated CU traits show a number of distinct genetic, biologi-

cal, emotional, cognitive, and social characteristics when compared with antisocial youth

who are not elevated on these traits, suggesting that the causal processes underlying the

behavior problems of these two groups may be different (Frick et al., 2014b).

Based on this research, the most recent edition of the Diagnostic and Statistical Manual

of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013) has

included CU traits as a specifier for the diagnosis of Conduct Disorder (CD) labeled “with

limited prosocial emotions” (LPE). To qualify for the specifier, the person must show two

or more of the following CU symptoms over at least 12 months across multiple relation-

ships and settings: (a) lack of remorse or guilt, (b) callous—lack of empathy, (c) uncon-

cerned about performance, and (d) shallow or deficient affect (APA, 2013). As noted in

DSM-5, for these symptoms to be indicative of the specifier, they must “reflect the indi-

vidual’s typical pattern of emotional and interpersonal functioning and not just occasional

occurrences in some situations” (APA, 2013, p. 47). Furthermore, the World Health

Organization (WHO) added a similar specifier for the diagnoses of both oppositional defi-

ant disorder (ODD) and conduct–dissocial disorder in the latest edition of the International

Classification of Disease (11th edition; ICD-11; WHO, 2018). In addition to the use of the

specifier with the diagnosis of ODD, which is not allowed in DSM-5, ICD-11 criteria also

includes an additional symptom describing “a relative indifference to the probability of

punishment” that is not included in DSM-5 criteria.

The adoption of this specifier in the two major systems for diagnosing severe behavior

problems has led to an increased focus on how to measure these traits in many different clini-

cal and forensic contexts. To date, CU traits have most often been assessed in research using

rating scales completed by the person being evaluated or by significant others, such as a

child’s parents and teachers (Kotler & McMahon, 2005; Sharp & Kine, 2008). One of the