Validation of the Clinical Assessment of Prosocial Emotions (CAPE) and Subtype Differentiation of Callous–Unemotional Traits in Children and Adolescents: A Study Protocol

Callous–unemotional (CU) traits are associated with specific cognitive and emotional deficits, which help explain their severe aggressive behavior. In the ICD-11/DSM-5, CU traits have been added to the diagnostic criteria for disruptive behavior disorder (DBD) as the “limited prosocial emotions” (LPE) specifier. The semi-structured Clinical Assessment of Prosocial Emotions (CAPE) interview is a new method to identify LPE. This study protocol describes the German translation of the semi-structured CAPE and the planned evaluation of its construct validity in a clinical sample of children diagnosed with DBD in Germany. Given that individuals with elevated CU traits can be categorized into primary (less anxiety, with less experience of abuse) and secondary (high anxiety, with more experience of abuse) variants, this study protocol will outline the planned exploratory analysis of these variants in a German clinical sample. The research questions will be examined in a multicenter, cross-sectional, clinical observational study using a case–control design. The study will include children and adolescents aged 8–18 and their primary caregivers. Multivariable general linear models will be used to assess the construct validity of CAPE and to explore differences between CU trait variants. Validating a German version of CAPE could provide clinicians and researchers with a standardized tool to assess LPE, enabling treatment tailored to CU trait variants. Trial Registration: German Clinical Trials Register, DRKS00035428, registered on 5 November 2024. Ethical approval was obtained from the Friedrich-Alexander Universität Erlangen-Nürnberg (reference number: 24-112-S) on 28 May 2024. Trial status: Recruiting ongoing.