The Clinical Assessment of Prosocial Emotions (CAPE): Initial Tests of Reliability and Validity in a Clinic-Referred Sample of Children and Adolescents

Recent changes to diagnostic criteria for serious conduct problems in children and adolescents have included the presence of elevated callous-unemotional traits to define etiologically and clinically important subgroups of youth with a conduct problem diagnosis. The Clinical Assessment of Prosocial Emotions (CAPE) is an intensive assessment of the symptoms of this limited prosocial emotions specifier that uses a structured professional judgment method of scoring, which may make it useful in clinical settings when diagnoses may require more information than that provided by behavior rating scales. The present study adds to the limited tests of the CAPE's reliability and validity, using a sample of clinic-referred children ages 6-17 years of age, who were all administered the CAPE by trained clinicians. The mean age of the sample was 10.13 years (SD = 2.64); 54% of the sample identified as male and 46% identified as female; and 67% of participants identified as White, 29% identified as Black, and 52% identified as another race/ethnicity (i.e., Asian, Hispanic/Latinx, or other). The findings indicated that CAPE scores demonstrated strong interrater reliability. The scores also were associated with measures of conduct problems and aggression, even when controlling for behavior ratings of callous-unemotional traits. Further, when children with conduct problem diagnoses were divided into groups based on the presence of the limited prosocial emotions specifier from the CAPE, the subgroup with the specifier showed more severe conduct problems and aggression. The results support cautious clinical use of the CAPE, its further development and testing, and research into ways to make its use feasible in many clinical settings.