of conduct disorder prior to age 10 years. 
312.89 (F91.9) Unspecified onset:  Criteria for a diagnosis of conduct disorder are
met, but there is not enough information available to determine whether the onset of
the first symptom was before or after age 10 years. 
Specify if:
With limited prosocial emotions:  To qualify for this specifier, an individual must have dis-
played at least two of the following characteristics persistently over at least 12 months and
in multiple relationships and settings. These characteristics reflect the individual’s typical
pattern of interpersonal and emotional functioning over this period and not just occasional
occurrences in some situations. Thus, to assess the criteria for the specifier, multiple infor-
mation sources are necessary. In addition to the individual’s self-report, it is necessary to
consider reports by others who have know n the individual for extended periods of time
(e.g., parents, teachers, co-workers, extended family members, peers).
Lack of remorse or guilt:  Does not feel bad or guilty when he or she does some-
thing wrong (exclude remorse when expre ssed only when caught and/or facing
punishment). The individual shows a general  lack of concern about the negative
consequences of his or her actions. For ex ample, the individual is not remorseful
after hurting someone or does not care about the consequences of breaking rules.
Callous—lack of empathy:  Disregards and is unconcerned about the feelings of
others. The individual is described as cold and uncaring. The person appears more
concerned about the effects of his or her actions on himself or herself, rather than
their effects on others, even when they result in substantial harm to others.