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However, experimental evidence for this distinction is mixed, and it is unclear whether these difficulties are a reliable marker of CD\/HCU compared to CD\/LCU. In a large sample (<jats:italic>N<\/jats:italic>\u2009=\u20091263, 9\u201318\u00a0years), we combined univariate analyses and machine learning classifiers to investigate whether CD\/HCU is associated with disproportionate difficulties with fear and sadness recognition over other emotions, and whether such difficulties are a reliable individual-level marker of CD\/HCU. We observed similar emotion recognition abilities in CD\/HCU and CD\/LCU. The CD\/HCU group underperformed relative to typically developing (TD) youths, but difficulties were not specific to fear or sadness. Classifiers did not distinguish between youths with CD\/HCU versus CD\/LCU (52% accuracy), although youths with CD\/HCU and CD\/LCU were reliably distinguished from TD youths (64% and 60%, respectively). In the subset of classifiers that performed well for youths with CD\/HCU, fear and sadness were the most relevant emotions for distinguishing them from youths with CD\/LCU and TD youths, respectively. We conclude that non-specific emotion recognition difficulties are common in CD\/HCU, but are not reliable individual-level markers of CD\/HCU versus CD\/LCU. These findings highlight that a reduced ability to recognise facial expressions of distress should not be assumed to be a core feature of CD\/HCU.<\/jats:p>","DOI":"10.1007\/s00787-021-01893-5","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T01:15:52Z","timestamp":1634606152000},"page":"589-600","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Machine learning classification of conduct disorder with high versus low levels of callous-unemotional traits based on facial emotion recognition abilities"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7479-0637","authenticated-orcid":false,"given":"Ruth","family":"Pauli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Kohls","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack C.","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Baumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Ackermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anka","family":"Bernhard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Martinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucres","family":"Jansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Oldenhof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Gonzalez-Madruga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areti","family":"Smaragdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel","family":"Gonzalez-Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u00f1aki","family":"Kerexeta-Lizeaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Boonmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Kersten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aitana","family":"Bigorra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaia","family":"Hervas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Stadler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aranzazu","family":"Fernandez-Rivas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Popma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Konrad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Herpertz-Dahlmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Fairchild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Freitag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Rotshtein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane A.","family":"De Brito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"1893_CR1","volume-title":"The mask of sanity","author":"H Cleckley","year":"1976","unstructured":"Cleckley H (1976) The mask of sanity, 5th edn. 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Freitag receives royalties for books on attention-deficit\/hyperactivity disorder and autism spectrum disorder. She has served as consultant to Desitin and Roche. No other authors report any conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The FemNAT-CD project received ethical approval from the relevant local ethics committees, as follows: Aachen: Ethik Kommission Medizinische Fakult\u00e4t der Rheinisch Westf\u00e4lischen Technischen Hochschule Aachen (EK027\/14). Amsterdam: Medisch Etische Toetsingscommissie (2014.188). Athens: Election Committee of the First Department of Psychiatry, Eginition University Hospital (641\/9.11.2015). Barcelona: Child and Adolescent Mental Health\u2014University Hospital Mutua Terrassa (acta 12\/13). Basel: Ethik Kommission Nordwest- und Zentralschweiz (EKNZ 336\/13). Bilbao: Hospital del Basurto. Birmingham and Southampton: University Ethics Committee and National Health Service Research Ethics Committee (NRES Committee West Midlands, Edgbaston; REC reference 3\/WM\/0483). Dublin: SJH\/AMNCH Research Ethics Committee (2014\/04\/Chairman (3)). Frankfurt: Ethik Kommission Medizinische Fakult\u00e4t Goethe Universit\u00e4t Frankfurt am Main (445\/13). Szeged (Hungary): Eg\u00e9szs\u00e9g\u00fcgyi Tudom\u00e1nyos Tan\u00e1cs Hum\u00e1n Reprodukci\u00f3s Bizotts\u00e1g (CSR\/039\/00392\u20133\/2014). This study was conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants over the legal age of consent (16 or 18\u00a0years) in their country provided written informed consent to participate. Participants under the age of consent provided written informed assent, with written informed consent provided by a parent or guardian.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All authors consented to the publication of this paper.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}