Perturbed decision making occurs more broadly than perturbed empathy or threat sensitivity. Decision-making impairments occur in youth who have conduct disorder with or without callous–unemotional traits,44 in youth with ADHD or oppositional–defiant disorder,48–50 and even in unaffected children of parents with conduct problems or drug addiction.51 Thus, impaired decision making may be a substrate for various types of conduct problems that frequently coexist, including DSM diagnoses of conduct disorder, ADHD, oppositional–defiant disorder, and substance-use disorders.
