Oppositional defiant disorder with chronic irritability-anger with limited prosocial emotions

**Definition:** All definitional requirements for oppositional defiant disorder with chronic irritability-anger are met. In addition, the individual exhibits characteristics that are sometimes referred to as ‘callous and unemotional’. These characteristics include a lack of empathy or sensitivity to the feelings of others and a lack of concern for others’ distress; a lack of remorse, shame or guilt over their own behaviour (unless prompted by being apprehended), a relative indifference to the probability of punishment; a lack of concern over poor performance in school or work; and limited expression of emotions, particularly positive or loving feelings toward others, or only doing so in ways that seem shallow, insincere, or instrumental.