Callous-Unemotional Traits among Children and Adolescents in Asian Cultures: A Systematic Review

Considerable evidence now exists for callous and unemotional (CU) traits as markers for a high-risk pathway to child and adolescent conduct problems implicating unique risk processes and treatment needs, but research has been limited largely to Western countries. We review the evidence base related to CU traits in Asian countries that has emerged in recent years, with respect to four key questions. Specifically, are higher CU traits among Asian children and adolescents associated with (1) increased severity of conduct problems; (2) similar neurodevelopmental and neurocognitive correlates as reported in Western countries; (3) similar environmental risk factors as reported in Western countries; and (4) poorer treatment outcomes? A systematic search identified 28 studies that have reported on child and adolescent CU traits in Asian countries. Consistent with Western samples, CU traits were associated with individual risk factors including atypical neural activation during cognitive tasks and poor empathy, as well as parenting risk factors. CU traits were also positively associated with most measures of conduct problems. Differences from findings in Western samples, however, emerged for areas such as correlates of reactive aggression and delinquent peer influence. Treatment has been investigated in only one study to date and is therefore a high priority for future research. The limitations of existing evidence are addressed along with key directions for future cross-cultural research, including measurement research with children and adolescents.