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

Abstract

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.

The Influence of Antisocial Behavior and Callous-Unemotional Traits on Trajectories of School Engagement and Achievement in South-Korean Children

“…Thus, these factors should be taken into account when considering the generalizability of findings. Recent evidence in support of cultural influences suggests that the manifestation (Allen et al, 2021) and correlates (Hwang et al, 2020) of callous-unemotional traits in children from East Asian countries may differ from those in Western countries (see Sng et al, 2020). In addition, the educational system of Korea is based on Confucianism, which encourages students to feel a strong sense of obligation to pursue scholastic achievement.…”

To what extent does punishment insensitivity explain the relationship between callous‐unemotional traits and academic performance in secondary school students?

“…Current findings need to be replicated in the primary school setting, given that the secondary school period features increased academic demands and higher expectations for student behaviour and independence in combination with less intensive support from teacherspotentially altering the nature and strength of relationships between CU traits, punishment insensitivity, and academic performance. Finally, given evidence for differences in the presentation and correlates of CU traits in East Asian and Western nations (Allen, Shou, Wang, & Bird, 2020;Sng et al, 2018;Sng, Hawes, Hwang, Allen, & Fung, 2020), and differences in teacher classroom management practices and means of assessing student academic achievement (Lewis, Romi, Qui, & Katz, 2005;Romi, Lewis, & Roache, 2013), there may be cultural variation in the relationships between CU traits, punishment insensitivity, and school grades. Future research should strive to investigate cultural differences in the interplay between CU traits and teacher-child interaction.…”

Longitudinal Associations between Callous-unemotional (CU) Traits and School-based Affiliative Relationships among South Korean Children

“…Peers may also play a less significant role in East Asian cultures, as studies of East Asian children have not found a significant association between CU traits and deviant peer affiliation (Ang et al, 2015;Chu et al, 2014), whereas there is consistent support for this link in Western samples (Backman et al, 2018). More research is needed to compare Western and Asian countries to provide a better understanding of the implications of cultural differences regarding CU traits and social affiliation (Sng et al, 2020).…”