Finally, revisions of diagnostic criteria should consider the differing contexts within and outside the US that may influence the age of onset of these disorders, the expression of CU traits, and the meaning that symptoms might have across culture, ethnicity, and developmental stage. Recognizing the importance of dimensional approaches [44, 47] is also necessary. Criteria that include specific thresholds for what is considered pathological or impairing are more likely to differ across culture, but the recognition of common symptoms across cultures is more easily achieved.
