Relational burden, depression, and loneliness among American older adults: an inquiry into the 'dark side of social capital'.

OBJECTIVES: Social networks and resources embedded in them are shown to promote mental health. This study examines whether there may be deleterious consequences of interpersonal ties and social capital on loneliness and depression in later life. METHOD: Using data from the latest wave of National Social Life, Health and Aging Project (NSHAP) 2015-2016, we examine how relational burden is associated with mental health outcomes among older American adults. We also assess whether relational burden measured at the contextual, or regional, level may moderate the link between collective efficacy (neighborhood cohesion) and depression/loneliness. RESULTS: Individual-level relational burden stemming from both kin and non-kin members is associated with higher levels of depression and loneliness. Moreover, regional-level kin and non-kin types of relational burden significantly amplify the negative relationship between collective efficacy and depression. For loneliness, however, we do not find such cross-level interaction. CONCLUSION: Unlike prior research using conventional measures of social capital (e.g. trust, frequency of social interaction, and organizational participation) to evaluate its potential downside, our study contributes to the literature by directly operationalizing the concept of 'relational burden', stress due to excessive demands from others, at individual and contextual levels of analysis.

Social distancing attitudes, national context, and health outcomes during the COVID-19 pandemic: Findings from a global survey.

This study analyzes global health consequences of the new coronavirus disease by focusing on the roles of normative beliefs on social distancing and country-level factors, i.e., mobility estimate and globalization index. We fitted mixed effects models to examine the associations between two outcome measures, depression and self-rated health, and their multilevel determinants using a subset of Global Behaviors and Perceptions in the COVID-19 Pandemic, an online survey consisting of more than 100,000 participants from 67 nations. Results show that both personal beliefs and general beliefs significantly predict depression and poor health. There is also a contextual effect of globalization on depression. In addition, the relationship between general beliefs and depression is stronger in countries with lower rates of mobility. With respect to poor health, the effect of general beliefs similarly varies inversely with the level of globalization. Our study indicates that one's own beliefs and the perception of others' regarding social distancing, along with contextual factors (measures of mobility and globalization), critically shape mental and physical health. Subjective and objective factors should be considered, in other words, in properly understanding the differential impact of COVID-19 across the world.

Examining the multilevel associations between psychological wellbeing and social trust: A primary analysis of survey data.

The present study examines the associations between multiple measures of social trust and two outcomes of psychological wellbeing (happiness and depression) among South Korean adults (n = 1549) living in residential communities, that is, administrative districts (n = 77) in and around the capital city of Seoul. Based on multilevel modeling, we find that familial trust positively predicts happiness at both individual and contextual levels; and it negatively predicts depression at the individual level only. In comparison, peer trust is negatively related only to depression at the individual level, albeit marginally. Lastly, general trust significantly predicts both outcomes at the community, but not individual, level. These mixed findings suggest that the trust-wellbeing relationship depends critically on issues of definition (how the variables are conceptualized) and measurement (how they are operationalized according to different units of analysis). Our study offers implications for the literature on social determinants of mental health broadly and, more specifically, on the role of social trust.

COVID-19 restrictions and mental distress among American adults: evidence from Corona Impact Survey (W1 and W2).

BACKGROUND: The present study examines the impact of coronavirus-related restrictions on mental health among American adults, and how this relationship varies as a function of time and two measures of vulnerability (preexisting physical symptoms and job insecurity). METHODS: We draw on data from two waves of Corona Impact Survey, which were fielded in late April and early of May 2020. Multilevel models were used to analyze the hierarchically nested data. RESULTS: Experiencing coronavirus disease-2019 restrictions significantly raise mental distress. This association is stronger for individuals with preexisting health conditions and those who worry about job prospects. These findings hold with the inclusion of region-wave covariates (number of deaths, wave dummy and aggregate measure of restrictions). Finally, there is a cross-level interaction: the restriction-distress connection is more pronounced in the second wave of data. CONCLUSIONS: Our research indicates that people who are more physically and/or financially vulnerable suffer more from the imposed restrictions, i.e. 'social isolation'. The mental health impact of coronavirus pandemic is not constant but conditional on the level of vulnerability.

Examining the Effects of Parental Influence on Adolescent Smoking Behaviors: A Multilevel Analysis of the Global School-Based Student Health Survey (2003-2011).

INTRODUCTION: Based on a large cross-national dataset, we investigated the role of parental smoking (a risk factor) and parental supervision (a protective factor) on the frequency of smoking by youths in resource-poor countries. In addition, we tested for cross-level interactions between these two predictors and national wealth on the outcome variable. METHODS: Pooled cross-sectional data from the Global School-based Student Health Survey (2003-2011) were analyzed, which consists of 58956 students in 31 countries. Hierarchical linear models were estimated to examine the associations between the two parental influence variables and adolescent smoking. RESULTS: Among the control variables, age, gender (male), the experience of being bullied, frequency of getting into physical fights, truancy, and anxiety were significantly related to higher frequency of smoking. With respect to the main predictors, both at the individual level, parental supervision was negatively associated with adolescent smoking, while parental smoking was positively related to it. Two cross-level interaction terms were also observed. National wealth (GDP per capita) significantly moderated, that is, increased, these effects of parental influence on how often the adolescents smoked. CONCLUSIONS: We provided new evidence on the factors related to adolescent smoking in low-income countries, a topic that has received very little attention. We showed that the associations between parental influences and adolescent smoking behaviors are not constant but vary according to the level of economic development. Future research should incorporate this comparative dimension in elaborating and specifying the conditions under which parental influences and other predictors differentially affect adolescent smoking. IMPLICATIONS: Prior research on adolescent smoking focused on developed countries. Based on the secondary analysis of the Global School-based Student Health Survey (2003-2011), this study examines the associations between parental influence (parental smoking and parental supervision) on the frequency of youth smoking behaviors in resource-poor countries. We show that parental smoking is positively related to adolescent smoking, while parental supervision is negatively related to it. We also find that these two associations vary according to national wealth: both effects are stronger in a country with higher per capita GDP.

Does Misery Love Company? Multilevel Relationships between Perceived Age Discrimination and Happiness among Older Europeans.

The present study examines how contextual age discrimination moderates the individual-level association between perceived age discrimination and happiness among older Europeans. In this endeavor, we test two opposing views: 1) the "social norm" hypothesis that predicts the association between perceived age discrimination and happiness to become weaker in areas with a higher average level of age discrimination; and 2) conversely the "contagion effect" hypothesis that predicts the association to grow stronger in such areas. Using data from the European Social Survey (2008), we estimate two- and three-level mixed effects models to test these opposing hypotheses. Our findings from multilevel analysis lend support to the social norm hypothesis. Specifically, the negative link between perceived age discrimination and happiness is weaker in subnational regions where the proportion of victims of age discrimination is higher.

Ready to Rumble? Popularity, Status Ambiguity, and Interpersonal Violence Among School-Based Children.

Previous literature has recognized the importance of social relationship in understanding people's engagement in aggressive behavior. Yet, largely due to data limitations, only few studies have empirically explored how social status precisely influences interpersonal violence. In this research, we investigate the determinants of peer-to-peer violence by focusing on individual's positions in the status hierarchy within adolescent peer networks. More specifically, our study examines and demonstrates the extent to which the likelihood of interpersonal violence rises, first, as a function of one's status (popularity) and, second, due to ambiguity between status positions of the parties involved in a physical altercation. Using a unique dataset collected on school-based children in Laos (Lao People's Democratic Republic) in 2016 (N = 1,332), we employ exponential random graph models to show the influence of status on the odds of involvement in on-campus violence. Results indicate that higher status, that is, more popular, students are more likely to be involved in a physical fight compared to their lower status counterparts. Moreover, we find a significant degree of similarity in status among students who engage in a fight. In other words, status ambiguity surrounding dyads in the peer network increases the likelihood of bringing them into a conflict situation. Our findings provide implications for understanding how social status shapes the dynamics of negative networks. By analyzing sociocentric network data, the present study extends and moves beyond prior findings mainly based on individual-level (non-dyadic) data.

Political Trust, Mental Health, and the Coronavirus Pandemic: A Cross-National Study.

Objectives: We investigate whether older adults who place greater trust in their political leadership fare better in terms of mental wellbeing during the COVID-19 pandemic. We also test if and how the trust-wellbeing relationship varies across individual- and country-level moderators. Methods: Based on cross-national data consisting of over 13,000 older adults in 66 countries, we estimate a series of multilevel models. Results: Within countries, political trust is significantly negatively associated with depressive symptoms. And this association is stronger for those who are subjectively less healthy. Between countries, the trust-depression link at the individual level is stronger in more "fragile" states. These findings are robust to a host of confounders including the experienced level of anxiety stemming from COVID-19. Discussion: During the novel coronavirus pandemic, political trust provides a significant mental health buffer for older adults. This protective role varies partly as a function of individual and contextual vulnerability.

Examining the Complex (Curvilinear and Contingent) Associations between Social Distancing Compliance and Subjective Health during a Global Health Crisis.

OBJECTIVES: This study investigated a potential curvilinear link between social distancing behavior and subjective health in later life. It also evaluated whether food insecurity and community social capital moderated the focal relationship. METHODS: Data were drawn from three waves of the COVID Impact Survey (N = 19,234). Mixed-effects models were fitted. RESULTS: Social distancing has a non-monotonic (U-shaped) relationship with subjective health, i.e., individuals with low and high levels of social distancing show relatively better health. Moreover, the negative linear relationship between social distancing and health is weaker among people suffering from food insecurity as well as those living in communities with lower stocks of social capital. DISCUSSION: This study sheds new light on the health implications of social distancing during the pandemic. Our findings dovetail with the steeling hypothesis, i.e., that social distancing is less harmful for U.S. older adults exposed to prior stressful or vulnerable conditions.

Social Isolation and Psychological Distress During the COVID-19 Pandemic: A Cross-National Analysis.

BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic resulted in social isolation globally, creating heightened levels of stress and anxiety. This study investigates the link between social isolation and mental well-being in later life, and how it varies across countries. RESEARCH DESIGN AND METHODS: We draw on a subset of older adults from Global Behaviors and Perceptions in the COVID-19 Pandemic, a unique global online survey of 13,660 participants from 62 countries. We use mixed-effects models to analyze the data. RESULTS: Social isolation (distancing) significantly predicts poor mental health operationalized as coronavirus-induced distress (p < .01). At the aggregate level, average distress varies positively across countries with higher numbers of coronavirus-related deaths (p < .10) and more fragile state capacity (p < .05), while varying negatively across those with more stringent anticoronavirus policies (p < .05). Finally, we report several cross-level interactions between social isolation and the total number of deaths (p = .025), policy stringency (p = .065), state fragility (p = .061), and globalization index (p = .071). DISCUSSION AND IMPLICATIONS: Our study shows that a proper understanding of the impact of COVID-19 on the mental well-being of older adults should consider the moderating role of national context.

Ageism, Religiosity, and Wellbeing Among Older Adults: Evidence From the European Social Survey (ESS4).

Research shows that ageism (systemic discrimination against people because of their age) significantly undermines physical and psychological wellbeing, particularly among older adults. Our aim is to contribute to the literature by investigating whether this negative association varies across national religious context. We estimate multilevel models by drawing on a subset of data (ages 55 and above) from the fourth round of the European Social Survey (2008/2009). We find that ageism is negatively related to measures of wellbeing (happiness, life satisfaction, self-rated health). More importantly, the relationship is less pronounced in countries with higher levels of religiosity. These findings suggest that the country's religious environment serves as a buffer against deleterious health consequences of ageism for the older population. Our study thus provides additional evidence on ageism as a critical risk factor and sheds novel light on the moderating role of country-level religiosity as a protective factor.

Individual and community social capital, mobility restrictions, and psychological distress during the COVID-19 pandemic: a multilevel analysis of a representative US survey.

This paper explores the role of social capital in mitigating the mental health harms of social/mobility restrictions instigated in the wake of the COVID-19 pandemic. We test whether: (a) social capital continued to predict lower mental distress during the pandemic; and (b) whether social capital buffered (moderated) the harm of social/mobility restrictions on psychological distress. In addition, we test the level at which social capital mitigation effects operated, i.e., at the individual- and/or contextual-level. To do so, we apply multilevel models to three waves of the COVID-19 Household Impact Survey consisting of probability samples of U.S. adults (with the average interview completion rate of 93%). In a novel approach, we explore two modes of capturing contextual social capital: aggregated individual-level survey responses and independently measured social capital indices (SCIs). Findings show that at the individual level social capital was associated with lower psychological distress. It also buffered the harm of restrictions: increasing restrictions had a weaker effect on distress among individuals interacting with neighbors more frequently. Importantly, mitigating processes of contextual social capital appeared conditional on how it was measured. Using aggregated survey responses, contextual social capital had no direct effect on distress but exerted an additional buffering role: individuals in counties with higher average neighbor-interaction experienced a weaker impact of restrictions. Using the independent SCI measures, we found county social capital reduced distress. However, its negative effect on distress becomes increasingly weaker the more restrictions an individual reported: where individuals reported lower restrictions, higher county SCI reduced distress; however, where individuals reported higher restrictions, higher county SCI had no effect on distress. More restrictive environments thus cut individuals off from the benefits of higher county social capital as measured using the SCI.

Income inequality, emotional anxiety, and self-rated health in times of the coronavirus pandemic: Evidence from a cross-national survey.

Using a unique cross-national dataset, we explore the interplay between household income, coronavirus-induced anxiety, national context, and self-rated health (SRH) across dozens of countries among more than 13,500 older adults. Based on multilevel models, we find that the emotional anxiety due to COVID-19 negatively predicts SRH, net of country random effects. And holding constant coronavirus-related stress and background controls at both individual and contextual (country) levels, higher income is positively associated with better subjective health. We also report cross-level interactions. The income-health gradient is stronger in countries with higher numbers of coronavirus-related deaths and, to lesser extent, infected cases. That is, health benefits of higher income are more pronounced in countries hit harder by the pandemic. Our study shows that globally income inequality exacerbates the unequal health consequences of COVID-19 for older segments of the population especially vulnerable to the disease.

Bullying Victimization, School Environment, and Suicide Ideation and Plan: Focusing on Youth in Low- and Middle-Income Countries.

PURPOSE: This study examines the relationship between bullying victimization, measured at individual and school levels, and suicide intent and plan among youth living in less developed parts of the world. METHODS: Multilevel modeling is used to estimate the degree to which school-level bullying has an independent effect on the two suicide measures and how it moderates the impact of individual-level victimization on contemplating and planning suicide. Data are drawn from the Global School-Based Student Health (2000-2012) survey that consists of probability samples of adolescents in low- and middle-income countries. RESULTS: By fitting three-level mixed effects models, we find that adjusting for personal experience of victimization, greater school-level prevalence of bullying has a positive independent relationship with suicide plan, but not ideation. Significant cross-level interaction effects are shown, that is, the bullying-suicide linkage at the individual level is moderated by the school environment. For suicide ideation only, it is weaker in schools where more students are bullied. The association is also less pronounced in the context characterized by higher proportion of physical violence among students and peer hostility on campus. CONCLUSIONS: The bulk of prior research narrowly defines the relationship between bullying and suicide at the individual (e.g., student) level. This study shows that school context (e.g., proportion of bullied peers) must be incorporated into the analysis in better understanding the conditions under which youth think about and/or plan on inflicting lethal self-harm.

Exploring the Association between Suicidality and Smoking Behavior among School-Based Children in Lao People's Democratic Republic (PDR).

This study examines the relationship between suicidality and smoking behavior. Specifically, it examines how and the degree to which suicide ideation and plan are associated with the probability of being a regular smoker among school-based children. Data come from Lao Student Health Survey (2017), a project funded by the National Research Foundation of Korea. Using primary hierarchically nested data (students clustered in classrooms across schools), we investigate the complex interplay between suicidality and smoking behavior in Lao PDR, a low-income country located in Southeast Asia. Results from fitting two-level random intercept models show that net of controls (e.g., gender, age, parental regulation, self-rated health, household SES), the likelihood of daily smoking is higher among students who have seriously considered committing suicide or have planned a suicide attempt. Controlling for individual-level factors, significant classroom-level contextual effects are also found with respect to peer relations. Finally, we observe a cross-level interaction: the positive association between suicide intent and odds of smoking is weaker in classrooms with better peer relations.

Impact of an Educational Program on Behavioral Changes toward Environmental Health among Laotian Students.

This study evaluates the effect of an integrated health care educational program on several behavioral changes related to environmental health among Laotian students. Students in the experimental group received education concerning environmental health-related issues, including air pollution and chemical exposure. Analyses of covariance (ANCOVA) and paired t-tests were conducted for the statistical analysis of the pre- and post-survey scores. The post-test scores of the experimental group regarding their risk perception and information-seeking behaviors towards air pollution and chemical exposure were higher than those of the control group after controlling for the pre-test scores. Moreover, in the experimental group, the girls' risk perception scores significantly increased after receiving the education, which was not observed in the control group. The risk perception score among non-drinking students also significantly increased after the program. These results indicate that the education program effectively enhanced the students' risk perception, especially that of girls and nondelinquent students.

Parental overprotection and youth suicide behavior in low- and middle-income countries: a multilevel analysis of cross-national data.

OBJECTIVES: Research on youth suicide behavior has emphasized parent-child relations as a critical protective factor. This study investigates whether "too much" regulation of children, i.e., overprotection, may actually increase the likelihoods of youth suicide intent and plan. METHODS: Data are drawn from the subset of the Global School-based Student Health Survey (2000-2012), consisting of children living in 48 low- and middle-income countries. Two-level hierarchical linear models are fitted to examine the potential curvilinear (U-shaped) association between parental monitoring and suicide behavior among youth. RESULTS: Adjusting for individual- and country-level covariates, significant support is found for non-monotonicity specifically among boys: Greater parental involvement in male children's lives lowers both suicide ideation and suicide plan to some extent but, after certain thresholds, increases the odds of both outcomes. Results for girls, however, are much less pronounced. CONCLUSIONS: In resource-poor countries marked by some of the highest teenage suicide rates in the world, overprotective parenting style is found to have negative and gendered consequences on the mental health of youth. More research is needed to confirm its replicability in economically more developed societies.

Investigating the Associations between Ethnic Networks, Community Social Capital, and Physical Health among Marriage Migrants in Korea.

This study examines factors associated with the physical health of Korea's growing immigrant population. Specifically, it focuses on the associations between ethnic networks, community social capital, and self-rated health (SRH) among female marriage migrants. For empirical testing, secondary analysis of a large nationally representative sample (NSMF 2009) is conducted. Given the clustered data structure (individuals nested in communities), a series of two-level random intercepts and slopes models are fitted to probe the relationships between SRH and interpersonal (bonding and bridging) networks among foreign-born wives in Korea. In addition to direct effects, cross-level interaction effects are investigated using hierarchical linear modeling. While adjusting for confounders, bridging (inter-ethnic) networks are significantly linked with better health. Bonding (co-ethnic) networks, to the contrary, are negatively associated with immigrant health. Net of individual-level covariates, living in a commuijnity with more aggregate bridging social capital is positively linked with health. Community-level bonding social capital, however, is not a significant predictor. Lastly, two cross-level interaction terms are found. First, the positive relationship between bridging network and health is stronger in residential contexts with more aggregate bridging social capital. Second, it is weaker in communities with more aggregate bonding social capital.

Is the relationship between parental abuse and mobile phone dependency (MPD) contingent across neighborhood characteristics? A multilevel analysis of Korean Children and Youth Panel Survey.

Research indicates that mobile phone dependency (MPD) is associated with various behavioral and internalizing problems. While a significant amount of findings points to its negative outcomes, there is a dearth of evidence concerning the determinants of MPD. This study focuses on this critical, yet understudied, subject by analyzing the associations between abusive parenting style, neighborhood characteristics, and MPD among youths in South Korea, a country with one of the highest mobile broadband penetration rates in the world. Based on the secondary analysis of two waves of Korean Children and Youth Panel Survey (KCYPS), a government-funded multiyear study, we investigate individual- and contextual-level factors underlying MPD. Findings show that, net of a host of time-lagged controls (including baseline dependency from the previous year), abusive parenting style significantly increases adolescent MPD. After adjusting for individual level characteristics, however, no contextual-level effect is found, i.e., residing in a neighborhood with a relatively higher proportion of parental abuse is not related to greater MPD. Finally, two cross-level interaction effects are observed. First, the association between parental abuse and MPD is weaker in a neighborhood context with better educated inhabitants (more college graduates). Second, it is reinforced in demographically "aged" communities with more elderly residents.

How Does Neighborhood Quality Moderate the Association Between Online Video Game Play and Depression? A Population-Level Analysis of Korean Students.

The main objective of our study is to assess the relationship between playing online video games and mental wellbeing of adolescents based on a nationally representative sample. Data come from the Korean Children and Youth Panel Survey (KCYPS), a government-funded multiyear research project. Through a secondary analysis of W2 and W3 of data collected in 2011 and 2012, we examine the extent to which time spent playing online games is related to depression, as measured by a battery of items modeled after the abridged version of Center for Epidemiologic Studies Depression Scale Revised (CESD-R). For proper temporal ordering, the outcome variable is drawn from the latter wave (W3), whereas all time-lagged covariates are taken from the earlier wave (W2). Multilevel regression models show that more game playing is associated with greater depression. Findings also indicate that, net of individual-level variables (e.g., gender, health, family background), living in a community with more divorced families adds to adolescent depression. Finally, a cross-level interaction is observed: the positive association between game playing and depression is more pronounced in an area characterized by a lower aggregate divorce rate.