Neighborhood resources are associated with neuropsychological outcomes among pediatric brain tumor survivors.

Background: Cancer-related cognitive impairment in survivors of pediatric brain tumors is a public health concern, yet studies seldom explore the role of social determinants of health beyond treatment effects. We investigated the influence of neighborhood resources using the Child Opportunity Index (COI) on neuropsychological functioning in survivors. Methods: Intelligence (IQ) and untimed reading and math proficiency were assessed retrospectively in 190 survivors. Multiple regression analyses explored associations among the COI composite and indices (Education, Health-Environment, Social-Economic) and neuropsychological outcomes, controlling for cumulative neurological risk and treatment exposures (Neurological Predictor Scale; NPS) and parental education. Results: Performance was on average within normal limits: IQ (M = 94.08, SD = 15.85, d=.37) with 13.4% of scores below impairment thresholds; reading (M = 95.08, SD = 17.36, d=.28) and math calculation (M = 91.84, SD = 18.82, d=.43) with 16.92% and 20.63% of scores below impairment thresholds, respectively. Each COI domain predicted reading and IQ after controlling for NPS, parental education, and age at diagnosis; however, the Education domain was the only significant predictor of math outcomes. Conclusion: The COI domains significantly predicted IQ and untimed academic skills in survivors, revealing the critical role of neighborhood resources on cognition above and beyond parental education and treatment factors. This is among the first studies to illuminate the influence of neighborhood resources on cognition in survivors. Future research should examine neighborhood context, an understudied construct, with importance in the move toward precision medicine.

The Role of Neighborhood Socioeconomic Status in Institutionalization of Home Health Care Patients With and Without Alzheimer's Disease and Related Dementias.

OBJECTIVES: To assess whether neighborhood socioeconomic status (SES) moderates the association between Alzheimer's disease and related dementias (ADRD) and successful discharge to the community. In addition, to explore whether the role of neighborhood SES on successful discharge for patients with ADRD varies by the severity of ADRD. DESIGN: This is a retrospective cohort study. SETTING AND PARTICIPANTS: Medicare Fee-for-service beneficiaries, aged 65 or older, who received home health care in 2019. METHODS: We used linear probability regression models with successful discharge to the community as the main outcome, and neighborhood SES and ADRD as independent variables. Also, we modified the Functional Assessment Staging Tool (FAST) to measure ADRD severity. RESULTS: Our study results show ADRD and residing in neighborhoods with lower socioeconomic conditions were independently associated with lower probabilities of successful discharge to the community. We also found that the differences in probabilities of remaining at home between patients with and without ADRD were larger among those in neighborhoods with lower SES (ADRD∗less disadvantaged neighborhood, coeff: -0.01, P < .001; ADRD∗more disadvantaged neighborhood, coeff: -0.02, P < .001; ADRD∗most disadvantaged neighborhood, coeff: 0.032, P < .001). Among patients with ADRD, patients with the most advanced ADRD were less likely to remain in their homes and community when living in neighborhoods with lower SES. CONCLUSIONS AND IMPLICATIONS: Our study results show that when patients with ADRD receiving home health care live in neighborhoods with lower SES, they face further challenges to remaining in their homes and community. Public health officials and community planners should consider using area-level interventions to improve care and health outcomes for patients with ADRD. Also, further research aimed at identifying the specific factors and resources influencing lower care quality and poorer health outcomes in socioeconomically disadvantaged neighborhoods, particularly for patients with ADRD, can provide valuable insights for the development and implementation of targeted interventions.

Cultural Differences in Rumination and Psychological Correlates: The Role of Attribution.

Cross-cultural research suggests that rumination may have weaker maladaptive effects in Eastern than in Western cultural contexts. This study examines a mechanism underlying cultural differences in mental health correlates of rumination from sociocultural cognitive perspective. We propose that cultures differ in how people attribute rumination, which can lead to cultural differences in the link between rumination and mental health correlates. We developed the Attribution of Rumination scale, tested cultural differences (Study 1), and examined its relationship with theoretically related constructs (Study 2). In Study 3, self-doubt attribution moderated the association between rumination and mental health, partly explaining cultural differences in the rumination-mental health link. Study 4 replicated self-doubt attribution moderating the link between rumination and mental health among Asians. Furthermore, greater exposure to American culture was associated with self-doubt attribution. This work provides a novel approach to understanding cultural differences in the association between rumination and negative psychological correlates.

The moderating role of neighborhood disadvantage on the link between functional limitations and self-rated health.

BACKGROUND: Self-rated health is an important health outcome and determinant of health. Improvements to our understanding on self-rated health could help design plans and strategies to improve self-rated health and achieve other preferred health outcomes. This study examined whether the link between functional limitations and self-rated health varies by neighborhood socioeconomic status. METHODS: This study used the Midlife in the United States study linked with the Social Deprivation Index developed by the Robert Graham Center. Our sample consist of noninstitutionalized middle to older adults in the United States (n = 6,085). Based on stepwise multiple regression models, we computed adjusted odds ratios to examine the relationships between neighborhood socioeconomic status, functional limitations, and self-rated health. RESULTS: Respondents in the socioeconomically disadvantaged neighborhoods were older, had higher percentage of females, non-White respondents, lower educational attainment, lower perceived neighborhood quality, and worse health status with greater number of functional limitations than those in socioeconomically advantaged neighborhoods. Results showed a significant interaction was found where neighborhood-level discrepancies in self-rated health was biggest among individuals with highest number of functional limitations (B = -0.28, 95% CI[0.53, -0.04], p = 0.025). Specifically, individuals with the highest number of functional limitations from the disadvantaged neighborhoods had higher self-rated health compared to those from advantaged neighborhoods. CONCLUSIONS: Our study findings highlight that neighborhood discrepancy in self-rated health is underestimated particularly among those with severe functional limitations. Moreover, when interpreting self-rated health status, values should not be taken face value, and should be considered together with the environmental conditions of where one resides.

Role of the valuation of nervousness in cortisol responses to psychosocial stress task and task performance in European American and East Asian students.

How people perceive and value negative affective states is associated with physiological responses to stressful events and moderates the association between negative feelings and physiological and behavioral outcomes. However, previous studies on valuation of negative affective states have been conducted mostly in Western cultures. Different cultural backgrounds shape how people view negative emotions as well as how people attend to internal emotional states, which may change the effects of valuing negative emotions. The present study thus examined whether valuation of nervousness was associated with the magnitude and duration of cortisol responses to a standardized laboratory stressor and task performance in East Asian and European American students. Two hundred undergraduate students were recruited through a large pool of students taking psychology courses. They engaged in demanding speech and arithmetic tasks as part of the Trier Social Stress Test (TSST). European American participants who had a higher valuation of nervousness showed lower cortisol reactivity. Valuing nervousness was associated with better speech performance in students from both cultural backgrounds, and the strength of this association was moderated by cortisol level. Our findings call attention to the importance of considering whether negative emotions are viewed as beneficial or an impediment, as well as the cultural context when responding to demanding and threatening situations.

Emotion regulation strategies and psychological health across cultures.

Emotion regulation is important for psychological health and can be achieved by implementing various strategies. How one regulates emotions is critical for maximizing psychological health. Few studies, however, tested the psychological correlates of different emotion regulation strategies across multiple cultures. In a preregistered cross-cultural study (N = 3,960, 19 countries), conducted during the COVID-19 pandemic, we assessed associations between the use of seven emotion regulation strategies (situation selection, distraction, rumination, cognitive reappraisal, acceptance, expressive suppression, and emotional support seeking) and four indices of psychological health (life satisfaction, depressive symptoms, perceived stress, and loneliness). Model comparisons based on Bayesian information criteria provided support for cultural differences in 36% of associations, with very strong support for differences in 18% of associations. Strategies that were linked to worse psychological health in individualist countries (e.g., rumination, expressive suppression) were unrelated or linked to better psychological health in collectivist countries. Cultural differences in associations with psychological health were most prominent for expressive suppression and rumination and also found for distraction and acceptance. In addition, we found evidence for cultural similarities in 46% of associations between strategies and psychological health, but none of this evidence was very strong. Cultural similarities were most prominent in associations of psychological health with emotional support seeking. These findings highlight the importance of considering the cultural context to understand how individuals from diverse backgrounds manage unpleasant emotions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Cultural Perspective on Functional Limitations and Well-Being.

Functional limitations-difficulty in carrying out activities of daily living-have been linked to poorer well-being in Western cultures. This might be partly due to the lower personal control associated with functional limitations. However, compared with the West, in Asian cultural contexts (e.g., Japan) where agency and control are based less predominantly on individual attributes, the link between functional limitations and well-being may be weaker. Using cross-sectional probability samples from the United States and Japan (Study 1), functional limitations were associated with lower well-being in both cultures, though the association was weaker in Japan than in the United States and personal control played a mediating role. Furthermore, analyses of longitudinal data (Study 2) showed the cross-cultural patterns generally consistent with the cross-sectional analyses of Study 1, though the cultural moderation was found for fewer well-being measures. Such findings enrich our understanding of how health status and well-being are related across cultures.