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Neighborhood disadvantage is associated with stable deficits in neurocognitive functioning in traumatically-injured adults. Health Place 2021 01;67:102493

Date

12/16/2020

Pubmed ID

33321457

Pubmed Central ID

PMC7854519

DOI

10.1016/j.healthplace.2020.102493

Scopus ID

2-s2.0-85097747335   2 Citations

Abstract

BACKGROUND: In trauma-exposed adults, the relationship between an individual's socioeconomic position (SEP) and post-traumatic stress disorder (PTSD) has been well demonstrated. One potential mechanism by which the stress associated with lower SEPs may impact trauma outcomes is through changes in neurocognition. In both healthy and clinical samples, area-level factors also appear to be independently related to neurocognition. Far less is known about how neighborhood socioeconomic disadvantage, may impact cognition in traumatically-injured adults. The current study employed hierarchical linear modeling to longitudinally investigate whether neighborhood disadvantage was associated with neurocognitive functioning in five domains: processing speed, sustained attention, controlled attention, cognitive flexibility, and response inhibition.

METHODS: One-hundred and ninety-five socioeconomically diverse traumatically-injured subjects (mean age = 32.8, 52.8% female) were recruited from an Emergency Department. Two-weeks, three-months, and six-months post-trauma, participants completed self-report measures and a computerized test battery to evaluate neurocognition. An Area Deprivation Index (ADI) score, a measure of a neighborhood's socioeconomic disadvantage, was derived from each participants' home address.

RESULTS: Greater neighborhood disadvantage was significantly related to lower scores in all domains. Results of hierarchical linear models revealed neighborhood disadvantage was significantly associated with processing speed, controlled attention, cognitive flexibility, and response inhibition across time, even after adjusting for individual annual household income, baseline PTSD symptoms, and previous adverse life experiences. This relationship was stable for all domains except sustained attention, which varied across time.

CONCLUSION: These findings indicate neighborhood disadvantage contributes uniquely to neurocognitive functioning and, for the majority of domains, these contributions are stable across time. The relationship between area-level variables and cognitive function may underlie individual vulnerability to developing psychiatric disorders. Future work should continue to examine the interaction between socioenvironmental stressors and PTSD symptoms longitudinally.

Author List

Webb EK, Weis CN, Huggins AA, Parisi EA, Bennett KP, Miskovich T, Krukowski J, deRoon-Cassini TA, Larson CL

Authors

Carissa N. Weis PhD Assistant Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Terri A. deRoon Cassini PhD Center Director, Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Cognition
Female
Health Status
Humans
Male
Social Environment
Stress Disorders, Post-Traumatic