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This volume is the first comprehensive resource to assist neuropsychologists to provide culturally competent services to Asian Americans. It highlights pertinent historical socio-cultural characteristics of the largest Asian American ethnic groups, which helps to conceptualize presentation, provide an optimal environment for test administration, interpret tests within a cultural context, and offer culturally sensitive feedback and recommendations. In addition, the volume gives a summary of the available neuropsychological literature for each Asian American ethnic group, recommendations for testing, and illustrative case samples. The second purpose of the volume is to provide a glimpse of how neuropsychology is currently practiced in different Asian countries, by reviewing the neuropsychological literature and by listing the available resources. This information gives valuable insights to neuropsychologists working with Asian communities throughout the world. Neuropsychology of Asian Americans is an essential resource for clinical neuropsychologists and school psychologists who perform neuropsychological services to Asians. It is also an important resource for academic neuropsychologists and students with Asians in their sample, as cultural variables may have moderating effects on data that information in this book helps to elucidate. Part 1. Asian American Neuropsychology . D. Fujii , Introduction. D. Fujii, B. Yee, S. Eap, T. Kuoch, M. Scully, Neuropsychology of Cambodian Americans. T. Wong , Neuropsychology of Chinese Americans. K. Nadal, J. Monzones , Neuropsychological Assessments and Filipino Americans: Cultural Implications for Practice. D. Fujii, A. Vang , Neuropsychology of Hmong. V. Phatak, V. Kamath, D. Fujii , Neuropsychology of Asian Indian Americans. B. Tsushima, V. Tsushima, D. Fujii , Neuropsychology of Japanese Americans. M.Y. Jo, L. Kwon Dawson , Neuropsychological Assessment of Korean Americans. D. Fujii , Neuropsychology of Laotian Americans. D. Fujii, T. Wu, K. Ratanadilok , Neuropsychology of Thai Americans. D. Ngo, M.T. Le, P.D. Le , Neuropsychology of Vietnamese Americans. Part 2. Neuropsychology in Asia . A. Chan, W. Leung, M.C. Cheung , Neuropsychology in China. K. Kumar , Neuropsychology in India. A. Isomura, M. Mimura, Neuropsychology in Japan. J. Chey, H. Park, Neuropsychology in Korea. N.C. Din , Neuropsychology in Malaysia. M.R. Lopa-Ramos , L. Ledesma , Neuropsychology in the Philippines. S. Collinson, D. Yeo , Neuropsychology in Singapore: History, Development, and Future Directions. K. Ratanadilok , Neuropsychology in Thailand Daryl Fujii is a board certified clinical neuropsychologist (American Board of Clinical Neuropsychology) and a fellow of the American Psychological Association. He has over 50 publications including an edited book, The Spectrum of Psychotic Disorders . Daryl has been actively promoting cross cultural neuropsychological competencies through his involvement with the American Academy of Clinical Neuropsychology (AACN) and Veteran’s Affairs Psychology Diversity Training Committee, and mentoring ethnic minority neuropsychologists through his participation in APA’s Division 40 Ethnic Minority Affairs Committee as well as training practicum students, interns, and post doctoral fellows. Daryl currently works as a geriatric neuropsychologist at the Pacific Island Health Care Services Center for Aging and is an international consultant and lecturer. \"While no one book can allow us to understand [cultural] differences fully, the current volume goes a long way in helping neuropsychologists feel much less helpless. ... When it comes to U.S. neuropsychologists seeing Asian clients ... The Neuropsychology of Asian-Americans is the place to look. ... A rewarding read for those who are interested in cross-cultural issues generally. The astonishing range of languages, levels and types of education, cultural practices and influences, and histories represented in this book is a useful antidote to Asian stereotyping. ... The writing is uniformly clear and straightforward, another indication of excellent editing. ... The Neuropsychology of Asian-Americans is a very practical book. It provides a concise guide to the clinician that is well-written and well-organized. Hopefully, it may serve as a model for future work concerning other immigrant populations. ... If we in the West truly want to understand the neuropsychological functioning of the human brain, we must become more aware of that other half of humanity that is addressed in this book.\" – Tedd Judd, Clinical Neuropsychologist, in Journal of the International Neuropsychological Society \" Daryl Fujii’s Neuropsychology of Asian Americans is an invaluable resource for any clinician, trainee, or student who wishes to gain cross-cultural competence with clients of Asian descent. While this book provides a comprehensive review of cultural factors that are directly applicable to neuropsychological assessment, the breadth and depth of information covered in this book is highly useful for any clinician who works with this population. \" - Lauren Drag, Ph.D., Department of Psychiatry, University of Michigan Health System, USA \"The Neuropsychology of Asian Americans superbly describes many cultural and linguistic factors that can undermine an evidence-based assessment of Asian Americans . ... The Neuropsychology of Asian Americans is a unique resource in that it provides historical background information regarding the stressors, conflicts, wars, and other sociological issues unique to each of the cultures discussed. ... The Neuropsychology of Asian Americans is an engaging, comprehensive, and informative text for any clinician who assesses or treats clients of Asian descent. The recommendations and case studies make the book easy to read and a practical reference. This book would also be useful to incorporate in course work on diversity and culturally competent practice in counseling or clinical psychology programs. It is a necessary read for any clinician using psychological or cognitive tests with Asian Americans. At the very least, any psychologist or neuropsychologist, especially those practicing in an urban environment, will benefit by having this text as a reference .\" – Robert B. Perna and Rebecca Villar in PsycCRITIQUES

The construction of an ethnic or racial identity is considered an important developmental milestone for youth of color. This review summarizes research on links between ethnic and racial identity (ERI) with psychosocial, academic, and health risk outcomes among ethnic minority adolescents. With notable exceptions, aspects of ERI are generally associated with adaptive outcomes. ERI are generally beneficial for African American adolescents' adjustment across all three domains, whereas the evidence is somewhat mixed for Latino and American Indian youth. There is a dearth of research for academic and health risk outcomes among Asian American and Pacific Islander adolescents. The review concludes with suggestions for future research on ERI among minority youth.

Using longitudinal data, the authors assessed 585 Dominican, Chinese, and African American adolescents (Grades 6–8, Mage at W1 = 11.83) to determine patterns over time of perceived ethnic-racial discrimination from adults and peers; if these patterns varied by gender, ethnicity, and immigrant status; and whether they are associated with psychological (self-esteem, depressive symptoms) and social (friend and teacher relationship quality, school belonging) adjustment. Two longitudinal patterns for adult discrimination and three longitudinal patterns for peer discrimination were identified using a semiparametric mixture model. These trajectories were distinct with regard to the initial level, shape, and changes in discrimination. Trajectories varied by gender and ethnicity and were significantly linked to psychological and social adjustment. Directions for future research and practice are discussed.

Background Asian American immigrants have a lower level of health literacy than non-Latino whites, but their level of health literacy and its impact on health outcomes may differ among subgroups. Objective We investigated the level of health literacy across five subgroups of Asian American immigrants and explored the association between health literacy and self-rated health status and symptoms of depression. Design We utilized a cross-sectional survey research design and a population-based sampling strategy using the 2007 California Health Interview Survey (CHIS). Participants We sampled 30,615 non-Latino whites and 3,053 Asian American immigrants (1,058 Chinese, 598 Koreans, 534 Filipinos, 416 South Asians, and 447 Vietnamese). Main Measures We used two questions as proxy measures to assess the level of health literacy in non-Latino whites and in both aggregated and disaggregated Asian American immigrant groups. We then investigated the effect of health literacy on two main health outcomes: self-rated health status and depression symptoms. Key Results The level of health literacy varied across the five subgroups of Asian American immigrants. Chinese, Korean, and Vietnamese groups had the lowest levels of health literacy, while Filipinos showed the highest level. Health literacy was positively correlated with health status in Chinese and Korean immigrants, and negatively correlated with depression symptoms in Korean and South Asian immigrants. Conclusion We found heterogeneity in health literacy among Asian American immigrants and found that health literacy had varying associations with health outcomes. The aggregated Asian American immigrant group results may mask the true health disparities that each Asian American immigrant group faces. Koreans were the only group found to have a significant association between the proxy for health literacy and both health outcomes. Further research is needed to better understand the causes of heterogeneity and to investigate health literacy as a critical determinant of immigrant health.

ABSTRACT BACKGROUND Differences in health behaviors may be important contributors to racial/ethnic disparities in the health status of adults. Studies to date have not compared whether there are health behavior differences in exercise and dietary behaviors among middle-age and older adults in the four largest racial/ethnic categories. OBJECTIVE To investigate racial/ethnic differences in exercise and dietary behaviors of middle-aged and older adults. DESIGN We used data from the 2007 California Health Interview Survey. Multivariable logistic regression was used to examine interactions between age and race/ethnicity in predicting two categories of health behaviors. Analyses were conducted adjusting for sociodemographic characteristics, health insurance status, and healthcare utilization. PARTICIPANTS A population-based sample of 33,189 California adults 45 years old and older: 26,522 non-Hispanic whites, 1,686 African American/blacks, 2,565 Asian/Pacific Islanders (1,741 English-proficient; 824 limited English-proficient), and 2,416 Latinos (1,538 English-proficient; 878 limited English-proficient). MAIN MEASURES Self-report leisure-time physical activity (moderate and vigorous) and daily consumption of fruits and vegetables. KEY RESULTS Racial/ethnic minorities generally engaged in less healthy exercise and dietary behaviors than whites, with differences more pronounced in middle adulthood. The disparities were the greatest among English-proficient minorities. Specifically, among middle-aged respondents, all racial/ethnic minorities engaged in less vigorous physical activity than whites (ORs range = 0.28 to 0.73; 95% CI range = 0.16-1.00). Additionally, middle-aged, English-proficient minorities engaged in less moderate physical activity compared to whites (ORs range =0.57 to 0.67; 95% CI range = 0.45-0.79). Furthermore, middle-aged, English-proficient Latinos had a poorer diet than whites (OR = 0.54; 0.39-0.75). Few significant racial/ethnic differences emerged in the exercise and dietary behaviors of older adults. CONCLUSIONS Racial/ethnic disparities in exercise and dietary behaviors are most notable among middle-aged, acculturated minorities. Results highlight the need to promote positive exercise and dietary behaviors during critical preventive ages, when racial/ethnic disparities are large and the potential to prevent chronic disease is great.

This study examined cross-ethnic friendship choices and intergroup attitudes in a sample of 762 sixth-grade Asian American students (Mage = 11.5 years) attending 1 of 19 middle schools that varied in ethnic composition. Multiple measures of friendship (quantity and quality) and intergroup attitudes (affective, cognitive, behavioral) toward White, Latino, and Black grademates were assessed. The results showed that Asian American students overnominated White students and undernominated Latino and Black students as their friends when school availability of each ethnic group was accounted for. Cross-ethnic friendships were related to better intergroup attitudes, especially the behavioral dimension of attitudes. Cross-ethnic friendships were least likely to change attitudes toward Blacks. Implications for future research, educational practice, and attitude intervention programs were discussed.

ABSTRACT BACKGROUND Asian Americans represent a mix of cultures and immigration experiences, which may put them differentially at risk for mental health problems. Yet, little is known about the mental health needs of older adults from various Asian subgroups compared to non-Hispanic whites. OBJECTIVES To compare the prevalence rates of mental distress of Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese older adults (aged 55 and older) to that of non-Hispanic whites; and to examine subgroup differences in utilization of mental health services. METHODS A cross-sectional analysis of a population-based sample of California adults responding to the 2007 California Health Interview Survey. Multivariable logistic regression analysis was used to examine subgroup differences in mental health status and use of mental health services among the six different Asian subgroups and non-Hispanic whites, adjusting for respondents’ demographic and health characteristics, socioeconomic status, and English-language proficiency. RESULTS A total of 20,712 respondents were included. Filipino [aOR=2.25; 95% CI=1.14-4.47] and Korean Americans [aOR=2.10; 95% CI=1.06-4.17] were more likely to report symptoms indicative of mental distress compared to non-Hispanic whites, yet were less likely to have seen a primary care provider [Filipino: aOR=0.41; 95% CI=0.18-0.90; Korean: aOR=0.24; 95% CI = 0.08-0.69] or have taken a prescription medication [Filipino: aOR=0.20; 95% CI=0.10-0.40; Korean: aOR=0.15; 95% CI=0.05-0.40], even after adjusting for indicators of respondents’ demographic and health characteristics, socioeconomic status, and English-language proficiency. In contrast, Japanese Americans were less likely to report symptoms indicative of mental distress [aOR=0.43; 95% CI=0.21-0.90], and were less likely to make use of mental health services compared to non-Hispanic whites. DISCUSSION/CONCLUSIONS The findings from this study not only highlight the unmet mental health needs among older Asian Americans, but also illustrate significant variations among the various Asian subgroups. Clinicians who work closely with these patients should regularly screen and assess older Asian adults for symptoms related to their mental health needs.

Objective Efforts to prevent leukemia have been hampered by an inability to identify significant risk factors. Exploring incidence patterns of leukemia subtypes by sex and race/ethnic group may generate new etiologic hypotheses and identify high-risk groups for further study. Methods Data from the North American Association of Central Cancer Registries for 1997-2002 were used to assess patterns of leukemia incidence by subtype, sex, age, race and ethnicity. Results A total of 144,559 leukemia cases were identified, including 66,067 (46%) acute and 71,860 (50%) chronic leukemias. The highest rates of acute myeloid leukemia with and without maturation were observed in Asian-Pacific Islanders (API). Hispanics had a higher incidence of acute lymphocytic leukemia, particularly in childhood, and promyelocytic leukemia than did non-Hispanics. African-Americans had the highest rates of HTLV-1 positive adult T-cell leukemia/lymphoma. A sharp increase in the incidence of chronic myeloid leukemia was observed for both APIs and Hispanics, 85 years and older. Conclusion Known risk factors are unlikely to explain the observed disparities in leukemia incidence. Further studies of differences in environmental and genetic risk factors in these populations by specific leukemia subtype may provide clues to the etiologies of these malignancies.

American Heart Association/Centers for Disease Control and Prevention guidelines support the measurement of C-reactive protein (CRP) to further risk stratify individuals at intermediate risk (10%-20% 10-year risk) for heart disease. Determining gender-specific differences in CRP may alter how CRP levels are interpreted and used to determine risk. MESA is a prospective cohort consisting of 6814 men and women aged 45 to 84 years recruited from 6 US communities. Nonparametric analyses were performed to determine differences in CRP levels by gender in the entire cohort and after stratifying by use of estrogen medication (n = 944). Stratifying by median body mass index (BMI) and generalized linear models were also used to account for confounding variables associated with CRP. Overall, women had substantially higher median CRP levels compared with men (2.56 vs 1.43 mg/L, P < .0001). After excluding women using estrogen and individuals with CRP >10 mg/L, median CRP levels remained higher in women compared with men (1.85 vs 1.33 mg/L, P < .0001). When participants were stratified into high and low BMI groups, the gender difference in CRP levels remained. This pattern of higher CRP levels in women was consistent across all ethnic subgroups even after multivariable adjustment. C-reactive protein levels were higher in women compared with men despite accounting for BMI and other common confounding variables. This gender difference was maintained across all ethnic subgroups. These results suggest that evaluation of gender-specific CRP cut points to determine cardiovascular risk should be considered.

The time to first cigarette of the day (TTFC) is a strong indicator of nicotine dependence behaviors such as nicotine uptake and quit success in young and older smokers. There are substantial differences in levels of nicotine dependence by race and ethnic group. Data from Wave III of the multiracial National Longitudinal Study of Adolescent Health were analyzed for young smokers between the ages of 21 and 28 (N = 1,425). Time to first cigarette data was compared between Hispanic, White, Black, Native American, and Asian smokers. Black smokers were significantly more likely to smoke within 5min of waking than White, Hispanic, and Asian smokers. Lower personal income predicted smoking within 5min of waking for both White and Black smokers. For White smokers, increased number of cigarettes per day and increased years of smoking also predicted smoking within 5min of waking. The number of days smoked or number of cigarettes per day did not predict smoking within 5min of waking among smokers. The higher prevalence of early TTFC among Blacks indicates increased nicotine and carcinogen exposure, and may help explain the increased lung cancer rates and failed cessation attempts among Black smokers. TTFC may be an important screening item, independent of cigarettes per day, for clinicians and interventions to identify those at highest risk for cessation failure and disease risk.