The Culture in Cross-Cultural The Culture in Cross-Cultural Neuropsychology:Neuropsychology:

An Attempt at Developing a An Attempt at Developing a Research Program and Its Research Program and Its

Implications for the Contemporary Implications for the Contemporary Practice of Clinical Practice of Clinical

Neuropsychology With HispanicsNeuropsychology With Hispanics

Crosscultural Challenges to Crosscultural Challenges to Neuropsychology’s Brain Theories Neuropsychology’s Brain Theories

and Clinical Practiceand Clinical Practice

New York Neuropsychology GroupNew York Neuropsychology GroupPsychology Forum,Psychology Forum,

New York Academy of SciencesNew York Academy of SciencesMay 1, 2004May 1, 2004

Antonio E. PuenteAntonio E. PuenteDepartment of PsychologyDepartment of Psychology

University of North Carolina at WilmingtonUniversity of North Carolina at WilmingtonWilmington, NC 28403Wilmington, NC 28403

910.962.3812910.962.3812puente@uncw.edupuente@uncw.edu

www.uncw.edu/people/puentewww.uncw.edu/people/puente

OutlineOutline

Purpose of PresentationPurpose of Presentation Background and BiasesBackground and Biases Assumptions and LimitationsAssumptions and Limitations Defining ConceptsDefining Concepts Changing Face of America’s Changing Face of America’s

DemographicsDemographics Examples from Four Neuropsychological Examples from Four Neuropsychological

StudiesStudies Current EffortsCurrent Efforts Pragmatic ObservationsPragmatic Observations Theoretical SpeculationsTheoretical Speculations

Purpose of PresentationPurpose of Presentation

Summary of 25 Years of Research Summary of 25 Years of Research Where Do Biopsychosocial Where Do Biopsychosocial Variables Fit in Brain Dysfunction?Variables Fit in Brain Dysfunction?

Searching for a Neuropsychological Searching for a Neuropsychological “g”“g”

Background and BiasesBackground and Biases

Not About Social Correctness; Not About Social Correctness; – It’s About ScienceIt’s About Science

EthnicityEthnicity EducationalEducational ProfessionalProfessional TheoreticalTheoretical

– SperrySperry– Vygotsky-LuriaVygotsky-Luria

Assumptions and Assumptions and LimitationsLimitations

Philosophy Vs SciencePhilosophy Vs Science

Functional Vs OrganicFunctional Vs Organic

Culture Vs BiologyCulture Vs Biology

Individual Vs ContextualIndividual Vs Contextual

Defining ConceptsDefining Concepts

CultureCulture (Shared Extra-genetic (Shared Extra-genetic Knowledge)Knowledge)

Brain and NeuropsychologyBrain and Neuropsychology (Processor of Information; (Processor of Information; Information about the Processor)Information about the Processor)

Intelligence and CognitionIntelligence and Cognition (Understanding/Tracking/Using (Understanding/Tracking/Using DiscreteDiscrete Information) Information)

Changing Face of America:Changing Face of America:A Focus on HispanicsA Focus on Hispanics

Add Demo Info hereAdd Demo Info here

Examples from Four Examples from Four Neuropsychological Neuropsychological

StudiesStudies

Background Background – Grenada, W.I.- Hypertension & StressGrenada, W.I.- Hypertension & Stress– Argentina- Fulbright & the MalvinasArgentina- Fulbright & the Malvinas– Puerto Rico- APA Visiting Psychologist Puerto Rico- APA Visiting Psychologist

Program & the Translation of TestProgram & the Translation of Test

Examples from Studies:Examples from Studies:Continued Continued

IntentionIntention– Why do Ethnic-Minorities do Poorly on Why do Ethnic-Minorities do Poorly on

Most Cognitive & Neuropsychological Most Cognitive & Neuropsychological Measures?Measures?

– Three Generations = Anglo SaxonThree Generations = Anglo Saxon– Cattell and the Concept of “g”Cattell and the Concept of “g”– Is There Common Information Is There Common Information

Processing Across Cultures?Processing Across Cultures?

Examples From Studies:Examples From Studies:Five AttemptsFive Attempts

Wechsler Intelligence ScalesWechsler Intelligence Scales

Luria-Nebraska BatteryLuria-Nebraska Battery

Amazon IndiansAmazon Indians

RussiaRussia

Intellectual Assessment (in general)Intellectual Assessment (in general)

Wechsler Scales: IWechsler Scales: I

BackgroundBackground– Item Bias on the Wechsler ScalesItem Bias on the Wechsler Scales– WISCWISC

Puerto Rican VersionPuerto Rican Version WAIS vs WISCWAIS vs WISC

Wechsler Scales: IIWechsler Scales: II Principal Collaborators In Psych Corp:Principal Collaborators In Psych Corp:

– William Hrabrick,, Aurelio Prifitera, William Hrabrick,, Aurelio Prifitera, Michael O’Callahan, David TulskyMichael O’Callahan, David Tulsky

Principal Co-Collaborators:Principal Co-Collaborators:– Alfredo Ardila, Josette Harris, Andres Alfredo Ardila, Josette Harris, Andres

Barona, Laura Herrans (& Monica Barona, Laura Herrans (& Monica Rosselli)Rosselli)

– Consulting Workgroup (7) Consulting Workgroup (7) Other Collaborators:Other Collaborators:

– 50-70 School and Clinical 50-70 School and Clinical Neuropsychologists Throughout the USNeuropsychologists Throughout the US

Wechsler Scales: IIIWechsler Scales: III

Time-FrameTime-Frame ItemsItems ProductionProduction SamplingSampling StandardizationStandardization

Wechsler Scales: IVWechsler Scales: IV

Time-Frame:Time-Frame:– Initial Work= late 1980s-1993Initial Work= late 1980s-1993– Formal Work= 1994-2001Formal Work= 1994-2001

Wechsler Scales: VWechsler Scales: V

Items:Items:– Borrowed ItemsBorrowed Items– Explicit and Implicit BiasExplicit and Implicit Bias– Across Hispanic Subgroup AgreementAcross Hispanic Subgroup Agreement– Scoring CriteriaScoring Criteria

Wechsler Scales: VIWechsler Scales: VI

Production:Production:– Using Prior WISC & Foreign VersionsUsing Prior WISC & Foreign Versions– DrawingsDrawings– PrintingPrinting– Pricing & PackagingPricing & Packaging– ProductionProduction

Wechsler Scales: VIIWechsler Scales: VII

Sampling:Sampling:– AgeAge– SexSex– Educational Level (child and parent)Educational Level (child and parent)– Country of OriginCountry of Origin– Acculturation LevelAcculturation Level– Language Preference of ChildLanguage Preference of Child– Socio-economic StatusSocio-economic Status

Wechsler Scales: VIIIWechsler Scales: VIII

Standardization:Standardization:– ExaminersExaminers

3636 Geographical & Cultural VariabilityGeographical & Cultural Variability Taped TryoutTaped Tryout

– MethodsMethods Tryout= 600Tryout= 600 Standardization= 1,000Standardization= 1,000 Test-Retest= 300Test-Retest= 300

Wechsler Scales: IXWechsler Scales: IX

Current Status:Current Status:– Re-constituted with Josette HarrisRe-constituted with Josette Harris– Possibly available in 2005Possibly available in 2005– Not Aware of the SpecificsNot Aware of the Specifics

Luria-Nebraska Luria-Nebraska Neuropsychological Neuropsychological

Battery: IBattery: I

BackgroundBackground– National Academy of Neuropsychology National Academy of Neuropsychology

1979 Meeting in Orlando1979 Meeting in Orlando– Luria-North Dakota Neuropsychological Luria-North Dakota Neuropsychological

BatteryBattery– Initial Collaboration with Golden & “Item Initial Collaboration with Golden & “Item

Interpretation of the Luria-Nebraska Interpretation of the Luria-Nebraska Neuropsychological Battery”Neuropsychological Battery”

– Chilean Journal of Psychology (1982)Chilean Journal of Psychology (1982)

LNNB: IILNNB: II Failed Attempts:Failed Attempts:

– ArgentinaArgentina– Puerto RicoPuerto Rico

Spanish Collaborators:Spanish Collaborators:– Madrid- Juan Tobal, Antonio Cano, Juan Madrid- Juan Tobal, Antonio Cano, Juan

Manuel Cepedez, Itziar IruarrizagaManuel Cepedez, Itziar Iruarrizaga– Granada- Juan Gody, Juana Garcia. Granada- Juan Gody, Juana Garcia.

Miguel PerezMiguel Perez– Other- Salamanca; TEA, Western Psych.Other- Salamanca; TEA, Western Psych.

LNNB: IIILNNB: III

Literature Review:Literature Review:– 500 Total Articles on the LNNB500 Total Articles on the LNNB– 34 on the LNNB and Ethnic/Foreign 34 on the LNNB and Ethnic/Foreign

SamplesSamples– 4= Children; 30= Adult4= Children; 30= Adult– Empirical= 23 (BD, Schizophrenia)Empirical= 23 (BD, Schizophrenia)– Translations= 9Translations= 9

LNNB: IVLNNB: IV

Problems:Problems:– ItemsItems

Hispanic SubcultureHispanic Subculture Literal TranslationLiteral Translation

– CopyrightCopyright LuriaLuria ChristensenChristensen TEATEA Western Psychological ServicesWestern Psychological Services

LNNB: VLNNB: V

Translation:Translation:– Original Translation by Bilingual Original Translation by Bilingual

NeuropsychologistNeuropsychologist– Back Translation by Two Bilingual Back Translation by Two Bilingual

NeuropsychologistNeuropsychologist– New Translation Developed New Translation Developed – Discrepancies With English Discrepancies With English

Translation ReconciledTranslation Reconciled

LNNB: VILNNB: VI

Major Item Changes:Major Item Changes:– Receptive Speech Receptive Speech – Expressive Speech Expressive Speech – Writing & Reading Writing & Reading – Arithmetic Arithmetic – Intellectual ProcessesIntellectual Processes

LNNB: VIILNNB: VII

Sampling:Sampling:– Total= 232 (men= 126; women= Total= 232 (men= 126; women=

106)106)– Mean Age= 39.88 (15-88)Mean Age= 39.88 (15-88)– Mean Education= 9.93(0-21)Mean Education= 9.93(0-21)

LNNB: VIIILNNB: VIII

Correlations with LNNB I:Correlations with LNNB I:– Range= .5356 to .7232Range= .5356 to .7232– Education= -.48 to -.72Education= -.48 to -.72– Scales= .52 to .845Scales= .52 to .845

LNNB: IXLNNB: IX

Next Steps:Next Steps:– Publishing Patient Group InfoPublishing Patient Group Info– TEA/Western Psychological TEA/Western Psychological

Corporation Copyright & Related Corporation Copyright & Related DifficultiesDifficulties

Amazon Indians: IAmazon Indians: I

Background:Background:– Culture-free SampleCulture-free Sample– Caribbean, Latin America, Spain, Caribbean, Latin America, Spain,

RussiaRussia Collaborators:Collaborators:

– Vivian Andrade (Brazil)Vivian Andrade (Brazil)– Miguel Perez (Spain)Miguel Perez (Spain)

Amazon: IIAmazon: II First Study First Study

TaskTask– CVLT Type Task (15 words)CVLT Type Task (15 words)– Words in Guaranis & PortugueseWords in Guaranis & Portuguese

SamplingSampling– Total= 20Total= 20– Guaranis (educated vs “uneducated”)Guaranis (educated vs “uneducated”)

Amazon: IIIAmazon: III(First Study Continued)(First Study Continued)

Results:Results:– Verbal Memory Verbal Memory

similar number of words in first trialsimilar number of words in first trial different learning curvesdifferent learning curves more words total for indigenous Indiansmore words total for indigenous Indians

Amazon Indians: IVAmazon Indians: IVSecond Study Second Study

SampleSample– N= 12 per groupN= 12 per group– Educated vs “non-educated” GuaranisEducated vs “non-educated” Guaranis

TasksTasks– CVLT type task (15 matched words)CVLT type task (15 matched words)– 12 Figures of indigenous animals12 Figures of indigenous animals– WMS-R Logical MemoryWMS-R Logical Memory– WAIS-R Digit SpanWAIS-R Digit Span– WAIS-R Block DesignWAIS-R Block Design

Amazon Indians: VAmazon Indians: VSecond Study (continued)Second Study (continued)

ResultsResults– No between-group differencesNo between-group differences– ““Un-educated” Indians did Un-educated” Indians did

significantly better in motor and significantly better in motor and visual tasks than in verbal tasks in visual tasks than in verbal tasks in either languageeither language

RussiaRussia

BackgroundBackground– Luria & VygotskyLuria & Vygotsky– Biannual International Luria Biannual International Luria

ConferenceConference– Anna AgranovichAnna Agranovich

Russia: IIRussia: II

SampleSample

Total = 40 per groupTotal = 40 per group

USAUSA RussiaRussia

AgeAge 28.95 (18-44)28.95 (18-44) 29.15 29.15 (18-43)(18-43)

Ed.Ed. 13.68 (12-17)13.68 (12-17) 14.25 14.25 (12-17)(12-17)

Russia: IIIRussia: III

Methodology/InstrumentsMethodology/Instruments

Hemisphere Hemisphere Anterior Anterior PosteriorPosterior

left/verballeft/verbal FluencyFluency Digits Digits ForwardForward

Digits BackwardDigits Backward Verbal Verbal MemoryMemory

right/visualright/visual Ruff Figural FluencyRuff Figural Fluency Visual MemoryVisual MemoryColor TrailsColor Trails Clock TestClock Test

Russia: IVRussia: IV ResultsResults

TestTest USAUSA RussiaRussia

– Verbal FluencyVerbal Fluency 21.7521.75 24.1824.18– Digits BackwardsDigits Backwards 7.83 7.83 6.75 6.75– Digits ForwardDigits Forward 10.5810.58 9.70 9.70– Verbal MemoryVerbal Memory 41.6541.65 43.5043.50– Visual MemoryVisual Memory 23.0523.05 22.63 22.63– ClockClock 8.55 8.55 8.83 8.83– RFFTRFFT 114.80 114.80 103.40 103.40– CTT1CTT1 26.0826.08 38.30 38.30– CTT2CTT2 61.6361.63 75.46 75.46

Intellectual Assessment of Intellectual Assessment of HispanicsHispanics

Add LA Poster info Add LA Poster info herehere

Current EffortsCurrent Efforts

Trail Making (Chile & US)Trail Making (Chile & US) Acculturation and Intelligence Acculturation and Intelligence

(Beta)(Beta) Intellectual Assessment in Intellectual Assessment in

HispanicsHispanics

Some Pragmatic Some Pragmatic ObservationsObservations

TranslationsTranslations– Typical vs RequiredTypical vs Required

TranslatorsTranslators– Typical vs RequiredTypical vs Required

NormsNorms– Paucity of DataPaucity of Data– Heterogeneity of GroupsHeterogeneity of Groups

Criterion ValidityCriterion Validity– Who is the Reference ValueWho is the Reference Value– What is “Brain Damage”What is “Brain Damage”

PersonnelPersonnel– Few Academics, in generalFew Academics, in general– Even Fewer Ethnic-Minorities Within the FieldEven Fewer Ethnic-Minorities Within the Field

Some Theoretical Some Theoretical QuestionsQuestions

New, Novel, & Extremely DifficultNew, Novel, & Extremely Difficult History and Culture Do MatterHistory and Culture Do Matter Personal Manipulation of History Personal Manipulation of History

and Culture Matter Even Moreand Culture Matter Even More Cultural Knowledge Might be the Cultural Knowledge Might be the

Manner in Which Natural Selection Manner in Which Natural Selection Expresses Itself in Homo SapiensExpresses Itself in Homo Sapiens

Clinical Neuropsychology Might Clinical Neuropsychology Might Help Unravel This ExpressionHelp Unravel This Expression

Answers with Questions:Answers with Questions:Where Do We Go From Here?Where Do We Go From Here? Is Reductionism Enough?Is Reductionism Enough? Is the Tabula Rasa Really Blank?Is the Tabula Rasa Really Blank? Does Individual Cognition Affect Does Individual Cognition Affect

Gene Pool Constitution?Gene Pool Constitution? If so, is Culture the Mechanism?If so, is Culture the Mechanism? Is Intelligence and Is Intelligence and

Neuropsychological Constructs (e.g. Neuropsychological Constructs (e.g. Memory, Problem Solving, etc.) Equal Memory, Problem Solving, etc.) Equal to Understanding of Culture?to Understanding of Culture?

If so, Does Mind Emerge from Brain If so, Does Mind Emerge from Brain and, in turn, Control Brain?and, in turn, Control Brain?