The Culture in Cross-Cultural Neuropsychology: An Attempt at Developing a Research Program and Its Implications for the Contemporary Practice of Clinical Neuropsychology With Hispanics

Crosscultural Challenges to Neuropsychology’s Brain Theories and Clinical Practice New York Neuropsychology Group Psychology Forum, New York Academy of Sciences May 1, 2004 Antonio E. Puente Department of Psychology University of North Carolina at Wilmington Wilmington, NC 28403 910.962.3812 puente@uncw.edu www.uncw.edu/people/puente

Outline Purpose of Presentation Background and Biases Assumptions and Limitations Defining Concepts Changing Face of America’s Demographics Examples from Four Neuropsychological Studies Current Efforts Pragmatic Observations Theoretical Speculations

Purpose of Presentation Summary of 25 Years of Research Where Do Biopsychosocial Variables Fit in Brain Dysfunction? Searching for a Neuropsychological “g”

Background and Biases Not About Social Correctness; Ethnicity It’s About Science Ethnicity Educational Professional Theoretical Sperry Vygotsky-Luria

Assumptions and Limitations Philosophy Vs Science Functional Vs Organic Culture Vs Biology Individual Vs Contextual

Defining Concepts Culture (Shared Extra-genetic Knowledge) Brain and Neuropsychology (Processor of Information; Information about the Processor) Intelligence and Cognition (Understanding/Tracking/Using Discrete Information)

Changing Face of America: A Focus on Hispanics Add Demo Info here

Examples from Four Neuropsychological Studies Background Grenada, W.I.- Hypertension & Stress Argentina- Fulbright & the Malvinas Puerto Rico- APA Visiting Psychologist Program & the Translation of Test

Examples from Studies: Continued Intention Why do Ethnic-Minorities do Poorly on Most Cognitive & Neuropsychological Measures? Three Generations = Anglo Saxon Cattell and the Concept of “g” Is There Common Information Processing Across Cultures?

Examples From Studies: Five Attempts Wechsler Intelligence Scales Luria-Nebraska Battery Amazon Indians Russia Intellectual Assessment (in general)

Wechsler Scales: I Background Item Bias on the Wechsler Scales WISC Puerto Rican Version WAIS vs WISC

Wechsler Scales: II Principal Collaborators In Psych Corp: William Hrabrick,, Aurelio Prifitera, Michael O’Callahan, David Tulsky Principal Co-Collaborators: Alfredo Ardila, Josette Harris, Andres Barona, Laura Herrans (& Monica Rosselli) Consulting Workgroup (7) Other Collaborators: 50-70 School and Clinical Neuropsychologists Throughout the US

Wechsler Scales: III Time-Frame Items Production Sampling Standardization

Wechsler Scales: IV Time-Frame: Initial Work= late 1980s-1993 Formal Work= 1994-2001

Wechsler Scales: V Items: Borrowed Items Explicit and Implicit Bias Across Hispanic Subgroup Agreement Scoring Criteria

Wechsler Scales: VI Production: Using Prior WISC & Foreign Versions Drawings Printing Pricing & Packaging Production

Wechsler Scales: VII Sampling: Age Sex Educational Level (child and parent) Country of Origin Acculturation Level Language Preference of Child Socio-economic Status

Wechsler Scales: VIII Standardization: Examiners Methods 36 Geographical & Cultural Variability Taped Tryout Methods Tryout= 600 Standardization= 1,000 Test-Retest= 300

Wechsler Scales: IX Current Status: Re-constituted with Josette Harris Possibly available in 2005 Not Aware of the Specifics

Luria-Nebraska Neuropsychological Battery: I Background National Academy of Neuropsychology 1979 Meeting in Orlando Luria-North Dakota Neuropsychological Battery Initial Collaboration with Golden & “Item Interpretation of the Luria-Nebraska Neuropsychological Battery” Chilean Journal of Psychology (1982)

LNNB: II Failed Attempts: Spanish Collaborators: Argentina Puerto Rico Madrid- Juan Tobal, Antonio Cano, Juan Manuel Cepedez, Itziar Iruarrizaga Granada- Juan Gody, Juana Garcia. Miguel Perez Other- Salamanca; TEA, Western Psych.

LNNB: III Literature Review: 500 Total Articles on the LNNB 34 on the LNNB and Ethnic/Foreign Samples 4= Children; 30= Adult Empirical= 23 (BD, Schizophrenia) Translations= 9

LNNB: IV Problems: Items Copyright Hispanic Subculture Literal Translation Copyright Luria Christensen TEA Western Psychological Services

LNNB: V Translation: Original Translation by Bilingual Neuropsychologist Back Translation by Two Bilingual Neuropsychologist New Translation Developed Discrepancies With English Translation Reconciled

LNNB: VI Major Item Changes: Receptive Speech Expressive Speech Writing & Reading Arithmetic Intellectual Processes

LNNB: VII Sampling: Total= 232 (men= 126; women= 106) Mean Age= 39.88 (15-88) Mean Education= 9.93(0-21)

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

LNNB: IX Next Steps: Publishing Patient Group Info TEA/Western Psychological Corporation Copyright & Related Difficulties

Amazon Indians: I Background: Collaborators: Culture-free Sample Caribbean, Latin America, Spain, Russia Collaborators: Vivian Andrade (Brazil) Miguel Perez (Spain)

Amazon: II First Study Task Sampling CVLT Type Task (15 words) Words in Guaranis & Portuguese Sampling Total= 20 Guaranis (educated vs “uneducated”)

Amazon: III (First Study Continued) Results: Verbal Memory similar number of words in first trial different learning curves more words total for indigenous Indians

Amazon Indians: IV Second Study Sample N= 12 per group Educated vs “non-educated” Guaranis Tasks CVLT type task (15 matched words) 12 Figures of indigenous animals WMS-R Logical Memory WAIS-R Digit Span WAIS-R Block Design

Amazon Indians: V Second Study (continued) Results No between-group differences “Un-educated” Indians did significantly better in motor and visual tasks than in verbal tasks in either language

Russia Background Luria & Vygotsky Biannual International Luria Conference Anna Agranovich

Russia: II Sample Total = 40 per group USA Russia Age 28.95 (18-44) 29.15 (18-43) Ed. 13.68 (12-17) 14.25 (12-17)

Russia: III Methodology/Instruments Hemisphere Anterior Posterior left/verbal Fluency Digits Forward Digits Backward Verbal Memory right/visual Ruff Figural Fluency Visual Memory Color Trails Clock Test

Russia: IV Results Verbal Fluency 21.75 24.18 Test USA Russia Verbal Fluency 21.75 24.18 Digits Backwards 7.83 6.75 Digits Forward 10.58 9.70 Verbal Memory 41.65 43.50 Visual Memory 23.05 22.63 Clock 8.55 8.83 RFFT 114.80 103.40 CTT1 26.08 38.30 CTT2 61.63 75.46

Intellectual Assessment of Hispanics Add LA Poster info here

Current Efforts Trail Making (Chile & US) Acculturation and Intelligence (Beta) Intellectual Assessment in Hispanics

Some Pragmatic Observations Translations Typical vs Required Translators Norms Paucity of Data Heterogeneity of Groups Criterion Validity Who is the Reference Value What is “Brain Damage” Personnel Few Academics, in general Even Fewer Ethnic-Minorities Within the Field

Some Theoretical Questions New, Novel, & Extremely Difficult History and Culture Do Matter Personal Manipulation of History and Culture Matter Even More Cultural Knowledge Might be the Manner in Which Natural Selection Expresses Itself in Homo Sapiens Clinical Neuropsychology Might Help Unravel This Expression

Answers with Questions: Where Do We Go From Here? Is Reductionism Enough? Is the Tabula Rasa Really Blank? Does Individual Cognition Affect Gene Pool Constitution? If so, is Culture the Mechanism? Is Intelligence and Neuropsychological Constructs (e.g. Memory, Problem Solving, etc.) Equal to Understanding of Culture? If so, Does Mind Emerge from Brain and, in turn, Control Brain?