NEUROPSYCHOLOGICAL ASSESSMENT Antonio E. Puente, Ph.D. Department of Psychology University of North Carolina at Wilmington Wilmington, NC Phone: (910) Fax: (910) International Symposium on Biological Aspects and Drug Therapies of Mental Disorders Habana, Cuba June, 2000

Outline of the Presentation n Introduction n Current trends: –Review of Literature –Division 40 Diagnostics n Available Tests n Specific Issues in Assessment n Summary

INTRODUCTION: Assumptions n Antonio E. Puente n North American Bias n Traditional Variables of Interest

Translators n Availability n Bias n Literal Translation

Norms n Limited Availability n Exchangeability of Norms n Sampling Techniques

Confounds n Cultural Adaptation n Educational Attainment n Non-Verbal Tests n Ecological Validity

Example: Luria n Russia n Denmark n United States n Spain

CURRENT TRENDS: Review of the Literature Psych Lit Rankings: Psych Lit Rankings: n Professional n Diagnostic n Testing n Rehabilitation n Forensic

Review of the Literature (Cont.) Psych Lit Rankings: Present n Professional n Diagnostic n Forensic n Testing n Rehabilitation

Topic Ranking for Neuropsychology Review n Diagnostic n Testing n Professional n Rehabilitation n Forensic

Topic Ranking for Journal of the International Neuropsychological Society n Diagnostics n Testing n Rehabilitation

Topic Rankings for Archives of Clinical Neuropsychology Present n Diagnostic n Testing n Professional n Rehabilitation n Forensics

Topic Ranking of APA Division of Neuropsychology Conferences present n Syndromes (e.g., head injury, AIDS) n Assessment n Developmental n Anatomy n Treatment/Recovery

Current Trends: Diagnostics n Syndromes –Head Injury –Dementia n Developmental –Pediatric –Aging n Psychopathology –Schizophrenia –Depression

AVAILABLE TESTS Selected Psychological Tests - Spain n PERSONALITY n AFFECTIVE n DEVELOPMENTAL

1. Personality n MMPI n CAQ, Cuestinario de Analisis Clinico n Cuestinario de Personalidad –Pinillas –Eysenk –Cattell n Cuestinario Psicologica de California n Kuder n 16 PF n Myers-Briggs

2. Affective n Inventario de Situaciones y Respuetas de Aniedas n Inventario de Actividad de Jenkins n Cuetinario de Ansiedad Estado/Rasgo (adutos/ninos)

3. Developmental n Frostig n Test Illinois de Aptitudes Psicolinguisticos

Selected Neuropsychological Tests - Spain n COMMUNICATION n MEMORY n SPATIAL & PRAXIC n COGNITION n INTELLECTUAL n BATTERY

1. Communication n Test de Vocabularo de Boston 2. Memory n Benton n Rivermead

3. Spatial & Praxic n Rey n Harris Test de la Dominancia Lateral 4. Cognition n Stroop

5. Intellectual n WAIS n WISC n WPPSI n Bayley n Otis n Factor “g” 6. Battery n Test de Barcelona n Luria

Selected Psychological Tests - United States n PERSONALITY –MMPI –16 PF n AFFECTIVE –Speilberger –Beck-II n DEVELOPMENTAL

Selected Neuropsychological Tests - United States n ORIENTATION & ATTENTION n COMMUNICATION n MEMORY n SPATIAL & PRAXIC ABILITIES n COGNITION/INTELLECTUAL n BATTERY

1. Orientation & Attention n Mini-mental state n Digit Symbols n “A” Cancellation Test

2. Communication n Spanish Naming Test n Boston Diagnostic Aphasia n Spanish Repetition Test n Reading & Writing Abilities Test n Spanish Phonemic Discrimination Test n Spanish Grammar Test n Verbal Fluency

3. Memory n Verbal Serial Learning Curve n Digit Span n Facial Memory Test

4. Spatial & Praxic Abilities n Draw a Cube n Finger Tapping

5. Cognition/Intellectual n EIWA n Beta III n Peabody n Woodcock-Munoz 6. Battery n Luria

SPECIAL ISSUES IN ASSESSMENT: Study Sample Sample Descriptions n 2700 = Total members of NAN in 1994 n 1200 = Total # sampled n 324 = Initial response (27%) n 242 = Second response (20 %) n 566 = Total responses (47 %) n 119 = Reported < 5hrs/week of evaluations n 447 = Total used from original sample

Results n Hours Spent Testing n Percentage of Batteries n Minutes to Administer n Percentage of Testing with Computers n Tests

Results I: Time Spent Testing n HoursN% n n n n n > n No response41

Results II: Number & % of Batteries n Practice AreasN% n Adaptive n Aphasia20546 n Behavioral Med12728 n Developmental11527 n Intellectual35479 n Neurobehavioral22851 n Neuropsychological42795 n Personality35379

Results III: Minutes to Administer Test n Practice AreasAdmin.ScoreInt. n Adaptive n Aphasia n Behavioral Med n Developmental n Intellectual n Neurobehavioral n Neuropsych n Personality

Results IV: Testing With Computers n Activity% n Administration 2 n Scoring10 n Interpretation 3

Results V: Test Frequency n Total # of Tests = 102 n Tests used exclusively by neuropsychologists = 8 n Longest tests used = –HRNB (400 min.) –Wechsler Scales (130 min.)

Results V: Top 26 Tests n MMPI n WAIS n WMS n Trial Making n FAS Word Fluency n Finger Tapping n HRNB n Boston Naming Test n Category test n WRAT -R/III n Beck Depression

Results V: Top 26 Tests (Cont.) n Rey Complex Figure Test n Wisconsin Card Sorting n California Verbal Learning n Grooved Pegboard n WISC-R/III n Aphasia Screening Test n Rorschach Inkblot n Hooper Visual Organization

Results V: Top 26 Tests (Cont.) n Hand Dynamometer n Dementia Rating Scale n Stroop n PASAT n Millon n Bender Gestalt n Thematic Apperception Test

SUMMARY: Predicted Trends for the New Millennia n Ecological Validity/ Value-Added n Continuum of Care n Globalization n Increase in Forensics n Call for Research n Neuropsychological “g”

SUMMARY: Theoretical Prospects n Neuropsychology as a Hybrid Discipline n To Expand, Neuropsychology Must Appreciate Ignored Disciplines n Historical and Philosophical Underpinnings Must be Better Understood n Neuropsychology Must make Further In- Roads with Science, Medicine, & Society

SUMMARY: Theoretical Prospects (Cont..) n The Cognitive and Subjective Must Play an Important Role n Neuropsychology will Become Universal n Is Psychology Nothing More than Neuropsychology Re-Defined by a Century of Misguided Behaviorism?