Presentation on theme: "Burton, V., Puente, A.E., Vilar-López, R.. Hispanics and Neuropsychology: Overview According to the 2010 census, Hispanics are now the largest minority."— Presentation transcript:
Burton, V., Puente, A.E., Vilar-López, R.
Hispanics and Neuropsychology: Overview According to the 2010 census, Hispanics are now the largest minority group within the United States (Census Bureau, 2010) Hispanic can be defined in many ways, typically including language, culture, and ethnicity The neuropsychological literature is relatively sparse and almost no information exists (outside of our work) on testing effort of Spanish speakers
Background Over the past two decades there has been a growth in the quantity of research regarding culture and psychology, less so in neuropsychology Much of what relates to neuropsychology is limited in cross-cultural and linguistic assessments such as test translations
Background continued A need for a better understanding of neuropsychological tests and Hispanics exists and is increasing. (Puente & Ardila, 2000) Tests of effort are an important tool in neuropsychology (most popularly cited article on the subject is Bush et. al, 2005) Specifically, no studies have been conducted in the United States with neuropsychological tests of effort and Spanish speakers. What has been done is limited to Spain (Vilar-Lopez)
Assessments and Culture Due to the use of assessments in neuropsychology, it is vital to develop assessments that are culturally and linguistically unbiased (Testing Standards, 1999; in revision). Tests have been developed in the English language with the majority culture as the norm groups
Prior Research Detection of malingering in a Spanish (Spain) population using three specific malingering tests (Vilar-López et al., 2007) No significant differences were found when compared to the North American samples of the test manuals What about individual involved in litigation and suspect of malingering?
Prior Research continued Use of specific malingering measures in a Spanish sample. (Vilar-López, Gómez-Río, Caracuel-Romero, Llamas-Elvira, & Pérez-García, 2008) Investigated a battery of assessments including the Rey 15-Item Test for Spanish speakers in Spain This study concluded that the Rey 15-Item should be used with restrictions, determined as less sensitive
Prior Research continued Malingering detection in a Spanish population with a known-groups design.(Vilar-López et al., 2008) Utilized the Dot Counting Test and the TOMM in Spain It was determined that the TOMM is an acceptable sensitive tool The Dot Counting Test was also determined as adequate, however, less sensitive for this population
Study Description: Differential prevalence design Community, clinical and forensic populations Residing in the United States.
Method: Participants Participants were collected from two sources: 1. Tileston Health Clinic (a free multi-disciplinary health clinic for the poor and uninsured) of Wilmington, N.C. 2. Private neuropsychological testing practice in Wilmington, N.C. Demographics collected: 1. age 2. sex 3. country of origin 4. years of education 5. Years lived in the United States 6. years of education in the country of origin 7. years of education in the United States.
Participants Control Group (CG) Capital Murder Group (CM) N=29 Mean age= Mean years of education= 9.50 Not involved in litigation N=28 Mean age= Mean years of education= 7.71 Involved in criminal cases: capital murder
Participants: continued Other Forensic Group N=25 Mean age= Mean years of education= 6.68 Involved in civil litigation cases: workers compensation, personal injury, or Social Security disability
Tests of Effort Rey 15-Item Test of Memory Malingering Dot Counting Test
Procedure IRB approval Data collected from Tileston Health Clinic: Participants approached in Spanish Signed informed consent Demographics collected Tests administered (counterbalanced)
Procedure Data collected from the private practice: Demographic information was collected Two out of the three SVTs required for inclusion Classified as Capital Murder Group or Other Forensic Group
Results Mexican N=54 Other N= 26 t/ 2 p Age; Mean (SD) (10.67)35.62 (11.43) Education; Mean (SD) 7.83 (3.72)8.00 (4.75) Gender (males/females) 33/2120/ Rey; Mean (SD) (3.80)11.81 (3.54) Dot Counting; Mean (SD) (6.91)14.31 (3.79) TOMM 1; Mean (SD) (6.36)45.68 (6.61) TOMM 2; Mean (SD) (5.12)47.68 (5.78) Descriptive statistics of the participants regarding nationality
Results Capital Murder Other Forensic Clinical Controls F/ 2 p Age; Mean(SD) (7.75)36.56 (10.18)41.61 (11.11) Education; Mean (SD) 7.71 (4.52)6.68 (3.97)9.50 (3.65) Gender (males/females) 25/323/27/ Descriptives for the capital murder, other forensic and clinical control groups
Results Capital Murder Other Forensic ControlsFpBonferroni Rey; Mean (SD) (3.30)7.33 (2.69)12.61 (2.87) <(1=3) Dot Counting; Mean (SD) (4.32)14.44 (4.39)13.81 (5.98) NA TOMM 1; Mean (SD) (5.24)38.11 (6.94)45.04 (22.93) <1 TOMM 2; Mean (SD) (1.59)43.56 (7.84)48.89 (2.22) <1 ANOVAs for the capital murder, other forensic and control groups on the effort tests Note: 1=Capital murder group; 2=Other forensic group; 3= Control group
Results Capital MurderOther ForensicControls 2 p PassFailPassFailPassFail Rey cutoff 6 N (%) 23 (95.8)1 (4.2)18 (85.7)3 (14.3) 28 (96.6) 1 (3.4) Rey cutoff 9 N (%) 22 (91.7)2 (8.3)11 (52.4)10 (47.6) 26 (89.7) 3 (10.3) Dot Countin g combo N (%) 18 (75)6 (25)12 (60)8 (40) 26 (92.9) 2 (7.1) TOMM 2 cutoff 45 N (%) 18 (90)2 (10)12 (66.7)6 (33.3) 27 (93.1)2 (6.9) Classification for the capital murder, other forensic and clinical control groups according to the effort tests
Discussion Comparison of countries of origin and sex- no differences were found Age and education were showed statistical significance ANOVAs were completed with the standardized residuals to determine differences between groups on effort tests
Discussion The Capital Murder group (CM) performed similarly to the Clinical Control group (CC) on both the Rey 15- Item Test and the Test of Memory Malingering The Other Forensic group (OF) tested with the least amount of effort on R-FIT and TOMM The Dot Counting Test proved to show no significant differences for any of the groups
Discussion Most interesting: the difference between the Capital Murder group and the Other Forensic group
Limitations and Future Research Design of the study Sample used Lack of comparison of control group for years spent within the United States. Known-groups design Extension of this research with larger samples within the United States Including other tests of effort Investigation of the correlation/relationship between the type of litigation individuals are involved in and testing effort
Summary & Questions These tests appear to be sufficient in addressing effort testing in Spanish speakers Important first step in the understanding of the use of neuropsychological tests with Spanish speakers in the U.S. The specificity of the tests for sub-populations is unknown Further studies, with replication and extension are needed for specificity and sensitivity to be determined At that point a better understanding of the value and limits of these tests will then be achieved