Although the role of culture has increasingly gained acceptance in clinical neuropsychology, relatively minimal research exists regarding the actual impact on clinical activities. In this study, we assess how using North American neuropsychological tests affects diagnostic accuracy in cognitive disorders of culturally diverse individuals. To address this question, participants from Colombia, Morocco, and Spain were administered five commonly used neuropsychological tests and the test results were used to determine whether they would be classified as having the DSM-5 diagnostic criteria for Mild Cognitive and Major Cognitive Disorder. Results reveal that diagnostic error occurred up to 20% of the time, and that the frequency of misdiagnosis differed by nationality. These results provide evidence that using tests from one culture to assess individuals from other cultures produces significant false positives. Findings are discussed in terms of the foundations of neuropsychological assessment and its relationship to cultural variables.
Batería de Evaluación Neuropsicológica Infantil (BENCI) is a computerized battery for the neuropsychological evaluation of children. This battery has been used in different studies to evaluate neuropsychological functions and neurodevelopment in children. The objective of this study is to test the validity and reliability of the first Arabic version of the BENCI on an Arabic population where neuropsychological tests are very scarce. We administrate the BENCI to 198 school-age children (98 boys and 100 girls) from Morocco. To examine the test retest reliability of the BENCI battery, we administered the battery 2 times to 43 children (23 boys and 20 girls) with 15 days in between the pre- and posttest. The results revealed good validity and reliability of the battery in Arabic children. Also, the BENCI battery has demonstrated the capacity to differentiate between children by their age group. This battery can be of great use to both the research and clinical areas of Arabic countries and/or in assistance to Arabic immigrants that live outside of their native country.
Although Arabic is one of the most widely used languages in the world, little is known on the availability of standardized neuropsychological tests in Arabic. We review the literature published before 2016, using the keywords Arab*, cogniti*, and neuropsycholo*, as well as keywords for each Arab country. PubMed, PsycINFO, Education Source, Academic Search Complete, Education Resources Information Center, Shamaa, and Arabpsynet databases were searched, in addition to a selected number of Arabic medical and educational journals. After excluding case reports, studies conducted on Arab groups residing outside the Arab world or Israel, and studies that employed intelligence scales or cognitive screens without standardization, 384 studies were eventually reviewed. Tests with most extensive use, adaptation, validation and norming were identified. The Raven Matrices, with its variants, was the most normed cognitive test for Arab individuals (normed in 16 countries). The rate of neuropsychology publications from the Arab countries combined, per year, was less than half of that of each American journal (top 10 journals pertaining to cognition). Nonetheless, the rate in Arab countries has increased after 2010. Publications were mostly from Egypt and Saudi Arabia, but the ratio of test adaptation-to-publication was the largest in Jordan and Lebanon. Approximately half of these publications did not employ cognitive tests that were developed, translated, adapted, or standardized according to international guidelines of psychological measurement. We provide recommendations on improving clinical neuropsychology to better serve Arab patients.
Situations of war and military conflict have been linked to the development of Post-Traumatic Stress Disorder (PTSD). To our knowledge, there are no studies that have examined, within the same conflict and the same culture, exposure to different traumatic events or traumatic events of different intensity. The aim of this study was to evaluate the symptoms of PTSD among Palestinian schoolchildren in two different areas of Hebron. A total of 381 schoolchildren from different parts of Hebron participated in the study. To evaluate the symptoms of PTSD, the children were asked to complete the Child Post Traumatic Stress Reaction Index. To evaluate the traumatic events experienced, they completed the Gaza Traumatic Event Checklist. Results indicate that 77.4% of the children living in Hebron show symptoms of moderate-to-severe PTSD, and 20.5% of them meet the DSM-IV diagnostic criteria for chronic PTSD. There were no significant differences in total symptoms between the two areas of Hebron, but there were differences within the specific types of symptoms. It is clear that the traumatic events of the war lead to the development of post-traumatic stress in children and that psychological intervention is necessary.Literature suggests that exposure to the traumatic events of war is related to high levels of PTSD among the victims of military conflicts. However, there are important differences between the stressors and prevalence of PTSD in each conflict due to cultural differences, type of conflict, and PTSD instruments ad-
Different studies have demonstrated that culture has a basic role in intelligence tests performance. Nevertheless, the specific neuropsychological abilities used by different cultures to perform an intelligence test have never been explored. In this study, we examine the differences between Spaniards and Moroccans in the neuropsychological abilities utilized to perform the Beta III as a non-verbal intelligence test. The results showed that the Spaniard group obtained a higher IQ than the Moroccan group in the Beta III. Moreover, the neuropsychological abilities that predicted scores for the Beta III were dependent on the country of origin and were different for each subtest. Besides showing the cultural effect on non-verbal intelligence test performance, our results suggest that a single test may measure different functions, depending on the subject's cultural background.
Objective Previous research has shown that cognitive tests can lead to misclassification when applying non-representative norms to measure cognitive performance. The objective of this study was to investigate whether this misclassification also occurs with a non-verbal so-called “culture-free” intelligence test administered to different age groups. Method The intelligence of a sample of healthy Moroccan children (N = 147) ages 7, 9, and 11 was assessed using the Coloured Raven’s Progressive Matrices (CPM). Raw scores were used to study age differences, as well as misclassifications when applying the norms of three countries culturally different from Morocco (United Kingdom, Spain, and Oman). Results Intelligence performance was not within the normal range when non-representative norms were applied to the Moroccan raw scores. Misclassifications accounted for a large percentage of the participants that supposedly displayed intelligence deficits, especially when applying the British norms. Up to 15.68% of the healthy children fell within the “intellectually impaired” range, and up to 62.5% fell “below average,” with these percentages especially higher at older ages. Conclusions Our findings confirm that “culture-free” tests should be adapted to each culture and applied together with their culture’s specific norms to prevent misclassification and allow for a better, unbiased neuropsychological assessment.
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