INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #19 Interpretation of Effort and Cultural Variables in Neuropsychological Assessment omar assaly, Wright State University, Dayton, United States tyler ramsey, Wright State, Dayton, United States julie williams, Wright State, Dayton, United States Category: Assessment/Psychometrics/Methods (Adult) Keyword 1: acculturation Keyword 2: assessment Keyword 3: multiculturalism Objective: Patients may exaggerate psychological or physiological symptoms for various reasons. These exaggerations are often found via behavioral observations and validity measures (Carone et. Al, 2010). Validity is crucial for neuropsychologists as assessments are utilized in legal consultations and evaluations, impacting proof of injury, liability, and disability assistance determinations. The American Academy of Clinical Neuropsychology (AACN) has come to the consensus that validity in neuropsychological testing must be proactively addressed (Sweet et al., 2021). Many contextual and cultural variables may impact the scores suggested by validity measures. The objective of this poster is to investigate how cultural and contextual variables can impact testing performance to avoid misinterpretation of invalid scores. Participants and Methods: Literature between 2000 and 2023 was obtained by searching on Google Scholar and PubMed databases. Keywords such as Culture, Effort, and Neuropsychology were used. Articles were selected on the criterion of relevance to the objective. Themes were then clustered to identify cultural and contextual variables that impact effort put forth during neuropsychological assessment. Results: The research identified variables for minority group distinction, including nationality, cultural distance, language, regional prevalence, reference group size, and majority group attitudes (Ardila, 2007). These factors impact an individual’s test-taking attitude, understanding of the test, and willingness to share information with the provider (Heilbronner et al., 2009). Patients from diverse backgrounds may experience isolation, low self-esteem, depression due to cultural minority status and homesickness, or “cultural solitude” (Ardila, 2007). Although new normative data has been developed, many norms continue to come from white, middle-class, English-speaking individuals with 12 years of education or more, further impacting the interpretation of effort in underrepresented groups (Casaletto & Heaton, 2017). Patients who put forth suboptimal effort in testing will often report being partially disengaged from testing because of not understanding the task versus intentional efforts to distort testing outcomes (Postal & Armstrong, 2013). Postal & Armstrong (2013) noted the importance of utilizing the invalid test findings to open dialogue with the patient to gain a better understanding of the individual and their concerns. Conclusions: The validity of neuropsychological assessments relies on the individual’s effort and can be influenced by cultural factors affecting comfort and understanding of instructions. Norms continue to be developed on those who are white, middle-class, educated, English speakers. Limiting norms in this way further disadvantages underrepresented groups. Therefore, researchers have recommended one strategy to maximize validity outcomes is to suspend testing when a validity measure has indicated invalid results and re-engage the client in the process by exploring identified barriers to the effort. Doing so, to preserve the effort measures, as well as retaining the individual’s confidence in testing may enhance the integrity of testing data (Armstrong & Postal, 2013; Carone et al., 2010). Further research is needed to bridge cultural differences in assessment understanding and participation, along with ongoing focus on diverse normative data. Clinicians should address cultural differences by using interpreters as needed, enhancing cultural competency through training, assessing acculturation during sessions, and collaberating with other providers experiences in working with cultural backgrounds.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #19

Interpretation of Effort and Cultural Variables in Neuropsychological Assessment

omar assaly, Wright State University, Dayton, United States
tyler ramsey, Wright State, Dayton, United States
julie williams, Wright State, Dayton, United States

Category: Assessment/Psychometrics/Methods (Adult)

Keyword 1: acculturation
Keyword 2: assessment
Keyword 3: multiculturalism

Objective:

Patients may exaggerate psychological or physiological symptoms for various reasons. These exaggerations are often found via behavioral observations and validity measures (Carone et. Al, 2010). Validity is crucial for neuropsychologists as assessments are utilized in legal consultations and evaluations, impacting proof of injury, liability, and disability assistance determinations. The American Academy of Clinical Neuropsychology (AACN) has come to the consensus that validity in neuropsychological testing must be proactively addressed (Sweet et al., 2021). Many contextual and cultural variables may impact the scores suggested by validity measures. The objective of this poster is to investigate how cultural and contextual variables can impact testing performance to avoid misinterpretation of invalid scores.

Participants and Methods:

Literature between 2000 and 2023 was obtained by searching on Google Scholar and PubMed databases. Keywords such as Culture, Effort, and Neuropsychology were used. Articles were selected on the criterion of relevance to the objective. Themes were then clustered to identify cultural and contextual variables that impact effort put forth during neuropsychological assessment.

Results:

The research identified variables for minority group distinction, including nationality, cultural distance, language, regional prevalence, reference group size, and majority group attitudes (Ardila, 2007). These factors impact an individual’s test-taking attitude, understanding of the test, and willingness to share information with the provider (Heilbronner et al., 2009). Patients from diverse backgrounds may experience isolation, low self-esteem, depression due to cultural minority status and homesickness, or “cultural solitude” (Ardila, 2007). Although new normative data has been developed, many norms continue to come from white, middle-class, English-speaking individuals with 12 years of education or more, further impacting the interpretation of effort in underrepresented groups (Casaletto & Heaton, 2017). Patients who put forth suboptimal effort in testing will often report being partially disengaged from testing because of not understanding the task versus intentional efforts to distort testing outcomes (Postal & Armstrong, 2013). Postal & Armstrong (2013) noted the importance of utilizing the invalid test findings to open dialogue with the patient to gain a better understanding of the individual and their concerns.

Conclusions:

The validity of neuropsychological assessments relies on the individual’s effort and can be influenced by cultural factors affecting comfort and understanding of instructions. Norms continue to be developed on those who are white, middle-class, educated, English speakers. Limiting norms in this way further disadvantages underrepresented groups. Therefore, researchers have recommended one strategy to maximize validity outcomes is to suspend testing when a validity measure has indicated invalid results and re-engage the client in the process by exploring identified barriers to the effort. Doing so, to preserve the effort measures, as well as retaining the individual’s confidence in testing may enhance the integrity of testing data (Armstrong & Postal, 2013; Carone et al., 2010). Further research is needed to bridge cultural differences in assessment understanding and participation, along with ongoing focus on diverse normative data. Clinicians should address cultural differences by using interpreters as needed, enhancing cultural competency through training, assessing acculturation during sessions, and collaberating with other providers experiences in working with cultural backgrounds.