INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Majestic Complex (Posters 61-120) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #73 The Need for Multicultural Assessment and Competencies: A Case of Bosnian Adolescence and Historical Traumatic Brain Injury Lauren Olson, Saint Louis University, St Louis, United States David Kaufman, Saint Louis University, St. Louis, United States Category: Cross Cultural Neuropsychology/ Clinical Cultural Neuroscience Keyword 1: cross-cultural issues Keyword 2: traumatic brain injury Keyword 3: adolescence Objective: Objective: An appreciation for the multicultural variables relevant to neuropsychological assessment in Bosnian clientele is limited and increasingly sparse in consideration of the lack of available literature pertaining to ethnically minoritized children and adolescents. Cognitive and psychiatric assessment measures have not traditionally been translated nor adapted to the Bosnian culture and, thus, a culturally valid and thorough assessment of neuropsychological functioning is traditionally hindered. We evaluated an 18-year-old Bosnian female with prior diagnoses of ADHD and bipolar disorder following social work request for a comprehensive understanding of current cognitive and psychiatric functioning secondary to a sustained severe traumatic brain injury in early childhood outside of the USA. The assessment process revealed marked limitations in contemporary neuropsychological practices in providing culturally competent services to Bosnian adolescents from non-English speaking families. Participants and Methods: Participants & Methods: A single-case design. Ms. X presented for neuropsychological assessment at an outpatient mental health center operated by a doctoral psychology training program in St. Louis, MO. Workup included extensive review of available inpatient and outpatient American medical records, biopsychosocial interview conducted with Ms. X (fluent English speaker) and her mother (assisted by interpretive services), and comprehensive neuropsychological assessment. Results: Results: Results of evaluation indicated Ms. X’s general intellectual abilities were in the exceptionally low range, with comparable verbal and nonverbal abilities, consistent with below average to exceptionally low academic abilities. Cognitive weaknesses were observed on tasks of visual confrontation naming, spontaneous verbal free recall and recognition, and task-switching. Cognitive impairments were observed on tasks of phonemic verbal fluency, processing speed, simple auditory registration and complex working memory, verbal task inhibition, and visuospatial integration, memory, and construction. Notably, some of the verbal measures used demonstrate marked susceptibility to linguistic and cultural bias. A subjective and objective assessment of mood and psychiatric symptom experience highlighted cultural barriers of traditional psychological terms; for example, symptoms of depression were often described as “boredom”. This discrepancy was further highlighted in disparities observed on self- and teacher-report ratings of emotional distress. Ultimately, Ms. X was found to meet criteria for Mild Neurocognitive Disorder secondary to known history of complicated severe TBI with loss of consciousness of unspecified duration and Major Depressive Disorder with severe anxious distress. Conclusions: Conclusions: This case study highlights concern regarding limitations in neuropsychological assessment practices when providing services to individuals of diverse ethnic and linguistic backgrounds, particularly those less represented in the literature (i.e., Bosnian). It further highlights the need for intentional training in multicultural assessment across the field, particularly during doctoral training, as many ethnic immigrants experience notable financial and systemic (i.e., insurance) barriers to obtaining neuropsychological assessment in an academic medical center or private practice context. Neuropsychology trainees and providers should take care to become knowledgeable about the diverse cultures in their immediate contexts as to be prepared to meet the needs of clientele in competently assessing cognitive and psychiatric functioning, collaborating with families and referral sources, and making appropriate recommendations.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Majestic Complex (Posters 61-120)

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

Final Abstract #73

The Need for Multicultural Assessment and Competencies: A Case of Bosnian Adolescence and Historical Traumatic Brain Injury

Lauren Olson, Saint Louis University, St Louis, United States
David Kaufman, Saint Louis University, St. Louis, United States

Category: Cross Cultural Neuropsychology/ Clinical Cultural Neuroscience

Keyword 1: cross-cultural issues
Keyword 2: traumatic brain injury
Keyword 3: adolescence

Objective:

Objective: An appreciation for the multicultural variables relevant to neuropsychological assessment in Bosnian clientele is limited and increasingly sparse in consideration of the lack of available literature pertaining to ethnically minoritized children and adolescents. Cognitive and psychiatric assessment measures have not traditionally been translated nor adapted to the Bosnian culture and, thus, a culturally valid and thorough assessment of neuropsychological functioning is traditionally hindered. We evaluated an 18-year-old Bosnian female with prior diagnoses of ADHD and bipolar disorder following social work request for a comprehensive understanding of current cognitive and psychiatric functioning secondary to a sustained severe traumatic brain injury in early childhood outside of the USA. The assessment process revealed marked limitations in contemporary neuropsychological practices in providing culturally competent services to Bosnian adolescents from non-English speaking families.

Participants and Methods:

Participants & Methods: A single-case design. Ms. X presented for neuropsychological assessment at an outpatient mental health center operated by a doctoral psychology training program in St. Louis, MO. Workup included extensive review of available inpatient and outpatient American medical records, biopsychosocial interview conducted with Ms. X (fluent English speaker) and her mother (assisted by interpretive services), and comprehensive neuropsychological assessment.

Results:

Results: Results of evaluation indicated Ms. X’s general intellectual abilities were in the exceptionally low range, with comparable verbal and nonverbal abilities, consistent with below average to exceptionally low academic abilities. Cognitive weaknesses were observed on tasks of visual confrontation naming, spontaneous verbal free recall and recognition, and task-switching. Cognitive impairments were observed on tasks of phonemic verbal fluency, processing speed, simple auditory registration and complex working memory, verbal task inhibition, and visuospatial integration, memory, and construction. Notably, some of the verbal measures used demonstrate marked susceptibility to linguistic and cultural bias. A subjective and objective assessment of mood and psychiatric symptom experience highlighted cultural barriers of traditional psychological terms; for example, symptoms of depression were often described as “boredom”. This discrepancy was further highlighted in disparities observed on self- and teacher-report ratings of emotional distress. Ultimately, Ms. X was found to meet criteria for Mild Neurocognitive Disorder secondary to known history of complicated severe TBI with loss of consciousness of unspecified duration and Major Depressive Disorder with severe anxious distress.

Conclusions:

Conclusions: This case study highlights concern regarding limitations in neuropsychological assessment practices when providing services to individuals of diverse ethnic and linguistic backgrounds, particularly those less represented in the literature (i.e., Bosnian). It further highlights the need for intentional training in multicultural assessment across the field, particularly during doctoral training, as many ethnic immigrants experience notable financial and systemic (i.e., insurance) barriers to obtaining neuropsychological assessment in an academic medical center or private practice context. Neuropsychology trainees and providers should take care to become knowledgeable about the diverse cultures in their immediate contexts as to be prepared to meet the needs of clientele in competently assessing cognitive and psychiatric functioning, collaborating with families and referral sources, and making appropriate recommendations.