D Rivera

Methodology for the development of normative data for ten Spanish-language neuropsychological tests in eleven Latin American countries.

BACKGROUND Within the field of neuropsychology, there is a significant lack of normative data for individuals in Latin America. OBJECTIVE To describe the methodology utilized to obtain the data and create norms for 10 Spanish-language neuropsychological tests administered in 11 Latin-American countries in a sample of 3,977 healthy individuals between the ages 18 and 90. METHOD The same data manipulation process was applied to the data collected (regardless of the scale or country) using a regression-based procedure that takes into account sex, age, and educational influences on neuropsychological test scores. CONCLUSIONS Following this procedure, we were able to generate age, education, and sex (if relevant) based norms for each test in each of the 11 countries studied. These norms are presented in the 10 articles that comprise this special issue.

Profession of neuropsychology in Latin America

ABSTRACT The purpose of this study was to analyze characteristics of individuals working in the profession of neuropsychology in Latin America in order to understand their background, professional training, current work situation, assessment and diagnostic procedures used, rehabilitation techniques employed, population targeted, teaching responsibilities, and research activities. A total of 808 professionals working in neuropsychology from 17 countries in Latin America completed an online survey between July 2013 and January 2014. The majority of participants were female and the mean age was 36.76 years (range 21–74 years). The majority of professionals working in neuropsychology in Latin America have a background in psychology, with some additional specialized training and supervised clinical practice. Over half work in private practice, universities, or private clinics and are quite satisfied with their work. Those who identify themselves as clinicians primarily work with individuals with learning problems, ADHD, mental retardation, TBI, dementia, and stroke. The majority respondents cite the top barrier in the use of neuropsychological instruments to be the lack of normative data for their countries. The top perceived barriers to the field include: lack of academic training programs, lack of clinical training opportunities, lack of willingness to collaborate between professionals, and lack of access to neuropsychological instruments. There is a need in Latin America to increase regulation, improve graduate curriculums, enhance existing clinical training, develop professional certification programs, validate existing neuropsychological tests, and create new, culturally-relevant instruments.

Past, present, and future of neuropsychology in Argentina

Abstract Objective: To describe the history, current situation, and future challenges of Argentinian neuropsychology. Method: A brief historical description highlighting the most representative authors and publications is made. In addition, a survey was administered to a sample of 135 neuropsychologists practicing neuropsychology in Argentina. The survey explored the current neuropsychological practices among the respondents. Results: Results show that most Argentinian neuropsychologists are: psychologists, women, and work in the clinical field in the country’s major cities. Besides, the practice of neuropsychology is mostly unregulated with few training opportunities. Conclusions: Argentinian neuropsychology emerged from neurology in the early twentieth century and slowly progressed until the 1960s when the first organized research groups were created. Since then, a substantial and steady progress followed. However, more training opportunities and a better regulation of the discipline are needed. No similar studies have been conducted in the past, thus becoming one of the first to describe the development of neuropsychology in Argentina.

Following international trends while subject to past traditions: neuropsychological test use in the Nordic countries

Abstract Objective: Historically, the neuropsychological test traditions of the four Nordic countries have spanned from the flexible and qualitative tradition of Luria-Christensen to the quantitative large battery approach of Halstead and Kløve–Matthews. This study reports current test use and discusses whether these traditions still influence attitudes toward test use and choice of tests. Method: The study is based on survey data from 702 Nordic neuropsychologists. Results: The average participant used 9 tests in a standard assessment, and 25 tests overall in their practice. Test use was moderated by nationality, competence level, practice profile, and by attitude toward test selection. Participants who chose their tests flexibly used fewer tests than those adhering to the flexible battery approach, but had fewer tests from which to choose. Testing patients with psychiatric disorders was associated with using more tests. IQ, memory, attention, and executive function were the domains with the largest utilization rate, while tests of motor, visual/spatial, and language were used by few. There is a lack of academic achievement tests. Screening tests played a minor role in specialized assessments, and symptom validity tests were seldom applied on a standard basis. Most tests were of Anglo-American origin. Conclusions: New test methods are implemented rapidly in the Nordic countries, but test selection is also characterized by the dominating position of established and much researched tests. The Halstead–Reitan and Luria traditions are currently weak, but national differences in size of test batteries seem to be influenced by these longstanding traditions.

Caregiving in Dementia and its Impact on Psychological Functioning and Health-Related Quality of Life: Findings from a Colombian Sample

Existing published studies about health-related quality of life (HRQOL) in caregivers of dementia patients living in Latin American countries are very limited. However, cultural aspects, personal values, and social structure may affect the way caregivers experience their role in different societies. The current study investigated the relationship between HRQOL and psychological factors using a cross-sectional design. The sample consisted of 102 informal caregivers of patients with dementia from Bogotá, Colombia, South America. Measures included the Patient Health Questionnaire (PHQ-9) for depression, the Satisfaction with Life Scale (SWLS), the Zarit Burden Interview, and the Short Health Questionnaire (SF36) for HRQOL. Canonical correlations revealed that there was a significant relationship between caregivers’ mental health and HRQOL, such that caregivers with better satisfaction with life and less symptoms of depression had more vitality and better general health. There is a strong relationship between mental health and health-related quality of life in Colombian caregivers of dementia patients living in their country of origin. Specific aspects of mental health, including satisfaction with life and depression, need to be addressed in order to improve caregivers’ quality of life. Given that mental health care resources may be scarce in Latin American countries, culturally appropriate interventions should focus on preventing/treating depression and promote life satisfaction, as a way to improve their quality of life.

Symbol Digit Modalities Test: Normative data for the Latin American Spanish speaking adult population

OBJECTIVE To generate normative data on the Symbol Digit Modalities Test (SDMT) across 11 countries in Latin America, with country-specific adjustments for gender, age, and education, where appropriate. METHOD The sample consisted of 3,977 healthy adults who were recruited from Argentina, Bolivia, Chile, Cuba, El Salvador, Guatemala, Honduras, Mexico, Paraguay, Peru, and, Puerto Rico. Each subject was administered the SDMT as part of a larger neuropsychological battery. A standardized five-step statistical procedure was used to generate the norms. RESULTS The final multiple linear regression models explained 29-56% of the variance in SDMT scores. Although there were gender differences on the SDMT in Mexico, Honduras, Paraguay, and Guatemala, none of the four countries had an effect size greater than 0.3. As a result, gender-adjusted norms were not generated. CONCLUSIONS This is the first normative multicenter study conducted in Latin America to create norms for the SDMT; this study will have an impact on the future practice of neuropsychology throughout the global region.

Rey-Osterrieth Complex Figure - copy and immediate recall: Normative data for the Latin American Spanish speaking adult population.

OBJECTIVE To generate normative data on the Rey-Osterrieth Complex Figure Test (ROCF) across 11 countries in Latin America, with country-specific adjustments for gender, age, and education, where appropriate. METHOD The sample consisted of 3,977 healthy adults who were recruited from Argentina, Bolivia, Chile, Cuba, El Salvador, Guatemala, Honduras, Mexico, Paraguay, Peru, and, Puerto Rico. Each subject was administered the ROCF as part of a larger neuropsychological battery. A standardized five-step statistical procedure was used to generate the norms. RESULTS The final multiple linear regression models explained 7-34% of the variance in ROCF copy scores and 21-41% of the variance in immediate recall scores. Although t-tests showed significant differences between men and women on ROCF copy and immediate recall scores, none of the countries had an effect size larger than 0.3. As a result, gender-adjusted norms were not generated. CONCLUSIONS The present study is the first to create norms for the ROCF in Latin America. As a result, this study will have important implications for the formation and practice of neuropsychology in this region.

Standard form of the Boston Naming Test: Normative data for the Latin American Spanish speaking adult population.

OBJECTIVE To generate normative data on the Boston Naming Test (BNT) across 10 countries in Latin America, with country-specific adjustments for gender, age, and education, where appropriate. METHOD The sample consisted of 3,779 healthy adults who were recruited from Argentina, Bolivia, Chile, Cuba, El Salvador, Guatemala, Mexico, Paraguay, Peru, and, Puerto Rico. Each subject was administered the BNT as part of a larger neuropsychological battery. A standardized five-step statistical procedure was used to generate the norms. RESULTS The final multiple linear regression models explained between 3-32% of the variance in BNT scores. Although t-tests showed significant differences between men and women for Mexico, Argentina, Chile, Cuba, Guatemala, and Bolivia on the BNT, none of the six countries had an effect size larger than 0.3. As a result, gender-adjusted norms were not generated. CONCLUSIONS This is the first normative multicenter study conducted in Latin America to generate norms for the BNT; this study will have substantial repercussions for the practice of neuropsychology throughout the global region.

Verbal fluency tests: Normative data for the Latin American Spanish speaking adult population

OBJECTIVE To generate normative data for the Verbal Fluency Tests across 11 countries in Latin America, with country-specific adjustments for gender, age, and education, where appropriate. METHOD The sample consisted of 3,977 healthy adults who were recruited from Argentina, Bolivia, Chile, Cuba, El Salvador, Guatemala, Honduras, Mexico, Paraguay, Peru, and, Puerto Rico. Each subject was administered the Verbal Fluency Test as part of a larger neuropsychological battery. A standardized five-step statistical procedure was used to generate the norms. RESULTS The final multiple linear regression models for the letter F explained 8-30% of the variance, 7-32% for letter A, 8-32% for the letter S, and 16-43% for the animal category in Verbal Fluency Test scores. Although t-tests showed significant differences between men and women on the Verbal Fluency Test, they did not have an effect size larger than 0.3. As a result, gender-adjusted norms were not generated. CONCLUSIONS This is the first normative multicenter study conducted in Latin America aiming to create norms for the Verbal Fluency Test; this study will have important outcomes for the future of neuropsychology in the region.

Modified Wisconsin Card Sorting Test (M-WCST): Normative data for the Latin American Spanish speaking adult population

OBJECTIVE To generate normative data on the Modified Card Sorting Test (M-WCST) across 11 countries in Latin America, with country-specific adjustments for gender, age, and education, where appropriate. METHOD The sample consisted of 3,977 healthy adults who were recruited from Argentina, Bolivia, Chile, Cuba, El Salvador, Guatemala, Honduras, Mexico, Paraguay, Peru, and Puerto Rico. Each subject was administered the M-WCST as part of a larger neuropsychological battery. A standardized five-step statistical procedure was used to generate the norms. RESULTS The final multiple linear regression models explained between 2-33% of the variance in M-WCST scores. Although t-tests showed significant differences between men and women from seven different countries on the M-WCST, the effect sizes were small. As a result, gender-adjusted norms were not generated. CONCLUSIONS This is the first normative multicenter study conducted in in Latin America aiming to create norms for the M-WCST; this study will have important implications for the future of neuropsychology in the region.