Transcript PSYCHOLOGICAL EVALUATION OF HISPANIC PATIENTS: …

PSYCHOLOGICAL EVALUATION OF
HISPANIC PATIENTS:
WHAT DOES TACO BELL KNOW ABOUT CRISTOBAL
COLON?
John Umstead Hospital, Butner, North Carolina
April 14, 2000
Antonio E. Puente
Department of Psychology
University of North Carolina at Wilmington
Wilmington, NC 28403-3297
Tel. 910.962.3812; Fax. 910.962.7010.
E-mail: [email protected]
GENERAL OUTLINE OF
PRESENTATION
1. Psychological Assessment of SpanishSpeakers
2. Review of practical Assessment
Instruments for the Spanish-Speaker
3. Case Presentations (Staff and Puente)
PSYCHOLOGICAL ASSESSMENT
OD SPANISH-SPEAKERS
1. Background of Confounds
2. Defining Hispanic
3. Demographics
4. Generic Difficulties
5. General Approaches
6. Interviewing
7. Psychological Testing
8. Neuropsychological Testing
9. Ethical, Training, & Public Policy Issues
10. Summary
BACKGROUND AND
CONFOUNDS
• Puente’s Biases
• A Matter of Perspectives:
The Case of Elian Gonzales
• Defining Ethnic-Minority:
The Case of the 2000 Census
Puente’s Biases
• Cuban
• Neuropsychologist
• Training in a University of Florida state
hospital
• Working as an academician and private
practice clinician
• Strong ties to Russian/Cuban and Spanish
psychology
A Matter of Perspectives:
The Case of Elian Gonzales
• Defining orientation
• Whose perspective?
• The problem of criterion validity
Defining Ethnic-Minority:
The case of the 2000 Census
• Majority Vs Minority group membership
• Difference between race and ethnicity
DEFINING HISPANIC
1. What is Hispanic?
2. Different Hispanics
3. Different Cultures and Languages
4. Intra-Ethnic Group Perceptions and
Conflicts
1. What is Hispanic?
• Language
• Religion
• Family
• Social Customs/Practices
• Educational
• Socio-Economic
2. Different Hispanics
• Latino, Chicano, Hispanic, etc.
• WISC/WAIS Expert Panel Group
Distinctions:
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Cuban
Puerto Rican
Mexican
Central American
South American
Spain
3. Different Cultures and
Languages
• Language
• Social/behavioral
• Cognitive
4. Intra-Ethnic group Perceptions
and Conflicts
• Racism and Racismo; Black Vs Hispanic
• Educational, vocational, political & social
differences
• Puerto Ricans Vs Cubans Vs Mexicans
• Spanish (Argentineans?) Vs all other
Hispanics
DEMOGRAPHICS
1. Counting Hispanics
– Green Cards
– Understanding the Census
2. United States Statistics
– Fastest growing ethnic-minority in the US
– Tend to have more children
– Current wave immigration to the US
3. North Carolina Trends
– North Carolina Catholic
– Migrant to blue-collar
– Major areas in North Carolina
GENERIC DIFFICULTIES
• Communication
• “Translated” Tests
• “Norms”
• Interpretation of results
• Cultural adaptation & educational
attainment
GENERAL APPROACHES
1. Translators
2. Family Involvement
3. Rapport
4. Acculturation
1. Translators
– Family Vs Non-Family
– Professional Vs Non-Professional
– Gold-Standard
2. Family Involvement
– Support
– Contamination
– Understanding Hispanic Family Dynamics
3. Rapport
– Time
– Relationship-Building
– Age
– Sex/Gender
– Socio-economic Differences
– Culture-Specific Customs
4. Acculturation
– Antecedents
– Processes
– Consequences
INTERVIEW
1. Records
2. General issues
3. Specific Concerns
1. Records
– Availability
– Comparability
2. General issues
– Structured Vs. Non-structured approaches
– Value & significance of a cultural
concept
– Modes of knowledge
– Modes of communication
– Specific terms or concepts
– Cognitive equivalence
3. Specific Concerns
– Family history
– Work history
– Religion
– Social
– Psychopathology
TESTING
1. General guidelines
2. Bias in Psychological Testing
3. The Use of Translated Tests
1. General Guidelines
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Use most recent version of the test
Administer the entire test
Appreciate prior test-taking experience
Test in the language selected by test-taker
Evaluate within the biopsychological
context
• Understand the importance of acculturation
• Interpret the results in light of empirical
data
• Always use a variety of tests scores to
arrive at conclusions
2. Bias in Psychological Testing
• Inappropriate content
• Inappropriate standardization samples
• Examiner and language bias
• Inequitable social consequences
• Measurement of different constructs
• Differential predictive validity
3. The Use of Translated Tests
• Copyright issues
• Language of translation
• Back translations
• Technically correct-Psychologically wrong
SELECTED
PSYCHOLOGICAL TESTS SPAIN
1. PERSONALITY
2. AFFECTIVE
3. DEVELOPMENTAL
1. Personality
– MMPI
– CAQ, Cuestinario de Analisis Clinico
– Cuestinario de Personalidad
• Pinillas
• Eysenk
• Cattell
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Cuestinario Psicologica de California
Kuder
16 PF
Myers-Briggs
2. Affective
• Inventario de Situaciones y Respuetas de
Ansiedad
• Inventario de Actividad de Jenkins
• Cuestinario de Ansiedad Estado/Rasgo
(adutos/ninos)
3. Developmental
• Frostig
• Test Illinois de Aptitudes Psicolinguisticos
SELECTED
NEUROPSYCHOLOGICAL TESTS SPAIN
1. Communication
2. Memory
3. Spatial & Praxic
4. Cognition
5. Intellectual
6. Battery
1. Communication
• Test de Vocabulario de Boston
2. Memory
• Benton
• Rivermead
3. Spatial & Praxic
• Rey
• Harris Test de la Dominancia Lateral
4. Cognition
• Stroop
5. Intellectual
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WAIS
WISC
WPPSI
Bayley
Otis
Factor “g”
6. Battery
• Test de Barcelona
• Luria
SELECTED PSYCHOLOGICAL
TESTS - UNITED STATES
1. PERSONALITY
– MMPI
– 16 PF
2. AFFECTIVE
– Speilberger
– Beck-II
3. DEVELOPMENTAL
SELECTED
NEUROPSYCHOLOGICAL TESTSUNITED STATES
1. Orientation & Attention
2. Communication
3. Memory
4.Spatial & Praxic Ability
5.Cognition/Intellectual
6. Battery
1. Orientation & Attention
• Mini-mental state
• Digit Symbols
• “A” Cancellation Test
2. Communication
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Spanish Naming Test
Boston Diagnostic Aphasia
Spanish Repetition Test
Reading & Writing Abilities Test
Spanish Phonemic Discrimination Test
Spanish Grammar Test
Verbal Fluency
3. Memory
• Verbal Serial Learning Curve
• Digit Span
• Facial memory Test
4. Spatial & Praxic Abilities
• Draw a Cube
• Finger Tapping
5. Cognition/Intellectual
• EIWA
• Beta III
• Peabody
• Woodcock-Munoz
6. Battery
• Luria
ETHICAL, TRAINING &
PUBLIC POLICY ISSUES
1. Personnel & Pipeline Issues: Where is Our
Future
2. Increase the Number of Tests and Norms
Currently Available
3. Encourage Publishing Companies to
Support These Issues
4. Support the Research that Provides the
Foundation for Clinical Activity
5. Teach Students about Ethnic Diversity in
Both Clinical and Academic Settings
6. Being “Aware” is Simply Not Enough
SUMMARY
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Defining Hispanic
Changing Demographics
Multi-Dimensional Problems
The Question of Cognitive Equivalence
Importance of Using a variety of Tests and
Sources of Information
• What is the Criterion?
• Where Do We Go From Here?
Table 1.
Ethnicity and Race According to the
1990 U.S. Census Data:Origin, Total
Number, and Subgroups
Table 2.
Several Structured Interviews Applicable
to Ethnic-Minority Population