Neuropsychological Assessment of Ethnic Minorities Clinical Issues

Antonio E. Puente

Department of Psychology

University of North Carolina at Wilmington

Wilmington, North Carolina

Miguel Perez-Garcia

Department of Psychology Universidad de Granada Granada, Spain

The psychology of individual differences underscores the importance of understanding the unique qualities of the person. Of particular importance is the issue of understanding the role of culture in the assessment of psychological abilities and disabilities. Indeed, the third article ever published in English on psychological assessment (Willey & Herskovits, 1927) was entitled "Psychology and Culture." In that article the influence of culture on human behavior as measured by psychological testing is debated. Over the last quarter of a century, it has become widespread knowledge that ethnic minorities represent a unique challenge to psychological assessment. Whether the issue is that of bias (e.g., Jensen, 1980) or cultural equivalence (e.g., Helms, 1992), most scientists and professionals have come to understand the unique challenges that must be faced to develop a comprehensive understanding of all individuals. Indeed, that is the purpose of this volume.

Although the preceding argument has become commonplace, its application to all areas of psychological assessment has not been realized (Betancourt & Lopez, 1993). This is clearly the case in one of the fastest and most important

Handbook of Multicultural Mental Health: Assessment and Treatment of Diverse Populations Copyright © 2000 by Academic Press. All rights of reproduction in any form reserved.

areas of psychological assessment, the evaluation of the behavioral, cognitive, and emotional sequalae of injury to the brain. Over the last 20 years, clinical neuropsychology has grown to become an important area of professional psychology (Puente, 1992; Puente & Marcotte, in press). Despite its unprecedented growth and impact, both in psychology and in medicine (most notably in neurology), the field has not considered the important variable of culture in its unique approach to the measurement of humans. Whether this ignorance is due to a willful disregard of ethnic minorities and cultural variables or simply historical inertia is rarely speculated (Puente & Perez-Garcia, in press) and not the topic of this chapter.

The purpose of this chapter is to attempt to alleviate this gross misunderstanding. Initially, we will outline the objectives and development of what is now being called cross-cultural neuropsychology. Traditionally, cross-cultural psychology has dealt with the comparisons of persons across distinct cultures (e.g., North Americans Europeans). In this case, we will expand the approach to subsume the contrast and comparisons of individuals from a majority group to those of a minority group. In fact, we define ethnicity much in the same way one would define culture. After outlining the objectives and development of the discipline, we will turn our attention to the application of these principles to neuropsychological evaluation. Issues such as illiteracy and adaptation will be considered. In addition, specific strategies for interviewing, testing, and interpreting results will be presented. Finally, suggestions for future training and research in the area will be considered.

It is important to note that although we look forward to presenting a new model as a solution to a long-standing problem in neuropsychology and the understanding of ethnic minorities, we realize the unique nature of our assumptions, model, and implications. To that end, we trust that the reader will consider this chapter as an introduction to a complex issue in neuropsychology and the psychological assessment of nonmajority group members. Further, we invite the reader to critique, revise, and expand this important and new area in neuropsychology and the assessment of the ethnic minority.

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