Lo Cultural en Cross Lo Cultural en Cross Cultural Cultural

NeuropsychologyNeuropsychologyAntonio E. PuenteAntonio E. Puente

University of North Carolina at WilmingtonUniversity of North Carolina at Wilmington

Universidad de los AndesUniversidad de los AndesAgosto 26, 2004Agosto 26, 2004

OutlineOutline

BackgroundBackground Basic ConceptsBasic Concepts Research ProgramResearch Program Possible InterpretationsPossible Interpretations Future ConsiderationsFuture Considerations

BackgroundBackground

HeritageHeritage Education & TrainingEducation & Training Clinical Work and its LimitationsClinical Work and its Limitations

Basic ConceptsBasic Concepts

Clinical NeuropsychologyClinical Neuropsychology• HistoryHistory• Current PerspectivesCurrent Perspectives

Typical Clinical ActivitiesTypical Clinical Activities Typical PatientsTypical Patients Focus on Detecting ImpairmentsFocus on Detecting Impairments

Basic Concepts IIBasic Concepts II

CultureCulture• Definition = Unwritten Social Rules of Definition = Unwritten Social Rules of

ConductConduct• Author of Rules = Majority GroupAuthor of Rules = Majority Group• Operant Conditioning of Cultural ConceptsOperant Conditioning of Cultural Concepts

ReinforcementReinforcement• Access to power, money, social opportunitiesAccess to power, money, social opportunities

PunishmentPunishment• Increased probability of poverty, illness, and Increased probability of poverty, illness, and

isolationisolation

Basic Concepts: IntegrationBasic Concepts: Integration Does Clinical Neuropsychology Tests Does Clinical Neuropsychology Tests

Measure the Majority Group Culture´s Measure the Majority Group Culture´s Notion of Acceptable Behavior?Notion of Acceptable Behavior?

If so, is Brain Damage or Impairment If so, is Brain Damage or Impairment Nothing More than a Misunderstanding or Nothing More than a Misunderstanding or Misapplication of Prevailing Social Rules?Misapplication of Prevailing Social Rules?

Finally, is There a Neuropsychological Finally, is There a Neuropsychological “g”, i.e., Common Cognitive and “g”, i.e., Common Cognitive and Emotional Variables Shared Across All Emotional Variables Shared Across All Cultures?Cultures?

Research ProgramResearch Program

United StatesUnited States Puerto RicoPuerto Rico ArgentinaArgentina SpainSpain RussiaRussia BrazilBrazil KenyaKenya

United StatesUnited States

Intellectual (The Psychological Intellectual (The Psychological Corporation)Corporation)• Translation and Standardization of the Translation and Standardization of the

WISCWISC Neuropsychological (Ardila & Rosselli)Neuropsychological (Ardila & Rosselli)

• Neuropsychological Evaluation of the Neuropsychological Evaluation of the Spanish SpeakerSpanish Speaker

Tests, norms, and limitationsTests, norms, and limitations Education and brain dysfunctionEducation and brain dysfunction

Puerto RicoPuerto Rico

APA Visiting Psychologist ProgramAPA Visiting Psychologist Program Inroduction of Clinical Inroduction of Clinical

Neuropsychology to Puerto RicoNeuropsychology to Puerto Rico Attempt at Adapting English Tests of Attempt at Adapting English Tests of

Cognition in Schizophrenics to Cognition in Schizophrenics to Spanish PopulationsSpanish Populations• Whitaker Index of Schizophrenic Whitaker Index of Schizophrenic

ThinkingThinking• Journal of Clinical PsychologyJournal of Clinical Psychology

ArgentinaArgentina

Fulbright Program (Malvinas War)Fulbright Program (Malvinas War) Introduction of Clinical Introduction of Clinical

Neuropsychology to ArgentinaNeuropsychology to Argentina Unable to Develop a Collaborative Unable to Develop a Collaborative

Research ProgramResearch Program• Medicine control of neurological & np Medicine control of neurological & np

issuesissues• Psychology´s focus on psychoanalysisPsychology´s focus on psychoanalysis• Lack of resourcesLack of resources

SpainSpain

Barcelona, Granada, Madrid, SalamancaBarcelona, Granada, Madrid, Salamanca Development of:Development of:

• Educational OpportuntiesEducational Opportunties Teaching Graduate Courses in NPTeaching Graduate Courses in NP Assist in establishing the specialtyAssist in establishing the specialty Visiting professors and studentsVisiting professors and students

• Research ProgramResearch Program Universidad Complutensa de MadridUniversidad Complutensa de Madrid

• Juan Miguel Tobal, Antonio Cano & Juan Manuel Juan Miguel Tobal, Antonio Cano & Juan Manuel CespedesCespedes

Universidad de GranadaUniversidad de Granada• Juan Godoy & Miguel Perez GarciaJuan Godoy & Miguel Perez Garcia

Spain IISpain II

Luria-NebraskaLuria-Nebraska• Translation & StandardizationTranslation & Standardization• Several Presentations and PublicationsSeveral Presentations and Publications

Other (examples)Other (examples)• Multiple SclerosisMultiple Sclerosis• EpilepsyEpilepsy• Ecologically Valid MeauresEcologically Valid Meaures

RussiaRussia

Moscow State University, Alexander Moscow State University, Alexander Luria´s LaboratoryLuria´s Laboratory• Janna Glozman & Tatiana AkutinaJanna Glozman & Tatiana Akutina• Dasha Krotova, Anna AgronovichDasha Krotova, Anna Agronovich

EducationEducation• Luria’s ConferencesLuria’s Conferences• Training & Eaxchange of IdeasTraining & Eaxchange of Ideas

ResearchResearch

RussiaRussia

General PublicationsGeneral Publications• Comparison of Russian & American Comparison of Russian & American

ApproachesApproaches• Russian PerestroikaRussian Perestroika

Recent EffortsRecent Efforts• Agranovich´s Attempt at Cross-Cultural Agranovich´s Attempt at Cross-Cultural

NeuropsychologyNeuropsychology Time is not on my sideTime is not on my side All things are not equalAll things are not equal

BrazilBrazil

Universidad Federal (Sao Paulo)Universidad Federal (Sao Paulo)• Vivian AndradeVivian Andrade

Guarani IndiansGuarani Indians• SampleSample• MeasuresMeasures• ResultsResults

KenyaKenya

Masai TribeMasai Tribe• Written LanguageWritten Language• Counting and DigitizingCounting and Digitizing• TimeTime• AcquisitionAcquisition• Social RulesSocial Rules

Interface with LeakyInterface with Leaky• The Role of Consciousness in EvolutionThe Role of Consciousness in Evolution

Possible Interpreations:Possible Interpreations:Lessons LearnedLessons Learned

PragmaticPragmatic• LegalLegal• FinancialFinancial• CommunicationCommunication• Social & Intellectual InterfacingSocial & Intellectual Interfacing• Varied Rules for Intellectual Engagment Varied Rules for Intellectual Engagment

& Productivity& Productivity

Lessons LearnedLessons Learned

TheoreticalTheoretical• Culture Affects Brain Function, Starting Culture Affects Brain Function, Starting

Very EarlyVery Early• Brain Function Cannot Be Understood Brain Function Cannot Be Understood

Outside of Socio-Cultural ContextOutside of Socio-Cultural Context• Again, is Brain Dysfunction Nothing More Again, is Brain Dysfunction Nothing More

than Cultural Misunderstanding?than Cultural Misunderstanding?• Possibilities of Finding Culture-Free Might Possibilities of Finding Culture-Free Might

be in Uneducated Individuals and Others be in Uneducated Individuals and Others in Long Term Cultural Isolation or in Long Term Cultural Isolation or HomogeneityHomogeneity

Future ConsiderationsFuture Considerations

Luria- The Idea of a Romantic Luria- The Idea of a Romantic ScienceScience

Sperry- The Interface Between the Sperry- The Interface Between the Objective (brain function) and the Objective (brain function) and the Subjective (Consciousness)Subjective (Consciousness)

Interfacing Methodology and Theory Interfacing Methodology and Theory

and both with Clinical Practiceand both with Clinical Practice