The impact of sociocultural factors on nonverbal neuropsychological test performance amoung Hispanic epilepsy patients

It is often assumed that nonverbal- and performance-based measures minimize the impact of cultural factors on neuropsychological test performance. However, few studies have examined the relationship between sociocultural factors and nonverbal neuropsychological test performance in Hispanics. Fewer still have done so within clinical populations. The present study examined the relationships between acculturation, education, ethnicity, and linguistic fluency and nonverbal neuropsychological test performance in a sample of 305 Hispanic and non-Hispanic White adults with and without epilepsy. In order to realize the study objectives, demographic, medical and neuropsychological test data were obtained for a neurologically normal group of Spanish-speaking Hispanics, and three ethnically and linguistically diverse groups of epilepsy patients, including English-speaking non-Hispanic Whites, English-speaking Hispanics, and Spanish-speaking Hispanics. The participants\u27 performance on nonverbal neuropsychological measures, including tests of visuospatial skills, visual learning and memory, fine motor skills, and executive functions were compared, and the relationships of education, acculturation, ethnicity, and linguistic fluency to nonverbal test performance were examined. The first hypothesized aim of this study examined whether level of acculturation to American culture was positively associated with nonverbal neuropsychological test performance among Spanish-speaking Hispanic adults with and without epilepsy, and was partially supported. The second hypothesis examined whether education was positively associated with nonverbal test performance, and was fully supported. The third hypothesis examined whether there were nonverbal test performance differences according to sociocultural group membership before and after controlling for education, and was partially supported. The fourth hypothesis tested whether language fluency predicted performance on timed nonverbal tests, and was partially supported. The final hypothesis compared whether rates of impairment on nonverbal tests were different after applying normative data obtained from both English and Spanish-speaking samples, and was partially supported. Finally, a post-hoc exploratory regression was conducted and found that sociocultural factors accounted for a greater proportion of variance in nonverbal test performance than neurological factors. The results demonstrate that the impact of sociocultural factors on nonverbal neuropsychological test performance is not attenuated by neurological illness, and indicate that acculturation should be considered when administering nonverbal tests