Open Access
Executive function tests: normative data for Spanish-speaking adults in the United States
(2024-09-02) Ramos Usuga, Daniela; Rivera, Diego; Xia, Bridget; Carrión, Carmen I.; Morel Valdés, Gloria M.; Moreno, Oswaldo; Rodríguez, Miriam J.; Krch, Denise; Wongserbchart, Wongthipa; Drago, Christin I.; García, Patricia; Rivera, Patricia M.; Olabarrieta Landa, Laiene; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Background: normative data for Spanish-speaking populations, particularly Hispanics in the U.S., is notably scarce. Objective: This study aims to establish normative data for executive function tests (M-WCST, SCWT) among Spanish-speaking Hispanics in the U.S. Methods: we assessed 245 individuals aged 18-80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin) and employed Bayesian regression to estimate norms, considering various sociodemographic factors influencing performance. Results: age impacts SCWT scores negatively, especially in older individuals, with stronger effects among those proficient in Spanish. Age also affects M-WCST performance more in individuals with longer U.S. residency. Education correlates with M-WCST outcomes, with lower attainment linked to more errors. Education interacts with Spanish proficiency, influencing SCWT scores differently based on proficiency levels. Sex and acculturation levels interact, affecting SCWT performance differently between men and women. Conclusions: establishing culturally sensitive normative data can enhance accurate identification of executive dysfunction and reduce misdiagnosis risks. This underscores the importance of considering sociocultural factors including acculturation and language proficiency in neuropsychological assessments to better serve diverse populations.
Open Access
Methodology for the generation of normative data for the U.S. adult Spanish-speaking population: a Bayesian approach
(SAGE, 2024-09-20) Rivera, Diego; Forte, Anabel; Olabarrieta Landa, Laiene; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
Objective: To present the methodology for a study generating normative neuropsychological test data for healthy Spanish-speaking adults (18-80 years old) living in the U.S. using Bayesian inference as a novel approach. Method: The study sample consisted of 253 healthy adults from eight U.S. regions (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin), with individuals originating from a diverse array of Latin American countries. To participate in the study, individuals must have met the following criteria: were between 18 and 80 years of age, had lived in the U.S. for at least 1 year (12 continuous months), self-identified Spanish as their dominant language, had at least one year of formal education, were able to read and write in Spanish at the time of evaluation, scored ¿23 on the Mini-Mental State Examination, scored <10 on the Patient Health Questionnaire¿9, and scored <10 on the Generalized Anxiety Disorder scale. Participants completed 12 neuropsychological tests. Reliability statistics and norms were calculated for all tests. Conclusions: This was the first normative study for Spanish-speaking adults in the U.S. to implement demographic, acculturation, and bilingual dominance measures as possible controls. Additionally, it was the first study to use Bayesian linear or generalized linear regression models for generating normative data in neuropsychology.
Open Access
Test of memory malingering 2nd edition: normative data from cognitively intact adults living in Spain
(Routledge, 2024-11-05) Arango Lasprilla, Juan Carlos; Ayearst, Lindsay E.; Rivera, Diego; Dini, Mia E.; Olabarrieta Landa, Laiene; Ramos Usuga, Daniela; Perrin, Paul B.; McCaffrey, Robert; Ciencias de la Salud; Osasun Zientziak
This study evaluated the universality of the TOMM 2 and provided a reference sample of cognitively intact adults living in Spain whose native language was Spanish. A total of 203 adults completed the TOMM 2 from June 2019 to January 2020. When using the original TOMM cutoff scores derived from English speakers, all participants scored in a range that would suggest that they passed the TOMM. When using a cut score less than 40 on Trial 1, only one participant in this study would be mistakenly classified as providing an invalid performance. Spanish-speaking adults in Spain from this study achieved a perfect score on Trial 1 at a rate more than double that of English-speaking individuals on the original TOMM. At the item level, all but one item met the minimum standard for performance validity; this item fell only marginally below the standard at 89%. This study found a very low failure rate for the TOMM 2, suggesting that the second edition has at least as high specificity as the original in Spanish adults.
Open Access
Psychometric properties and normative data using item response theory approach for three neuropsychological tests in Waranka children population
(MDPI, 2025-02-15) Fierro Bósquez, María José; Fuentes Mendoza, Eliana María; Olabarrieta Landa, Laiene; Abiuso Lillo, Trinidad; Orozco Acosta, Erick; Mascialino, Guido; Arango Lasprilla, Juan Carlos; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
: Objective: To evaluate the psychometric properties of the Shortened Version of the Token Test (SVTT), the Peabody Picture Vocabulary Test (PPVT-III), and the Rey–Osterrieth Complex Figure (ROCF) using an item response theory (IRT) framework and to establish normative data for Waranka children and adolescents based on their ability scores. Methods: A total of 436 healthy people aged between 6 and 17 participated in this study. The factor structure was evaluated using confirmatory factor analysis (CFA) and the difficulty and discrimination parameters using IRT through the two-parameter logistic model for the SVTT and PPTV-III, while for the ROCF, the graded response model was used. The ordinal alpha and McDonald’s omega were used for reliability. Results: For most items, a low ability was enough to achieve the highest scores for the ROCF and SVTT. For the PPVTIII, the items aligned sequentially based on the difficulty, and a low level of ability was enough to achieve the highest score for the first 40 items. The ROCF, SVTT, and PPVTIII demonstrated adequate reliability. The ROCF copy and immediate recall scores were influenced by the mean parents’ years of education (MPE) and quadratic age interaction. The SVTT performance was affected by the quadratic age and sex interaction, and the PPVT-III by the interaction effect of the MPE and quadratic age. Conclusions: This is the first study to analyze the psychometric properties of the ROCF, SVTT, and PPVT-III through IRT models that are accurate and relevant for the validity of the obtained data and generate normative data in the under-represented nation of Ecuador for clinical and research purposes.
Embargo
Analysis of sociodemographic and linguistic influences on verbal fluency performance in Basque and Catalan bilingual adults
(Oxford University Press, 2025-08-11) Olabarrieta Landa, Laiene; Rivera, Diego; Alegret, Montserrat; Pérez-Cordón, Alba; Forte, Anabel; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
The aim of the study was to generate norms for letter, semantic, and verb fluency tests for Basque and Catalan speakers from Spain. The sample consisted of 275 bilinguals aged between 18 and 85 years who completed the tests for each language (Basque-Spanish or Catalan-Spanish) with order counterbalanced. The influence of predictors was evaluated with Generalized Linear Mixed Models. Language by letter and type of language by semantic category interactions were found, where people scored higher in letter fluency when tested in Spanish than in Basque or Catalan, and produced more words in the animals category compared to fruits and occupations. Production increased in all tests with higher education. Letter and semantic fluency scores increased until ages 40-45, after which they decreased, except for action fluency, where Basque speakers had decreased scores with age. Basque men scored higher than Basque women in letter and semantic fluency, but lower in verb fluency; while Catalan women scored higher than Catalan men in semantic and verb fluency, but lower in letter fluency. The study provides, for the first time, verbal fluency norms for Basque and enriches norms availability for Catalan. Socio-psycholinguistics aspects may have an impact on performance.
Open Access
Multivariate base rates of low scores on tests of executive functions in a multi-country Latin American sample
(Routledge, 2021) Rivera, Diego; Mascialino, Guido; Brooks, Brian L.; Olabarrieta Landa, Laiene; Longoni, Melina; Galarza-Del-Ángel, Javier; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
The objective of the study was to determine the prevalence of low scores in a diverse Latin American population for two neuropsychological commonly used tests to evaluate executive functions and to compare the number of low scores obtained using normative data from a Spanish-speaking population from Latin America versus an English-speaking population from U.S.A. Healthy adults (N = 5402) were administered the Modiﬁed Wisconsin Card Sorting Test and Stroop Color-Word. Low scores on measures of executive functioning are common. Clinicians working with Spanish-speaking adults should take into account the higher probability of low scores on these measures to reduce false-positive diagnoses of cognitive deficits in an individual.
Open Access
15-item version of the Boston naming test: normative data for the Latin American spanish-speaking adult population.
(American Psychological Association, 2023) Del Cacho Tena, Ana María; Merced, Kritzia; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Olabarrieta Landa, Laiene; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
Objective: Naming is commonly impaired in people with neurodegenerative diseases and brain injury, and as a result, its accurate assessment is essential. The aim of this study was to provide normative data for the 15-item Spanish version of the Boston Naming Test (BNT) for an adult population from eight Latin American countries/regions. Method: The total sample consisted of 2,828 participants from Argentina, Chile, Cuba, El Salvador, Mexico, Honduras, Paraguay, and Puerto Rico. Multiple regressions were used to generate normative data following a four-step process. Results: Regression models showed a linear effect of age on the 15-item BNT total score for Argentina, Chile, Mexico, and Puerto Rico. In contrast, Paraguay showed a quadratic age effect. Almost all countries showed a positive linear effect of education, except Cuba which had a quadratic effect. Sex was a significant predictor in Argentina, Chile, Cuba, and Mexico, where in women scored lower than men. Conclusions: This study generates normative data for the 15-item Spanish version of the BNT and offers a free open-source calculator that will assist in the efficacious use of this neuropsychological test in clinical practice and research.
Open Access
Network analysis of neurobehavioral symptom patterns in an international sample of spanish-speakers with a history of COVID-19 and controls
(MDPI, 2023) Perrin, Paul B.; Ramos Usuga, Daniela; West, Samuel J.; Merced, Kritzia; Klyce, Daniel W.; Lequerica, Anthony H.; Olabarrieta Landa, Laiene; Alzueta, Elisabet; Baker, Fiona C.; Iacovides, Stella; Cortes, Mar; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: Psychometric network analysis provides a novel statistical approach allowing researchers to model clusters of related symptoms as a dynamic system. This study applied network analysis to investigate the patterns of somatic, cognitive, and affective neurobehavioral symptoms in an international sample of Spanish-speaking individuals with a history of COVID-19 positivity and non-COVID controls; (2) methods: the sample (n = 1093) included 650 adults from 26 countries who reported having previously tested positive for COVID-19 (COVID+) through a viral and/or antigen test (average of 147 days since diagnosis). The control group (COVID−) was comprised of 443 adults from 20 countries who had completed the survey prior to the COVID19 pandemic; (3) results: relative to the COVID− network, the COVID+ network was very wellconnected, such that each neurobehavioral symptom was positively connected to the network. The organize-to-headache and dizzy-to-balance connections in the COVID+ network were stronger than in the COVID− network. The hearing, numbness, and tense symptoms were more central to the COVID+ network with the latter connected to the sleep, fatigue, and frustrated symptoms. The COVID− network was largely disjointed, with most of the somatosensory symptoms forming their own cluster with no connections to other symptom groups and fatigue not being connected to any other symptom. The cognitive and affective symptoms in the COVID− network were also largely connected to symptoms from within their own groups; (4) conclusions: These findings suggest that many of the long-term neurobehavioral symptoms of COVID-19 form a discernable network and that headaches, frustration, hearing problems, forgetfulness, and tension are the most central symptoms. Cognitive and behavioral rehabilitation strategies targeting these central symptom network features may hold promise to help fracture the lingering symptom network of COVID-19.
Open Access
WHO-UCLA auditory verbal learning test: normative data for Spanish-speaking adults in the United States
(SAGE, 2024-09-18) Arango Lasprilla, Juan Carlos; Rivera, Diego; Rodríguez, Miriam J.; Christ, Bryan R.; Moreno, Oswaldo; Ramos Usuga, Daniela; Olabarrieta Landa, Laiene; Perrin, Paul B.; Carrión, Carmen I.; Morel Valdés, Gloria M.; Krch, Denise; Amaya, Ariana; Drago, Christin I.; García, Patricia; Rivera, Patricia M.; Ciencias de la Salud; Osasun Zientziak
Background: Hispanics are a significant demographic in the US, with diverse cultures and languages. Yet, assessing cognition in this group is complex as cultural and linguistic factors have been found to affect test performance. Objective: To generate normative data on the WHO-UCLA AVLT in a sample of Spanish speaking Hispanics residing in the U.S. Methods: The sample included 245 Spanish speaking individuals aged 18-80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin). Participants were administered the WHO-UCLA AVLT as part of a comprehensive neuropsychological battery. A Bayesian regression approach was used to estimate normative data, including covariates found to be important for predicting performances on measures of learning and memory. Results: Bayesian models showed a logarithmic link between education and all WHO-UCLA AVLT trials, except recognition. For delayed recall, increased Spanish proficiency benefited women's performance exclusively. Time in the U.S. was a significant predictor for Total Recall, indicating worse performance with longer resi-dency. Conclusions: Recognizing cultural factors like language proficiency and duration of U.S. residence is essential for accurately evaluating cognitive function among His-panics. This research emphasizes the significance of accounting for cultural nuances in developing norms for neuropsychological assessments, thereby improving their relevance and effectiveness in diverse communities.
Open Access
Normative data estimation in neuropsychological tests: a systematic review
(Oxford University Press, 2024) Del Cacho Tena, Ana María; Christ, Bryan R.; Arango Lasprilla, Juan Carlos; Perrin, Paul B.; Rivera, Diego; Olabarrieta Landa, Laiene; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Objective: To quantify the evolution, impact, and importance of normative data (ND) calculation by identifying trends in the research literature and what approaches need improvement. Methods: A PRISMA-guideline systematic review was performed on literature from 2000 to 2022 in PubMed, Pub-Psych, and Web of Science. Inclusion criteria included scientific articles about ND in neuropsychological tests with clear data analysis, published in any country, and written in English or Spanish. Cross-sectional and longitudinal studies were included. Bibliometric analysis was used to examine the growth, productivity, journal dispersion, and impact of the topic. VOSViewer compared keyword co-occurrence networks between 1952¿1999 and 2000¿2022. Results: Four hundred twelve articles met inclusion and exclusion criteria. The most studied predictors were age, education, and sex. There were a greater number of studies/projects focusing on adults than children. The Verbal Fluency Test (12.7%) was the most studied test, and the most frequently used variable selection strategy was linear regression (49.5%). Regression-based approaches were widely used, whereas the traditional approach was still used. ND were presented mostly in percentiles (44.2%). Bibliometrics showed exponential growth in publications. Three journals (2.41%) were in the Core Zone. VOSViewer results showed small nodes, long distances, and four ND-related topics from 1952 to 1999, and there were larger nodes with short connections from 2000 to 2022, indicating topic spread. Conclusions: Future studies should be conducted on children¿s ND, and alternative statistical methods should be used over the widely used regression approaches to address limitations and support growth of the field.