Open Access
Normative data for executive function tests in an Ecuadorian Waranka minority population
(Taylor & Francis, 2024-07-01) Fierro Bósquez, María José; Olabarrieta Landa, Laiene; Christ, Bryan R.; Arjol, David; Perrin, Paul B.; Arango Lasprilla, Juan Carlos; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Objective: To generate normative data (ND) for executive functions tests in the Waranka minority population of Ecuador. Method: Four-hundred participants aged 6–17 completed the Symbol-Digit Modalities Test (SDMT), Trail-Making Test (TMT), Modified-Wisconsin Card Sorting Test (M-WCST), and Test of Colors-Words (STROOP). Scores were normed using multiple linear regressions, including age, age2, natural logarithm of mean parent education (MPE), sex, bilingualism, and two-way interactions as predictors. Results: Age by MPE and Age2 by MPE interactions arose for SDMT, so that children with illiterate parents scored lower than those with literate parents. Girls scored higher in SDMT. All TMT and M-WCST scores were influenced by age2. Age by MPE interaction was found for TMT–A, so that children with higher MPE went faster; and age by bilingualism interaction for TMT–B, so that more bilingual children needed less time. Stroop-Word and Color were influenced by age2 by MPE interaction, so that children, while older, scored higher, especially those with higher MPE. Also, age2 by sex interaction arose, so that girls increased scores curvilinearly while boys linearly. Word-Color was influenced by age, while Stroop-interference by age2. Age by MPE interaction was found for MCST-Categories and Perseveration, so that perseverations decreased to then increased, especially in those with illiterate parents. M-WCST-Category scores increased to then decrease later on age in children with illiterate parents. Z-scores calculated through indigenous ND were significantly lower than generated through non-indigenous norms. Conclusions: ND for minority populations are critical since Waranka sample performed worse when using non-indigenous norms for z-score calculation.
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
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.
Open Access
Factor structure of the 10-item CES-D scale among patients with persistent COVID-19
(Wiley, 2022) Ramírez Vélez, Robinson; Olabarrieta Landa, Laiene; Rivera, Diego; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The presence of persistent coronavirus disease 2019 (COVID-19) might beassociated with significant levels of psychological distress that would meet thethreshold for clinical relevance. The Center for Epidemiologic Studies DepressionScale (CES-D) version 10 has been widely used in assessing psychological distressamong general and clinical populations from different cultural backgrounds. To ourknowledge, however, researchers have not yet validated these findings amongpatients with persistent COVID-19. A cross-sectional validation study wasconducted with 100 patients from the EXER-COVID project (69.8% women;mean (±standard deviation) ages: 47.4 ± 9.5 years). Confirmatory factor analyses(CFAs) were performed on the 10-item CES-D to test four model fits: (a)unidimensional model, (b) two-factor correlated model, (c) three-factor correlatedmodel, and (d) second-order factor model. The diagonal-weighted least-squares estimator was used, as it is commonly applied to latent variable modelswith ordered categorical variables. The reliability indices of the 10-item CES-D in patients with persistent COVID-19 were as follows: depressive affect factor(α=0.82Ord;ω=0.78u−cat), somatic retardation factor (α=0.78Ord;ω=0.56u−cat),and positive affect factor (α=0.56Ord;ω=0.55u−cat). The second‐order model fitshowed good Omega reliability (ω=0.87ho). Regarding CFAs, the unidimensional‐factor model shows poor goodness of fit, especially residuals analysis (root meansquare error of approximation [RMSEA] = 0.081 [95% confidence interval,CI = 0.040–0.119]; standardized root mean square residual [SRMR] = 0.101). The two‐factor correlated model, three‐factor correlated model, and second‐order factormodel showed adequate goodness of fit, and theχ2difference test (∆X2) did not show significant differences between the goodness of fit for these models(∆X= 4.11282;p= 0.127). Several indices showed a good fit with the three‐factor correlated model: goodness‐of‐fit index = 0.974, comparative fit index = 0.990,relative noncentrality index = 0.990, and incremental fit index = 0.990, which were all above 0.95, the traditional cut‐off establishing adequate fit. On the other hand RMSEA = 0.049 (95% CI = 0.000–0.095), where an RMSEA < 0.06–0.08 indicates anadequate fit. Item loadings on the factors were statistically significant (λ≥0.449j;p's < 0.001), indicating that the items loaded correctly on the corresponding factors and the relationship between factors (φ≥0.382;p's≤0.001. To our knowledge, thisis the first study to provide validity and reliability to 10‐item CES‐D in a persistentCOVID‐19 Spanish patient sample. The validation and reliability of this shortscreening tool allow us to increase the chance of obtaining complete data in aparticular patient profile with increased fatigue and brain fog that limit patients' capacity to complete questionnaires.
Open Access
Phonological and semantic verbal fluency test: Scoring criteria and normative data for clustering and switching strategies for Colombian children and adolescents
(Wiley, 2023) Álvarez Medina, María Nazareth; Vergara Moragues, Esperanza; Arango Lasprilla, Juan Carlos; Restrepo Moreno, Juan Carlos; Calderón Chagualá, José Amilkar; Rivera, Diego; Olabarrieta Landa, Laiene; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: Verbal fluency tests (VFT) are highly sensitive to cognitive deficits. Usually, the score on VFT is based on the number of correct words produced, yet it alone gives little information regarding underlying test performance. The implementation of different strategies (cluster and switching) to perform effi-ciently during the tasks provide more valuable information. However, normative data for clustering and switching strategies are scarce. Moreover, scoring criteria adapted to Colombian Spanish are missing. Aims: (1) To describe the Colombian adaptation of the scoring system guidelines for clustering and switching strategies in VFT; (2) to determine its reliability; and (3) to provide normative data for Colombian children and adolescents aged 6–17 years. Methods & Procedures: A total of 691 children and adolescents from Colombia completed phonological (/f/, /a/, /s/, /m/, /r/ and /p/) and semantic (animals and fruits) VFT, and five scores were calculated: total score (TS), number of clusters (NC), cluster size (CS), mean cluster size (MCS) and number of switches (NS). The intraclass correlation coefficient was used for interrater reliability. Hierarhical multiple regressions were conducted to investigate which strategies were associated with VFT TS. Multiple regressions were conducted for each strategy, including as predictors age, age2, sex, mean parents’ education (MPE), MPE2 and type of school, to generate normative data. Outcomes & Results: Reliability indexes were excellent. Age was associated with VFT TS, but weakly compared with strategies. For both VFT TS, NS was the strongest variable, followed by CS and NC. Regarding norms, age was the strongest predictor for all measures, while age2 was relevant for NC (/f/phoneme) and NS (/m/ phoneme). Participants with higher MPE obtained more NC, and NS, and larger CS in several phonemes and categories. Children and adolescents from private school generated more NC, NS and larger CS in /s/phoneme. Conclusions & Implications: This study provides new scoring guidelines and normative data for clustering and switching strategies for Colombian children and adolescents between 6 and 17 years old. Clinical neuropsychologists should include these measures as part of their everyday practice.
Open Access
Spain, the land of diversity
(Routledge, 2022) Olabarrieta Landa, Laiene; Goméz López, María Jesús; González Wongvalle, Isabel; Rivera, Diego; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
The aim of this chapter is to present relevant cultural aspects that a neuropsychologist should take into account in order to provide adequate service to Spanish patients and their families. In the first section, there is an introduction to the Spanish culture, which is linked to small case studies that reflect its relevance from a neuropsychological point of view. Spain is culturally complex, with different regions that maintain their own traditions and languages. For Spaniards, social relationships and family are so important that patients may prioritize some rehabilitation goals against others in order to recover their social functioning. Likewise, the complex relationship between languages and education is presented, as well as the educational and socioeconomic level of the country. In the second section, the importance of social relationships and the role of the family in the neuropsychological assessment and rehabilitation, as well as the context in which the patient lives, are explored closely through RJ case. Finally, the chapter ends with a summary of the most relevant ideas to consider when assessing a Spanish patient.
Open Access
Treatment effectiveness for male intimate partner violence perpetrators depending on problematic alcohol use
(Elsevier, 2022) Siria Mendaza, Sandra; Fernández-Montalvo, Javier; Echauri, José Antonio; Azkárate, Juana; Martínez, María; Olabarrieta Landa, Laiene; Rivera, Diego; Ciencias de la Salud; Osasun Zientziak
Background: Problematic alcohol use (PAU) is highly correlated with intimate partner violence perpetration (IPV). However, when treatments for male IPV perpetrators that address alcohol consumption are evaluated, the results are varied. Therefore, the main goal of this study was to assess the differential long-term effectiveness of a standard individual treatment programme for male IPV perpetrators depending on the presence of PAU. Methods: The sample was composed of 641 male IPV perpetrators who completed a specialized individual treatment programme for gender violence perpetrators. All of the participants were followed for one year after treatment completion. Results: The effects of PAU on treatment success were evaluated by means of multiple logistic regression analyses. The full model was reliable (χ2 = 10.243; df = 3; p = .016), and overall, 88.8% of the predictions were accurate. The findings indicated that the probability of successful treatment does not depend on the presence of PAU. Conclusions: The relationship between IPV perpetration and PAU is highly complex, and several underlying mechanisms should be further evaluated. Accordingly, interventions should not only screen for alcohol consumption but also for all individual characteristics that might necessitate tailored treatment.
Open Access
Moderate, little, or no improvements in neurobehavioral symptoms among individuals with long COVID: A 34-country retrospective study
(MDPI, 2022) Ramos Usuga, Daniela; Perrin, Paul B.; Bogdanova, Yelena; Olabarrieta Landa, Laiene; Alzueta, Elisabet; Baker, Fiona C.; Iacovides, Stella; Cortes, Mar; Arango Lasprilla, Juan Carlos; Ciencias de la Salud; Osasun Zientziak
(1) Background: Some people with COVID-19 develop a series of symptoms that last for several months after infection, known as Long COVID. Although these symptoms interfere with people’s daily functioning and quality of life, few studies have focused on neurobehavioral symptoms and the risk factors associated with their development; (2) Methods: 1001 adults from 34 countries who had previously tested positive for COVID-19 completed the Neurobehavioral Symptom Inventory reporting the symptoms before their COVID-19 diagnosis, during the COVID-19 infection, and currently; (3) Results: Participants reported large-sized increases before vs. during COVID-19 in all domains. Participants reported a medium-sized improvement (during COVID-19 vs. now) in somatic symptoms, a small-sized improvement in affective symptoms, and very minor/no improvement in cognitive symptoms. The risk factors for increased neurobehavioral symptoms were: being female/trans, unemployed, younger age, low education, having another chronic health condition, greater COVID-19 severity, greater number of days since the COVID-19 diagnosis, not having received oxygen therapy, and having been hospitalized. Additionally, participants from North America, Europe, and Central Asia reported higher levels of symptoms across all domains relative to Latin America and Sub-Saharan Africa; (4) Conclusions: The results highlight the importance of evaluating and treating neurobehavioral symptoms after COVID-19, especially targeting the higher-risk groups identified. General rehabilitation strategies and evidence-based cognitive rehabilitation are needed in both the acute and Long COVID phases.
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
Early predictors of employment status one year post injury in individuals with traumatic brain injury in Europe
(MDPI, 2020) Arango Lasprilla, Juan Carlos; Zeldovich, Marina; Olabarrieta Landa, Laiene; Vindal Forslund, Marit; Núñez Fernández, Silvia; Derecho; Zuzenbidea
Sustaining a traumatic brain injury (TBI) often affects the individual's ability to work, reducing employment rates post-injury across all severities of TBI. The objective of this multi-country study was to assess the most relevant early predictors of employment status in individuals after TBI at one-year post-injury in European countries. Using a prospective longitudinal non-randomized observational cohort (The Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) project), data was collected between December 2014-2019 from 63 trauma centers in 18 European countries. The 1015 individuals who took part in this study were potential labor market participants, admitted to a hospital and enrolled within 24 h of injury with a clinical TBI diagnosis and indication for a computed tomography (CT) scan, and followed up at one year. Results from a binomial logistic regression showed that older age, status of part-time employment or unemployment at time of injury, premorbid psychiatric problems, and higher injury severity (as measured with higher Injury severity score (ISS), lower Glasgow Coma Scale (GCS), and longer length of stay (LOS) in hospital) were associated with higher unemployment probability at one-year after injury. The study strengthens evidence for age, employment at time of injury, premorbid psychiatric problems, ISS, GCS, and LOS as important predictors for employment status one-year post-TBI across Europe.