TY - JOUR
T1 - Adaptation and Validation of a Computerized Neurocognitive Battery in the Xhosa of South Africa
AU - Scott, J. Cobb
AU - Moore, Tyler M.
AU - Stein, Dan J.
AU - Pretorius, Adele
AU - Zingela, Zukiswa
AU - Nagdee, Mohammed
AU - Ngqengelele, Linda
AU - Campbell, Megan
AU - Sibeko, Goodman
AU - King, Mary Claire
AU - McClellan, Jon M.
AU - Port, Allison M.
AU - Jackson, Chad
AU - Ruparel, Kosha
AU - Susser, Ezra S.
AU - Gur, Ruben C.
N1 - Publisher Copyright:
© 2021 American Psychological Association
PY - 2021
Y1 - 2021
N2 - Objective: Large-scale studies have revolutionized biomedical research, and neurocognitive tests can help elucidate the biological basis of neuropsychiatric diseases. However, studies have predominantly been conducted in Western settings. We describe the development and validation of a computerized battery (PennCNB) with the Xhosa population of South Africa. Method: Individuals with schizophrenia (n = 525) and a normative comparison group (n = 744) were balanced on age, sex, education, and region. Participants provided blood samples, were assessed psychiatrically, and were administered a PennCNB translation to isiXhosa, including measures of executive functions, episodic memory, complex cognition, social cognition, and sensorimotor speed. Feasibility was examined with test completion rates and input from administrators, and psychometric structural validity and associations with clinical and demographic characteristics were examined. Results: Tests were well tolerated by participants, as >87% had one (or fewer) test missing. Results suggested a similar factor structure to prior PennCNB studies in Western contexts, and expected age and sex effects were apparent. Furthermore, a similar profile of schizophrenia was observed, with neurocognitive deficits most pronounced for executive functions, especially attention, as well as memory, social cognition, and motor speed relative to complex cognition and sensorimotor speed. Conclusions: Results support the feasibility of implementing a culturally adapted computerized neurocognitive battery in sub-Saharan African settings and provide evidence supporting the concurrent validity of the translated instrument. Thus, the PennCNB is implementable on a large scale in non-Western contexts, shows expected factor structure, and can detect cognitive deficits associated with neuropsychiatric disorders. Obtaining valid measures of cognition by nonspecialized proctors is especially suitable in resource-limited settings, where traditional testing is prohibitive. Future work should establish normative standards, test–retest reliability, and sensitivity to treatment.
AB - Objective: Large-scale studies have revolutionized biomedical research, and neurocognitive tests can help elucidate the biological basis of neuropsychiatric diseases. However, studies have predominantly been conducted in Western settings. We describe the development and validation of a computerized battery (PennCNB) with the Xhosa population of South Africa. Method: Individuals with schizophrenia (n = 525) and a normative comparison group (n = 744) were balanced on age, sex, education, and region. Participants provided blood samples, were assessed psychiatrically, and were administered a PennCNB translation to isiXhosa, including measures of executive functions, episodic memory, complex cognition, social cognition, and sensorimotor speed. Feasibility was examined with test completion rates and input from administrators, and psychometric structural validity and associations with clinical and demographic characteristics were examined. Results: Tests were well tolerated by participants, as >87% had one (or fewer) test missing. Results suggested a similar factor structure to prior PennCNB studies in Western contexts, and expected age and sex effects were apparent. Furthermore, a similar profile of schizophrenia was observed, with neurocognitive deficits most pronounced for executive functions, especially attention, as well as memory, social cognition, and motor speed relative to complex cognition and sensorimotor speed. Conclusions: Results support the feasibility of implementing a culturally adapted computerized neurocognitive battery in sub-Saharan African settings and provide evidence supporting the concurrent validity of the translated instrument. Thus, the PennCNB is implementable on a large scale in non-Western contexts, shows expected factor structure, and can detect cognitive deficits associated with neuropsychiatric disorders. Obtaining valid measures of cognition by nonspecialized proctors is especially suitable in resource-limited settings, where traditional testing is prohibitive. Future work should establish normative standards, test–retest reliability, and sensitivity to treatment.
KW - Computerized testing in africa
KW - Isixhosa translation of neurocognitive testing battery
KW - Neurocognitive assessment in resource-limited settings
KW - Neurocognitive profile of schizophrenia in african samples
KW - Neuropsychology in sub-saharan africa
UR - http://www.scopus.com/inward/record.url?scp=85115440622&partnerID=8YFLogxK
U2 - 10.1037/neu0000742
DO - 10.1037/neu0000742
M3 - Article
C2 - 34242045
AN - SCOPUS:85115440622
SN - 0894-4105
VL - 35
SP - 581
EP - 594
JO - Neuropsychology
JF - Neuropsychology
IS - 6
ER -