Generally representative is representative of none: commentary on the pitfalls of IQ test standardization in multicultural settings.

OBJECTIVE: The aim of this paper is to address the issue of IQ testing within the multicultural context, with a focus on the adequacy of nationwide population-based norms vs. demographically stratified within-group norms for valid assessment purposes. Burgeoning cultural diversity worldwide creates a pressing need to cultivate culturally fair psychological assessment practices. METHOD: Commentary is provided to highlight sources of test-taking bias on tests of intellectual ability that may incur invalid placement and diagnostic decisions in multicultural settings. Methodological aspects of population vs. within-group norming solutions are delineated and the challenges of culturally relevant norm development are discussed. Illustrative South African within-group comparative data are supplied to support the review. A critical evaluation of the South African WAIS-III and the WAIS-IV standardizations further serves to exemplify the issues. RESULTS: A flaw in both South African standardizations is failure to differentiate between African first language individuals with a background of advantaged education vs. those from educationally disadvantaged settings. In addition, the standardizations merge the performance outcomes of distinct racial/ethnic groups that are characterized by differentially advantaged or disadvantaged backgrounds. Consequently, the conversion tables are without relevance for any one of the disparate South African cultural groups. CONCLUSIONS: It is proposed that the traditional notion of a countrywide unitary norming (also known as 'population-based norms') of an IQ test is an unsatisfactory model for valid assessment practices in diverse cultural contexts. The challenge is to develop new solutions incorporating data from finely stratified within-group norms that serve to reveal rather than obscure cross-cultural disparity in cognitive test performance.

Mild traumatic brain injuries in early adolescent rugby players: Long-term neurocognitive and academic outcomes.

BACKGROUND: Information is scant concerning enduring brain injury effects of participation in the contact sport of Rugby Union (hereafter rugby) on early adolescents. OBJECTIVE: The objective was prospectively to investigate differences between young adolescent male rugby players and non-contact sports controls on neurocognitive test performance over 3 years and academic achievement over 6 years. METHOD: A sample of boys from the same school and grade was divided into three groups: rugby with seasonal concussions (n = 45), rugby no seasonal concussions (n = 21) and non-contact sports controls (n = 30). Baseline neurocognitive testing was conducted pre-season in Grade 7 and post-season in Grades 8 and 9. Year-end academic grades were documented for Grades 6-9 and 12 (pre-high school to year of school leaving). A mixed model repeated measures ANOVA was conducted to investigate comparative neurocognitive and academic outcomes between the three sub-groups. RESULTS: Compared with controls, both rugby groups were significantly lower on the WISC-III Coding Immediate Recall sub-test. There was a significant interaction effect on the academic measure, with improved scores over time for controls, that was not in evidence for either rugby group. CONCLUSIONS: Tentatively, the outcome suggests cognitive vulnerability in association with school level participation in rugby.

Employed family caregivers of cognitively impaired elderly: an examination of role strain and depressive symptoms.

This paper compares employed and non-employed caregivers of cognitively impaired elderly family members. Using two competing positions derived from role theory, role conflict and role expansion, we explored whether holding the positions of both caregiver and worker led to greater role overload and psychological role conflict, or provided an outlet that helps caregivers better manage the demands placed on them. We found no differences between employed and non-employed caregivers on measures of role overload, worry and strain, and depression. For working caregivers, however, greater conflict on the job was associated with higher role overload and worry and strain while beneficial work experiences were only weakly associated with lower role overload and worry and strain. There was an interaction effect between positive work experiences and role overload when predicting depressive symptoms. These results provide some support for role conflict, but also suggest that caregivers may vary considerably in how they adapt to multiple roles.

Prejudice, social distance, and familiarity with mental illness.

In this study, the paths between two prejudicial attitudes (authoritarianism and benevolence) and a proxy measure of behavioral discrimination (social distance) were examined in a sample drawn from the general public. Moreover, the effects of two person variables (familiarity with mental illness and ethnicity) on prejudice were examined in the path analysis. One hundred fifty-one research participants completed measures of prejudice toward, social distance from, and familiarity with mental illness. Goodness-of-fit indexes from path analyses supported our hypotheses. Social distance is influenced by both kinds of prejudice: authoritarianism (the belief that persons with mental illness cannot care for themselves, so a paternalistic health system must do so) and benevolence (the belief that persons with mental illness are innocent and childlike). These forms of prejudice, in turn, are influenced by the believers' familiarity with mental illness and their ethnicity. We also discuss how these findings might contribute to a fuller understanding of mental illness stigma.

Predictors of institutionalization of cognitively impaired elders: family help and the timing of placement.

Although predictors of nursing home placement have attracted a good deal of attention in gerontological research, the type and amount of family assistance offered to caregivers prior to institutionalization has not been extensively examined. This study analyzed the impact of family help on the timing of placement among cognitively impaired care recipients. Using longitudinal data from the Adult Day Care Collaborative Study, an event-history analysis was performed to determine the effects of family help after sociodemographic characteristics, caregiving stressors, and indicators of caregiver well-being were taken into account. Results showed that caregivers were far less likely to institutionalize their relatives when family members provided overnight help and assisted with activities of daily living care. These findings suggest that specific types of family help play an important role in delaying nursing home placement among older adults suffering from dementia.

U.S. health manpower policy: will the benefits justify the costs?

The United States is now training and importing new physicians at a rate that will increase the ratio of physicians-to-population by nearly 50 percent over the next 25 years. Similar increases in the supply of other health manpower will also result from current enrollment levels. The added costs associated with these increased health-manpower-to-population ratios will equivalent to diverting another 4 percent of more of GNP--roughly $50 billion annually in today's frame of reference--from other purposes into health care. But only marginal, if any, improvements in the overall health of the American people are likely to result. Therefore, current policies need to be reexamined and serious consideration given to reducing the rates at which the health manpower pool is increasing.