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The application of 'dysexecutive syndrome' measures across cultures: Performance and checklist assessment in neurologically healthy and traumatically brain-injured Hong Kong Chinese Volunteers
Chan, R.C.K. & MANLY, T.
Journal of the International Neuropsychological Society, 8(6), 771-780
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Deficits in planning, self-regulation and attention are relatively common consequences of traumatic brain injury. Such 'dysexecutive' deficits tend to be most exposed in complex, real world situations. As a consequence clinicians often have to supplement formal tests with interviews, questionnaires and observation in order to make comprehensive assessments. While there is little doubt that dysexecutive symptoms occur across different cultures, the expression of those symptoms, the way in which they are experienced by others, and the propensity of friends/relatives to report negative features may vary considerably. The cross-cultural use of standardized checklists and measures - that have predominantly been studied with Western groups - therefore requires empirical support. Here a group of 68 healthy Chinese speaking volunteers were asked to complete translations of two UK developed questionnaire measures (the Dysexecutive Questionnaire and Cognitive Failures Questionnaire) and to perform two executive tasks (The Six Elements Test and the Tower of Hanoi). Both self-rating versions of the questionnaires, and versions completed by a relative about the participant, elicited similar scores to those of UK samples. More detailed analysis of the CFQ suggests that patterns of item use, as well as the overall score, are similar for the two populations. Accordingly, the conditions assessing the clinical sensitivity of the measures to brain injury for Cantonese speaking Hong Kong residents were met. Thirty patients with mild and moderate traumatic brain injuries completed the questionnaires and the tests. As with previous Western samples, questionnaire ratings from relatives best differentiated between the patient group and neurologically healthy age, sex and education level matched control group. Similarly, the questionnaire ratings of relatives formed the better predictors of patient performance on the two performance measures. The results indicate that translations of dysexecutive checklists and measures can be useful in a different culture and provide further evidence that the self-reports of head injured patients, who may have limited insight, may not form the best predictor of everyday difficulties.