Graduation Semester and Year
Fall 2024
Language
English
Document Type
Dissertation
Degree Name
Doctor of Philosophy in Social Work
Department
Social Work
First Advisor
Diane B. Mitschke, Ph.D., LMSW
Abstract
This dissertation examines the cultural validity of cognitive assessment tools for forcibly displaced populations (FDP) through theoretical critique, scoping review, and empirical investigation. Guided by Homeostatic Socio-Cognitive Systems (HSCS) theory, which posits that cognitive patterns are shaped by sociocultural contexts, this research is motivated by two critical public health issues: the documented prevalence of subjective cognitive decline among FDP and the lack of culturally valid assessment tools for these populations.
Through three integrated articles, this dissertation demonstrates how current cognitive assessments embed Western analytic assumptions that may misrepresent the cognitive abilities of individuals from collective cultures. The theoretical critique reveals how the Montreal Cognitive Assessment (MoCA), despite widespread use, reflects cognitive patterns characteristic of Western individualistic societies. The scoping review documents the pervasive use of potentially problematic assessment approaches in FDP research, highlighting significant gaps in cultural adaptation. The empirical investigation, using cognitive interviews with Karen refugees (N = 8), provides evidence of how cultural and educational backgrounds influence cognitive task performance, demonstrating specific ways standardized assessments may fail to capture authentic cognitive functioning.
This research advances a framework for culturally congruent cognitive assessment emphasizing five key principles: contextual embeddedness, relational understanding over taxonomic classification, practical experience over abstract reasoning, flexible response formats, and cultural ecological validity. Recommendations for future research emphasize community-engaged, interdisciplinary approaches to assessment development, involving sustained partnerships between academic institutions, healthcare providers, and FDP communities.
This dissertation contributes to cognitive health equity by advocating for assessment practices that authentically reflect diverse cognitive patterns. The findings provide a foundation for developing tools that more accurately evaluate cognitive function among FDP, ultimately supporting better identification of cognitive impairment and more effective interventions for these vulnerable populations.
Keywords
Forcibly displaced populations, Collective cultures, Holistic cognitive styles, Cognitive assessment, Cultural validity, Cultural adaptation
Disciplines
Social Work
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Kitchens, Katherine, "Enhancing Cognitive Assessment for Forcibly Displaced Populations: An Integrated Theoretical, Methodological, and Empirical Investigation" (2024). Social Work Dissertations. 189.
https://mavmatrix.uta.edu/socialwork_dissertations/189