Cultural appropriateness of the hooper visual organization test? Greek normative data

Cross-cultural differences may affect performance on neuropsychological tests, even on those, which are non-verbal. We examined the appropriateness of the Hooper Visual Organization Test (HVOT) for use in the Greek population. In doing so, we sought to establish the internal consistency of its items, determine the influence of demographic characteristics on performance, create a normative database, and establish its ability to differentiate patient groups from healthy individuals for the Greek population. We administered the full test to 206 healthy adults in Greece (109 women), a group of 67 psychiatric patients with schizophrenia and a group of 31 neurological patients with multiple sclerosis. With respect to the healthy group, the reliability analysis of the 30-item scale yielded a Cronbach's alpha of .85, while item analysis was also very high for all items. Seventy percent of the items were perceived correctly by more than 60% of the sample. The remaining items yielded lower accuracy rates, which we attributed to their level of difficulty, rather than unfamiliarity (or low familiarity) in the Greek population. Regression analyses revealed that age and education level, but not sex, significantly influenced participants' performance, with older age and lower level of education contributing to poorer performance. Both patient groups performed more poorly on the test, compared to age- and education-matched healthy controls. Finally, we present norms for the Greek population according to age and level of education. The traditional form of the HVOT appears to be a reliable and valid neuropsychological tool for the Greek population.