Journal of the International Neuropsychological Society

Research Articles

Neuropsychological Performance in Mainland China: The Effect of Urban/Rural Residence and Self-Reported Daily Academic Skill Use

Saurabh Guptaa1 c1, Florin Vaidaa1, Katie Riggsa1, Hua Jina1, Igor Granta1, Lucette Cysiquea2, Chuan Shia3, Xin Yua3, Zunyou Wua4, Robert K. Heatona1 and The HIV Neurobehavioral Research Center (HNRC) Group

a1 Department of Psychiatry, University of California, San Diego, San Diego, California

a2 Brain Sciences, Department of Psychiatry, University of New South Wales, Sydney, Australia

a3 Beijing Mental Health Institute, Beijing, China

a4 China Centers for Disease Control, Beijing, China


Age, education, and gender are the most common covariates used to define normative standards against which neuropsychological (NP) performance is interpreted, but influences of other demographic factors have begun to be appreciated. In developing nations, urban versus rural residence may differentially affect numerous factors that could influence cognitive test performances, including quality of both formal and informal educational experiences and employment opportunities. Such disparities may necessitate corrections for urban/rural (U/R) status in NP norms. Prior investigations of the U/R effect on NP performance typically have been confounded by differences in educational attainment. We addressed in this by comparing the NP performance of large, Chinese urban (Yunnan Province, n = 201) and rural (Anhui Province, n = 141) cohorts of healthy adults, while controlling for other demographic differences. Although the groups did not differ in global NP scores, a more complex pattern was observed within specific NP ability domains and tests. Urban participants showed better performance in select measures of processing speed and executive functions, verbal fluency, and verbal learning. Self-reported daily use of academic skills was predictive of many U/R differences. Controlling for academic skill use abrogated most U/R differences but revealed rural advantages in select measures of visual reasoning and motor dexterity. (JINS, 2011, 17, 000–000)

(Received June 18 2010)

(Revised October 07 2010)

(Accepted October 12 2010)

(Online publication November 17 2010)


c1 Correspondence and reprint requests to: Saurabh Gupta, HIV Neurobehavioral Research Center, 220 Dickinson, Suite B, San Diego, California 92103. E-mail: