Depression Scales and IQ Measures Fail Some Who Need Help the Most

Psychological testing has a circuitous and questionable path to widespread acceptance as a reliable evaluation tool. The question posed for mental evaluation designed by Alfred Binet, i.e., intelligence testing, was to weed out and separate the children needing “assistance” in schools in France.

Once tested, they could be sent off to schools for these individuals. Was this for their benefit or that of society, and were the initial tests by Binet genuinely valid? The test had 30 questions.

Translated and revised to become an American test by Herbert Goddard, this original Binet-Simon test and a puzzle test provided a way to separate immigrants at Ellis Island and direct the “feeble-minded” to low-level jobs. One of the reasons? Racism and bias ran rampant.

Italian and Irish immigrants had little to no schooling, and many couldn’t read and were, therefore, of low intellect as rated by those in charge. How many of us could pass an I.Q. test administered in Russian and printed out in the Cyrillic alphabet? Could we even know what to do with a puzzle if the directions were spoken in a language we were unfamiliar with?

One current, widely used I.Q. test for kids displayed (maybe still?) a lack of cultural understanding and rated against some children. The test of judgment was one where a specific problem existed, and the child was scored on what they said they’d do in that situation.

When I read the question, I knew what a child in a poor neighborhood would do, and I wouldn’t have scored against them for what I saw as a smart action. To my mind, that portion of the test is culturally biased. Remember that call for “culture-free testing” or “culture-fair testing?” Who missed this one? Schools all over the U.S. use this test and others for school placement.

The question of intelligence has been one where many psychologists have attempted to devise one test to measure everything. Howard Gardner believed there wasn’t a singular intelligence, but multiple intelligences (Linguistic, Logical/Mathematical, Spatial, Bodily-Kinesthetic, Musical, Interpersonal, Intrapersonal, and Naturalist), and each should be measured. Gardner outlined these intelligences in his book Frames of Mind. Some forms of intelligence, he noted, could be enhanced by exposure to learning and culture.

Other psychologists, for example, Alexander Luria, studied neurologic aspects of psychology with his Luria-Nebraska battery of tests. One caveat most psychologists never hear is that Luria cautioned that it would take several years to become proficient in administering the test.

I do not know if the battery was normed on a diverse cultural sample. However, today we may turn to neurologic imaging for answers to individual deficits/difficulties.

I.Q. tests aren’t the only ones that are not sensitive to cultural considerations. Tests to assess depression have come under the research microscope, and we find them wanting, especially with Black women, an understudied group. An analysis of depressive symptoms in Black mothers found: In this sample of A.A. women with increased cardiometabolic burden, increased stress was associated with depressive symptoms that standard screening tools may not capture.

One reason depression may not be adequately assessed is the stereotype of the “strong black woman” (SBW), where self-silencing is one of the cardinal features. Seeking out or admitting to a need for mental health services does not mesh well with this image. The question for researchers is how to best devise tests of emotion for groups other than the usual white samples.

Any medical or psychological test must acknowledge the inherent factors of discrimination, culture, and bias. As in artificial intelligence algorithms, psychological test construction can have bias unacknowledged and unstudied by those who create and validate the tests.

Much work remains for everyone involved in providing care for all who come to them, and reliable, valid tests are a mandate for everyone.