Western Standards of Psychologic - Essay Example

? There are a number of physical illnesses which can adequately be diagnosed through, for example, a toxicology screen. Biochemical markers in the human body, can be measured sufficiently to diagnose an entire corpus or wide-range of treatable health problems. Although psychiatry is itself a science, it cannot be said to lend itself to perfect quantitative method of diagnoses the way hematology and toxicology have methods for diagnosing physical problems. And yet, no one would deny that biochemical considerations are involved in psychiatry. The brain is after all, the same physical composition as the rest of the body, and moreover, many psychiatric drugs effectively control – and, through biochemistry, symptoms, from a variety of psychiatric disorders. While the etiology or understanding of causes of disorders in psychiatry and the treatment of symptoms has progressed, the assessment process of psychiatry does pose a lot of challenges to scientific legitimacy. It will be argued in the following analysis that bias in testing [Goldstein 533] remains a persistent problem in the clinical evaluation of psychiatric disorders or with formal assessments, and this bias is particularly prevalent in the evaluation of people who are not from a group with values reflecting a European or American background, along with being in the socio-economic group of the middle-class and above. Cultural bias in testing is a fairly long-understood phenomenon. In the United States, it has for some time been known for example that visible minorities, and in particular, African Americans have done worse on a proportionate basis than middle-class youth from a European background on the standardized entrance test for university. At at the same time, the standardized testing used at the graduate level, with, for example, law school and medical school demonstrate that there is a consistency among minorities and individuals of the dominant class. In other words, if an individual can make it to an undergraduate program and through that, their cultural differences or 'bias in testing' at the end of the program are not as significant as when they entered the undergraduate program. It has long been known that the test-scores reflect not just academic ability, but a familiarity and command of the cultural values that are expressed or a part of the language of the test [Goldstein 540]. Further, critics point to an inverted situation as a counter-example of how 'test bias' involves cultural variables that help shape or determine the outcome or results. The counter-example would be a situation where individuals from the middle-class and above, and from a European background were to take an exam written entirely with the idioms of a culture that was non-European [Martin, Volkmar, and Lewis: 61]. One can imagine the difficulties a white male from the suburbs of outer Liverpool, Manchester or London would fair on an exam that was written using the terminology and sentence structure of a first-generation Jamaican who was living in Brixton. Jamaican is a good example of a language or medium for communication with significant linguistic differences than the 'received pronunciation' that might be taught at Eton or Harrow School's. Jamaican has differences in both dialect with regard to English usage, but also incorporates terminology from “Patois” that is arguably a self-contained language that does not exactly correspond to a European language. That is, even though there are a lot of structural and semantic similarities. It can be said that one of the principle or central problems with bias in testing concerns the very notion of “linguistic relativity”. This is a notion that maintains that there are not always perfect translations that can be made between languages, and moreover, that this imperfect translation has much to do with other cultural variables such as values, belief systems and basic knowledge and shared understanding of the world, so to speak. However much it can be said that there is bias in testing when testing across cultures, there have also been a number of evaluation criteria and assessment tools in recent years that attempt to establish non-linguistic criteria. In direct response to the limitations of linguistic based testing, a number of non-verbal tests have been developed in the past few decades. Some of these non-verbal tests that are now employed in psychiatry include: Raven's Progressive Matrices, the Leiter International Performance Scale, and the Peabody Picture Vocabulary Test, and the General Abilities Test for Adults [McCallum 223]. It is important to stress that some of these tests have been found to have limited cultural bias [Kaufman and Lichtenberger, 2002]. Moreover, the bias that is inherent in the relationship between cultural beliefs and language is not only challenged by the fact that these are non-verbal tests, or tests that use visual information for the layout and communication medium, they are also tests that were designed with cultural bias in the first place. That is to say that while they have the advantage of being 'non linguistic', they also emerged as tests with the assumption that there is cultural bias in testing in the first place. Thus, even the questions and not just the medium reflect the problem of bias in testing. When considering or evaluating the attempts to go beyond 'cultural bias' with regard to psychological or psychiatric assessments, a further element for consideration must be made toward the 'evaluative' dimension in the assessment process. What the relative success of the non-verbal tests show, is that careful consideration or greater awareness enhances the potential for not skewed outcomes. The System of Multicultural Pluralistic Assessment or SOMPA attempts to differentiate pragmatically, that which can be assessed without bias and that which needs a further stage of consideration. On the positive side of the SOMPA, is that they separate a significant amount of the “medical” information in the assessment process from that which comes from the “social system” and requires further analysis [Groth-Marnat 57]. The assessment of physical conditions such as hearing, vision and motor function, allows the psychiatrist to rule out any medical conditions that might be determining or shaping neurobiology. These assessments rule out some and arguably, a significant number of disorders and are therefore one of the more pragmatic responses to the type of 'bias' discussed above. The SOMPA further tries to create “sub groups” with specific cultural markers so that some of the bias of the dominant group is challenged. What is meant by this, is easily described with an example. 'Success' is a good example of assessment. While socio-economic benchmarks are often good indicators, they do have some inherent bias unless alternative information is considered [Groth-Marnat 58]. Someone who spends five years doing post-doctoral research and contributing to the community of knowledge through their output, is likely not going to have the same financial status of someone who spent the same interval of a decade working as a stock broker who may have accumulated millions because of luck with their speculation. While the stock broker in this example might be successful as measured by socio-economic variables, no one would maintain that someone who has spent the same interval learning and contributing to a body of knowledge was not successful. This comparison of the 'stock broker' and the post doctoral researcher stands to show that a strictly quantitative benchmark like socio-economic success. What the SOMPA seeks to do, is to look at those qualitative variables that might go into adjusting for qualitative problems. For instance, a sub-group consideration might be those seeking religious enlightenment. Not unlike the post-doctoral graduate student, some cultures place a high premium on the individuals who turn their lives over to some religious order or set of doctrines, and more in particular, such sub groups likewise often have a vow of poverty. While the SOMPA tries to adjust for cultural differences by introducing an assessment criteria based on sub-groups, it is not an assessment without limitations. Further, it is not an assessment method that does not have its critics and it should be stressed that while it is a common example of positive results cited in the literature of psychiatric assessments [Groth-Marnat 59], it is also an educational assessment tool. Intelligence, along with medical information, are only components that also must include other psychological variables. The example concerning 'success' was one raised to demonstrate the limitations of these psychological variables that have any connection to 'culture'. The example given above stands to serve as demonstrating how “world views” shape cultural beliefs, practices and opinions [Course Reading 15]. Psychiatry comes out of one particular 'world view', and that is connected with western science. Our world view as defined in the course reading, are those elements or aspects of our knowledge that present for us a type or form of “certainty” [Course Reading 17]. Ayurveda medicine in India, and Chinese medicine are both systems that have produced certainty for several thousands of years. Where a Chinese practitioner might assess a patient as having their 'chi' out of alignment or balance, a Western educated psychiatrist might evaluate the very same patient as suffering from bipolar disorder. Both assessors in this example, might recommend to the individual that they should try and get some good solid sleep, and they would both probably be correct. While there would be more to the recommendations and assessment of both, this example stands to demonstrate how a 'world view' can both produce 'certainty', but also, produce the 'same results'. Therefore, it has been argued that cultural and in particular, linguistic relativity make psychiatric diagnosis difficult. While a lot of medical and other information is not cultural determined and therefore objective, it is the case that with psychiatry, behaviour is conditioned, shaped, and finally, evaluated using criteria that is relative. Works Cited: Course Readings. Chapter Title: Worldviews and culture. Goldstein, Gerald (Ed.) 2000. Handbook of Psychological Testing. Third Edition. Oxford: Elsevier Science. Groth-Marnat, Gary (Ed.). 2003. Handbook of Psychological Assessment. Third Edition. Hobokon: John Wiley. Kaufman, A.S., & Lichtenberger, E.O.. 2002. Assessing adolescent and adult intelligence. Second Edition.  Boston: Allyn & Bacon. Martin, Andres and Volkmar, Fred R. (Ed.). Lewis's Child and Adolescent Psychiatry. A Comprehensive Textbook. Fourth Edition. Philadelphia: Lippincott, Williams and Wilkins. McCallum, R. Steve (Ed.). 2003. Handbook of Non-Verbal Assessment. New York: Kluwer. On the Problem of Cultural Bias in Psychological Testing. Read More