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Reducing racial bias in neuropsychological rehabilitation
Gary A James1, Jessica P Conklin1, Nicole A Thompson1
1Shepherd Center, 2020 Peachtree Rd NW Atlanta, Georgia, USA.
Objective:
Research has consistently demonstrated race-based differences in indices of absolute level of functioning (e.g. above average, average, below average) on neuropsychological tests primarily due to cultural bias, with suggestions that it is more difficult to identify relative degree of decline from estimated premorbid level of functioning for racial minority groups.
Method:
To test this hypothesis, the current study calculated and compared indices of absolute level of functioning and indices of relative decline for a sample of 239 individuals (69 Black, 170 White) with heterogeneous neurological disorders at a rehabilitation center.
Results:
As hypothesized, between-group comparisons indicated: individuals identifying as Black scored significantly lower on 9 of 10 neuropsychological measures of absolute level of functioning; but both groups did not significantly differ statistically on relative decline scores for all neuropsychological tests, regardless of race.
Conclusion:
Results suggest that indices of relative decline, based on comparisons of individual neuropsychological test scores to estimates of premorbid functioning, provide an equitable method to calculate the degree to which individuals identifying as both Black and White experience neuropsychological impairment. However, issues of cultural bias remain in the use of indices of absolute level of functioning. Rehabilitation and research implications are discussed.
