In recent years, the integration of multimodal machine learning in wellbeing assessment has offered transformative potential for monitoring mental health. However, with the rapid advancement of Vision-Language Models (VLMs), their deployment in clinical settings has raised concerns due to their lack of transparency and potential for bias. While previous research has explored the intersection of fairness and Explainable AI (XAI), its application to VLMs for wellbeing assessment and depression prediction remains under-explored. This work investigates VLM performance across laboratory (AFAR-BSFT) and naturalistic (E-DAIC) datasets, focusing on diagnostic reliability and demographic fairness. Performance varied substantially across environments and architectures; Phi3.5-Vision achieved 80.4% accuracy on E-DAIC, while Qwen2-VL struggled at 33.9%. Additionally, both models demonstrated a tendency to over-predict depression on AFAR-BSFT. Although bias existed across both architectures, Qwen2-VL showed higher gender disparities, while Phi-3.5-Vision exhibited more racial bias. Our XAI intervention framework yielded mixed results; fairness prompting achieved perfect equal opportunity for Qwen2-VL at a severe accuracy cost on E-DAIC. On AFAR-BSFT, explainability-based interventions improved procedural consistency but did not guarantee outcome fairness, sometimes amplifying racial bias. These results highlight a persistent gap between procedural transparency and equitable outcomes. We analyse these findings and consolidate concrete recommendations for addressing them, emphasising that future fairness interventions must jointly optimise predictive accuracy, demographic parity, and cross-domain generalisation.
Vision-language models (VLMs) are increasingly used to make decisions from visual inputs. We introduce FAIRLENS, a benchmark and evaluation framework for measuring both the fairness and the validity of VLM responses in three high-stakes domains: hiring, legal, and healthcare. FAIRLENS pairs real face images spanning gender, race, and age groups with closed- and open-ended questions, giving more than 100K image-question pairs per model, and evaluates responses from four complementary views: demographic parity over adverse outcome rates, soundness, demographic association over unsupported roles and statuses, and bias in free-text generation. Soundness is the central validity criterion: a response is sound when it follows the evidence stated in the question and abstains when the image cannot support an answer. Evaluating eight VLMs, we find that the primary failure is unwarranted inference rather than unequal treatment. Models routinely infer qualifications, threat, illness, or professional role from a face instead of abstaining, and the weakest model does so on 99% of the questions its input cannot answer. These failures are most severe in legal and healthcare, where recognizing insufficient evidence matters most, and disparity metrics alone would miss them: parity gaps are small in absolute terms, yet when baseline adverse rates are low the same gap means one demographic group receives adverse labels several times as often as another, and a small gap can equally reflect a model that treats every group unsafely. Bias in free-text responses is only loosely coupled to multiple-choice accuracy, so correct structured answers do not imply safe generation. FAIRLENS shows that fair high-stakes VLM behavior requires similar treatment across groups and refusal to infer high-stakes attributes from appearance, and its question suite transfers to any face corpus with demographic annotations.
Vision-Language Models (VLMs) map complex visual inputs to semantic spaces, but interpreting the cross-modal reasoning of VLMs currently relies on post-hoc explainers evaluated via unimodal perturbation metrics. We expose a limitation in this paradigm: because multimodal datasets contain language priors and modality biases, VLMs frequently exhibit cross-modal redundancy, allowing them to answer visual queries using text alone. Consequently, unimodal metrics penalize faithful explainers, triggering an evaluation collapse where visual and textual rankings fundamentally contradict each other. %(Kendall's τ=−0.06). To resolve this, we introduce Synergistic Faithfulness (Fsyn), a scalable metric rooted in the Shapley Interaction Index that strictly isolates the joint Harsanyi dividend between modalities, serving as a highly accurate surrogate (ρ=0.92) while achieving a 24× computational speedup. Evaluating 8 distinct XAI methods across 3 VLM architectures and 3 benchmark datasets, reveals that explainers proposed for VLMs heavily over-index on visual salience and significantly underperform adapted attention-based methods in capturing true cross-modal synergy. By decoupling visual plausibility from cross-modal faithfulness, this work provides a rigorous evaluation framework required to safely audit VLM reasoning in high-stakes deployments.
Vision-Language Models (VLMs) such as CLIP are now foundational to multimodal systems, yet their robustness to spurious correlations remains poorly understood at scale. We present the first large-scale empirical study of 194 publicly available VLMs, including 16 model families, covering a wide range of model sizes, 24 training datasets, and three evaluation benchmarks, namely ImageNet (overall performance), CelebA (typical single-attribute bias), and UrbanCars (complex multi-attribute biases). Across these settings, the Spearman correlation between model scale and performance weakens as evaluation shifts from ImageNet (ρ=0.68) to single-attribute (ρ=0.48) and further to multi-attribute (ρ=0.05) bias benchmarks. In contrast, properties of the training data (size and quality) show more consistent relationships with worst-group accuracy across both bias benchmarks. Notably, curated datasets yield improvements of up to 25% over uncurated alternatives at a comparable scale. Finally, the effect of architectural choices (e.g., patch size, image resolution) is highly context-dependent, varying with the nature of the benchmark, including the type of bias and its spatial distribution within images.
Ioannis Sarridis, Ioannis Kompatsiaris, Symeon Papadopoulos