Clinical biases in diagnosis

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In the abnormal psychology option, what is the difference between cognitive biases and clinical biases?

Clinical biases are cognitive biases that take place when a psychiatrist or psychologist is trying to make a diagnosis and label the behaviour. They can arise from experience (‘these symptoms nearly always mean this mental health problem’) and result in a misdiagnosis when other explanations for the behaviour are too readily discarded. This is a confirmation bias – symptoms are interpreted to confirm the mental health professional’s original swift diagnosis. It was demonstrated in Rosenhan (1973)  when the admitting medical staff interpreted the very vague symptoms described as schizophrenia, and even more clearly when the normal behaviour exhibited by the pseudo-patients was interpreted by medical staff to confirm the validity of the original diagnosis.

They can also arise from an existing societal and/or personal bias, such as an ethnic or gender bias. Jenkins-Hall and Sacco (1991) found that a sample of USA psychotherapists showed an ethnic bias against black clients in that they evaluated depressed black clients more negatively than depressed white clients. While both groups were diagnosed with depression, the black clients (ethnic minority in this case) were seen as being less socially capable and were evaluated as more seriously depressed, using a standardised scale. A larger study by Bertakis et al (2001) demonstrated that women were much more likely than men to be diagnosed as depressed by their primary care physicians, even with a similar number of visits. This showed a gender bias in diagnosis.

So, there is a clear link between this material and the study of cognitive biases, especially confirmation bias.

References

Bertakis, K.D., Helms, J., Callahan, E.J., Rahman, A., Leigh, P. & Robbins, J.A. (2001).  Patient Gender Differences in the Diagnosis of Depression in Primary Care.  Journal of Women’s Health & Gender-Based Medicine, 10(7), pp. 689-698.

Jenkins-Hall , K. & Sacco , W.P. (1991).   Effect of Client Race and Depression on Evaluations by White Therapists.  Journal of Social and Clinical Psychology, 10(3), pp. 322-333.

Rosenhan, D. L. (1973). On being sane in insane places. Science179(4070), pp. 250-258.

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