Eliminating overconfidence in psychodiagnosis: Strategies for training and practice.

Abstract

Research in several domains has revealed that when individuals are asked to estimate the probability that their judgments are correct, they reveal an overconfidence effect. Judgments produced in decision environments such as psychodiyrosis, which are by nature complex and ambiguous, appear to be most vulnerable to overconfidence. By implication, this phenomenon threatens the validity of clinical judgment and subjects clients to risks of flawed diagnoses and unsuitable treatments. The authors propose that effective remedies to overconfidence begin in training programs that lead students through problem-solving experiences that can invdidate facile, premature, and dubious dlyrostic judgments. Syndromes det3n.d by the DSM-IV are permeable and fuzzy sets, and students must be trained to assign membership to these sots with caution. Key wods: overconiidence, clinical judgment, debiasing, fuzzy sets. Win Psycho1 Sci Pmc 4d35-345, 1997JWhen psychologists make judgments about clients based on clinical databases that are necessanly incomplete and often ambiguous, they do so, knowingly or otherwise, under condltions of uncertainty. Research has shown that inferences generated under such conditions are ofien expressed with unwarranted confidence. In that perspective, this article presents a selective and brief review of the literature on overconfidence, hghhghting important empirical findlngs that have relevance to this problem in clinical psychology and in other judgment contexts.

Confidence and accuracy in assessments of short-term risks presented by forensic psychiatric patients

“…Instead, there is a human tendency to be overconfident in the accuracy of our decisions (Harvey, 1997). Research in the area of clinical decision-making offers similar conclusions (Arkes, 1981;Faust & Ziskin, 1988;Smith & Dumont, 1997). In their review of clinical psychological judgment, Wedding and Faust (1989) noted a lack of evidence that accuracy is related to experience, expertise, or confidence in the correctness of predictions.…”

“…In particular, research demonstrates strong associations between clinicians' assessments and tribunal decisions (Hilton & Simmons, 2001;Whittemore, 1999). Thus, overconfidence regarding estimates of dangerousness may misdirect the decision-making body (Smith & Dumont, 1997). In the case of overestimated risk (false positive), we may see unwarranted limitation of the patient's civil liberties.…”

Are the unskilled doomed to remain unaware?

“…Specifically, the UUP has been reported to be robust to feedback (Hacker et al, 2000;Ferraro, 2010;Ehrlinger et al, 2008). Whether or not the unskilled can improve calibration through experience and feedback, thereby reducing the UUP, is also an important practical question from the perspective of the optimization of education and training procedures (Smith & Dumont, 1997;Stone & Opel, 2000).…”

“…Overconfidence may have negative consequences (Dunning, Heath, & Suls, 2004), such as medical diagnostic errors (e.g., Smith & Dumont, 1997;Haun et al, 2000) and economic losses due to excessive market entry (e.g., Camerer & Lovallo, 1999) or overexposure to risk (e.g., Malmendier & Tate, 2005). It is, therefore, important to understand how overconfidence, and miscalibration in general, can be reduced.…”

Errors/Biases in Clinical Decision Making

“…Overconfidence effects have been demonstrated on a number of clinical tasks, including those in which psychologists are asked to make predictions regarding their clients' prognoses (Smith & Dumont, 1997). Hindsight bias may lead mental health professionals to overestimate their predictive capacities because the correct answers to difficult clinical questions often seem obvious in retrospect.…”