Investigating Clinician Adherence to Diagnosis by Criteria: A Replication of Morey and Ochoa (1989)

Blashfield, Roger K.; Herkov, Michael J.

doi:10.1521/pedi.1996.10.3.219

Cited by 43 publications

(36 citation statements)

References 5 publications

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“…Although the DSM-III (APA, 1980) and subsequent editions of the manual have provided specific operational definitions of disorders, research has shown that clinicians often fail to adhere to the diagnostic criteria (Blashfield & Herkov, 1996;Morey & Ochoa, 1989), thereby increasing the likelihood of inaccurate diagnosis. Although a more structured approach to diagnosis is not always appropriate, clinicians often make diagnostic decisions relying solely upon clinical judgment (Blashfield & Herkov, 1996;Garb, 2005).…”

Section: Dsmmentioning

confidence: 99%

“…Indeed, a number of researchers have shown that many clinicians fail to adhere to diagnostic criteria (Blashfield & Herkov, 1996;Morey & Ochoa, 1989), preferring instead to rely upon idiosyncratic methods of diagnostic conceptualization (Whaley & Geller, 2007).…”

Section: Diagnostic Decision-makingmentioning

confidence: 99%

“…For example, Blashfield and Herkov (1996) suggested that use of a prototype approach might be appropriate with Borderline Personality Disorder, as clinicians tend to differentially weight certain criteria because they are more typical of the disorder.…”

Section: Diagnostic Decision-makingmentioning

confidence: 99%

“…Compared to these structured approaches, clinicians are prone to under-diagnose, over-diagnose, or misdiagnose a range of disorders when relying upon clinical judgment (Whaley & Geller, 2007). In two studies examining diagnostic bias, the diagnosis assigned by clinicians was compared to a criterion-based diagnosis, which was based on ratings of the patients' symptoms (Blashfield & Herkov, 1996;Morey & Ochoa, 1989). Both studies found considerable disparity between the assigned diagnosis and the criterion diagnosis, with both over-diagnosis (i.e., assigning a diagnosis when the symptom ratings suggested the patient did not meet criteria) and under-diagnosis (i.e., failing to assign a diagnosis when symptom ratings indicated that the patient met criteria for the diagnosis).…”

Section: Diagnostic Decision-makingmentioning

confidence: 99%

“…Both studies found considerable disparity between the assigned diagnosis and the criterion diagnosis, with both over-diagnosis (i.e., assigning a diagnosis when the symptom ratings suggested the patient did not meet criteria) and under-diagnosis (i.e., failing to assign a diagnosis when symptom ratings indicated that the patient met criteria for the diagnosis). Although Morey and Ochoa (1989) concluded that when clinicians failed to adhere to diagnostic criteria it resulted in misdiagnosis, Blashfield and Herkov (1996) suggested that the results reflected two different styles of decision-making: a prototype approach and the DSM approach.…”

Section: Diagnostic Decision-makingmentioning

confidence: 99%

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Diagnosis of depersonalization disorder

DeHoff¹

2011

PsycEXTRA Dataset

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Depersonalization Disorder (DPD) is considered both under-researched and underdiagnosed. A variety of reasons have been proposed for the under-diagnosis of DPD, including the high frequency of depersonalization as a symptom and comorbidity of DPD with other disorders. Under-diagnosis of DPD has also been attributed to inadequate diagnostic criteria in the DSM-IV-TR, as it lists only four criteria and only one specifically addresses the phenomenon of depersonalization. Several groups of researchers have proposed more comprehensive and in-depth conceptualizations of DPD. Further, common biases in clinical decision-making, such as an over-reliance on cognitive heuristics and the use of prototypes, can contribute to inaccurate diagnosis and under-diagnosis. A national sample of licensed psychologists was randomly selected and recruited from the membership of the American Psychological Association. The study was conducted on-line and participants were asked to read one of two DPD cases, assign a diagnosis, and rate the representativeness of a series of diagnoses for the case. They were also asked to rate the presence of a list of symptoms, including the DSM-IV-TR and ICD-10 criteria for DPD, and the symptoms and dimensions of DPD and depersonalization from the literature. Half of the participants were asked to assign a diagnosis and then rate symptoms (simulated prototype approach) while the others rated the symptoms before assigning a diagnosis (simulated DSM-IV approach). The study found that clinicians under-diagnosed DPD and that the DSM-IV depersonalization criterion had high sensitivity but not adequate specificity. Results indicated that a simulated DSM-IV approach

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Section: Dsmmentioning

confidence: 99%

Section: Diagnostic Decision-makingmentioning

confidence: 99%

Section: Diagnostic Decision-makingmentioning

confidence: 99%

Section: Diagnostic Decision-makingmentioning

confidence: 99%

Section: Diagnostic Decision-makingmentioning

confidence: 99%

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Diagnosis of depersonalization disorder

DeHoff¹

2011

PsycEXTRA Dataset

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Personality Disorders

Trull¹,

Widiger²

2003

Handbook of Psychology

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Personality disorders are diagnosed on a separate axis in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders in recognition of their prevalence and their impact on the treatment and course of most every other mental disorder. Ten personality disorders are included in DSM‐IV: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, and obsessive‐compulsive. The phenomenology, epidemiology, etiology, childhood development, and pathology of each are discussed. Also discussed are issues of gender and culture bias, comorbidity, and the conceptualization of personality disorders as maladaptive variants of common personality traits. This alternative conceptualization is in contrast to the current DSM‐IV conceptualization of personality disorders as disorders with specific etiologies and pathologies that are qualitatively distinct from general personality functioning.

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Assessment and Data Collection

Nugent

2008

Comprehensive Handbook of Social Work and Social Welfare

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Investigating Clinician Adherence to Diagnosis by Criteria: A Replication of Morey and Ochoa (1989)

Cited by 43 publications

References 5 publications

Diagnosis of depersonalization disorder

Diagnosis of depersonalization disorder

Personality Disorders

Assessment and Data Collection

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