Patient variable biases in clinical judgment: Conceptual overview and methodological considerations.

Abstract

Specific conceptual factors are presented as having contributed to the negative findings of past psychotherapy bias research. Among these factors are the restrictive nature of both the definition of bias and the model of the biased clinician. A review of published studies of several patient variable biases (e.g., gender, race/ethnicity, and age) indicated that bias may best be defined in broader terms and that its occurrence may be more circumscribed than originally conceived. In addition, the lack of a theoretical perspective in this area of research is noted and the applicability of some social cognitive processes is discussed. Methodological factors are also considered, and recommendations for future research are offered.

Race, ethnicity, and eating disorders: Considerations for DSM-V

“…Misinformed use of presumed prevalence rates may play a role in clinician bias. 18 What can be done to increase provider sensitivity and ability to detect eating disorders in women of color? With very little education on eating disorders for healthcare professionals in training, 19 this is a significant challenge.…”

Influence of information related to child physical abuse on professional ratings of adjustment and prognosis

“…Clinical judgment is known to be infl uenced by a variety of factors, and errors in judgment can have a negative impact on the individual being evaluated (Faust, 1986;Garb, 1989;Lopez, 1989;Nezu & Nezu, 1989).The present study examined the infl uence of information related to a history of physical abuse on judgments related to treatment and social functioning. Participants were two diverse groups of professionals, representing social work and clinical psychology.…”

“…The analog case methodology has been utilized in prior research (Ellis, Robbins, Schult, Ladany, & Baker, 1990;Hansen, Warner-Rogers, & Hecht, in press;Howe, Herzberger, & Tennen, 1988;Pain & Sharpley, 1989) and has been called for as a necessary approach to systematically examine clinical judgment (Lopez, 1989). The methodology is very useful for establishing experimental control, however it is unknown how results of this particular analog model would relate to judgments in actual practice.…”

“…Although there has been considerable research and theory development on clinical decision making, there is still substantial evidence that clinical judgments are often fl awed and may result in negative consequences for those being judged (Lopez, 1989;Meehl, 1986;Nezu & Nezu, 1989).A variety of types of stimuli may elicit inaccurate or biased responses among professional populations (Nezu & Nezu, 1989), and the presence of a label has been one of the most researched forms of infl uence (Langer & Abelson, 1974;Leake & King, 1977). Understanding of such infl uences is essential because they can result in responses by professionals that are unwarranted or extreme.…”

Culture-sensitive functional analytic psychotherapy

“…A client's unfamiliarity with mainstream social conventions may be mistaken for pathology, and the therapist may encourage him or her to adopt the dominant culture's commonsense beliefs and life goals; these might be inappropriate to the client's milieu or irrelevant to the problems for which he or she seeks therapy. Moreover, the converse may also be true (Lopez, 1989). The therapist may overlook serious problems buried among badly understood features of the client's culture in such a way that cultural differences may result in either overor underpathologization.…”