The influence of causal connections between symptoms on the diagnosis of mental disorders: Evidence from online and offline measures.

Abstract

An experiment conducted with students and experienced clinicians demonstrated very fast and online causal reasoning in the diagnosis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders. The experiment also demonstrated that clinicians' causal reasoning is triggered by information that is directly related to the causal structure that explains the symptoms, such as their temporal sequence. The use of causal theories was measured through explicit, verbal diagnostic judgments and through the online registration of participants' reading times of clinical reports. To detect both online and offline causal reasoning, the consistency of clinical reports was manipulated. This manipulation was made by varying the temporal order in which different symptoms developed in hypothetical clients, and by providing explicit information about causal connections between symptoms. The temporal order of symptoms affected the clinicians' but not the students' reading times. However, offline diagnostic judgments in both groups were influenced by the consistency manipulation. Overall, our results suggest that clinicians engage in fast and online causal reasoning processes when dealing with diagnostic information concerning mental disorders, and that both clinicians and students engage in causal reasoning in diagnostic judgment tasks.

The Diagnosis of Mental Disorders Is Influenced by Automatic Causal Reasoning

“…This effect suggests (a) that participants' causal beliefs affect online, fast, and efficient Type 1 processes during reading and (b) that these Type 1 processes involve the computation of causal coherence. Our findings complete previous findings by Flores, Cobos, López, Godoy, and González-Martín (2014). This study showed that RTs and diagnostic judgments are affected by the temporal coherence between the observed sequence of symptoms and the temporal sequence implicated by causal assumptions of the participating clinicians.…”

“…One may think that more experienced clinicians would be less affected by causal considerations in diagnostic decision making as they receive extensive training on the correct use of the DSM. The experimental findings cited earlier prove otherwise Flores, Cobos, López, Godoy, & González-Martín, 2014;Kim & Ahn, 2002). Conversely, it might be argued that experienced clinicians are especially vulnerable to influences of causal knowledge because Type 1 processes play an important role in experts' reasoning.…”

“…Inspired by theories of reading comprehension (Graesser, Singer, & Trabasso, 1994), Flores, Cobos, López, Godoy, and González-Martín (2014) explained their results by postulating that reasoners engage in Type 1 processes to generate a mental model, which tries to integrate the diagnostic information provided at the beginning of the clinical reports, respective preexisting causal knowledge, and the information about symptoms provided later on. Depending on the coherence of the resulting mental model with the given diagnosis, reasoners may come up with a feeling of coherence.…”

Highways to happiness for autistic adults? Perceived causal relations among clinicians

“…The factor that ranked highest among all choices was also the most central factor in the PCR network: depressed mood. This is in line with literature demonstrating that clinicians causal reasoning when dealing with diagnostic information concerning mental disorders is related to the causal model they adhere to [33][34][35].…”

Clinicians’ Personal Theories of Developmental Disorders Explain Their Judgments of Effectiveness of Interventions

“…Previous studies also indicated that clinicians’ causal assumptions are related to treatment preferences (e.g., Ahn et al, 2009 ; Flores, Cobos, López, Godoy, & Ganzález-Martín, 2014 ), but no study investigated how personal theories of disorders are linked to inferences about the relative effectiveness of treatments. De Kwaadsteniet, Hagmayer, Krol, and Witteman (2010) studied clinicians’ causal models of individual clients (i.e., their clinical case conceptions) and found that these models predicted clinicians’ judgments of the relative effectiveness of different interventions for the specific client.…”