The Lay Concept of Conduct Disorder: Do Nonprofessionals Use Syndromal Symptoms or Internal Dysfunction to Distinguish Disorder from Delinquency?

Wakefield, Jerome C.; Kirk, Stuart A.; Pottick, Kathleen J.; Hsieh, Derek K.; Tian, Xin

doi:10.1177/070674370605100402

Cited by 27 publications

(16 citation statements)

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“…As family members are normally the gateway to engagement of their children in treatment, future studies might explore the influence of context on their judgments of treatment effectiveness. For judgments of the existence of mental disorder, research has demonstrated that laypersons often make similar distinctions as professionals (Wakefield et al 2006;Garb 1998;Marsh et al 2014), and some scholars think that the similarities may reflect general reasoning processes (Marsh et al 2014). From these findings, we expect that parents may be equally sensitive to the importance of context for making judgments about treatment.…”

Section: Iqr Interquartile Rangementioning

confidence: 95%

“…Existing research offers evidence that experienced clinicians are sensitive to the social context surrounding adolescent antisocial behavior, and that they judge youth as less likely to have a mental disorder when context suggests the behavior might be a normal reaction to a harsh environment, rather than irrational responses resulting from internal dysfunction (Hsieh 2001;Hsieh andKirk 2003, 2005;Pottick et al 2003Pottick et al , 2007Wakefield et al 2002Wakefield et al , 2006. Other research studies have found that clinicians differentially use contextual information to weigh the importance of symptoms in judging whether a youth should be considered as having a diagnosis of conduct disorder (De Los Reyes and Marsh 2011;Marsh et al 2016), and have demonstrated that contextual information not only influences how clinicians arrive at diagnoses, but can also influence their judgments about other aspects of the clinical encounter, such as prognosis, need for professional help, and appropriateness of medication .…”

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confidence: 99%

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Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth?

Pottick

Tian

Kirk

et al. 2017

J Psychopathol Behav Assess

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Using a between-subject 3 × 3 design of an experimentally manipulated realistic case vignette of Black, White, and Hispanic youth in a survey mailed to 1540 experienced psychologists, psychiatrists, and social workers, the authors examined if clinicians alter their judgments about treatment for antisocially behaving youth based on the symptom's social context (e.g., life circumstances) and the youth's race or ethnicity, even among youth who are otherwise identical in terms of behavioral symptoms. Vignettes describe behaviors meeting DSM-IV criteria for conduct disorder, but contain contextual information suggesting either internal dysfunction (ID) or a normal response to a difficult environment [i.e., environmental-reaction (ER)]. Comparison was symptomonly (SO). Judgments of effectiveness of 14 treatments for youth exhibiting antisocial behavior were examined. Frequencies and median scores of perceived effectiveness level (1-9, Likert) were compared in bivariate analyses, stratifying context and youth's race or ethnicity. The context of the behavior was associated significantly with differences in effectiveness judgments in 13 of 14 treatments. Within ID and ER contexts, clinicians judged three different treatments as effective (median ≥ 7 of 9). In the SO condition, clinicians were less selective, judging six as effective. In the ID context, psychiatric medications, systems oriented family therapy, and residential care were judged more effective for White than for Black or Hispanic youth. Evidence-based practice research may be hampered by inattention to the social context of behavioral symptoms. Context may activate implicit racial assumptions about treatment effectiveness. Implications are for clinical training to improve service delivery, and future clinical research.

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Section: Iqr Interquartile Rangementioning

confidence: 95%

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confidence: 99%

Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth?

Pottick

Tian

Kirk

et al. 2017

J Psychopathol Behav Assess

Self Cite

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“…Wakefield et al. () looked at vignettes administered to social work graduate students, laypeople, and clinicians to assess judgments of a White or Mexican youth with antisocial behaviors. By adjusting text to explain behavior as either an environmental reaction or an internal dysfunction, the team found ethnicity/race differences in the impact of context on judgments of whether or not the youth had the disorder (Wakefield et al.…”

Section: Introductionmentioning

confidence: 99%

“…Green et al (2007) reported on the use of vignettes administered through an Internet-based tool and using implicit association tests (IATs) (Project Implicit, Harvard; http://www.implicit.harvard.edu), finding that while most physicians did not admit to explicit racial preference, many showed implicit preference for White patients that predicted differences in their treatment recommendations. Wakefield et al (2006) looked at vignettes administered to social work graduate students, laypeople, and clinicians to assess judgments of a White or Mexican youth with antisocial behaviors. By adjusting text to explain behavior as either an environmental reaction or an internal dysfunction, the team found ethnicity/race differences in the impact of context on judgments of whether or not the youth had the disorder (Wakefield et al 2006).…”

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confidence: 99%

Lessons from the Use of Vignettes in the Study of Mental Health Service Disparities

Lapatin

Gonçalves

Nillni

et al. 2011

Health Services Research

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Objective To examine the development, feasibility, and use of a vignette approach as an important tool in health services disparities research. Data Source Interviews with vignette developers and qualitative data from a novel mental health services disparities study that used vignettes in two samples: (1) predominantly low-income parents of children attending mental health specialty care who were Latino or non-Latino White and (2) Latino and non-Latino mental health clinicians who treat children in their practice. Study Design We conduct a content analysis of qualitative data from patients and providers in the Ethnic Differences Study to explore the feasibility of vignette methodology in health services disparities research, and we identify lessons learned that may guide future vignette development. Principal Findings Vignettes provide a valuable approach that is acceptable to participants, elicits important insight on participant experience and services, and sheds light on factors that can help optimize study design for exploring health disparities questions. Conclusions Researchers, clinicians, and others should consider a set of factors that help determine when a vignette approach is warranted in research, training, or for other uses, including how best to address identified weaknesses.

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“…Particularly when symptoms occur without preceding life events, labeling as mental illness is no necessary precondition for perceiving a need for professional help. Similar disparities in lay judgments of illness status and need-for-help judgments have also been reported for conduct disorders [21]. This is an important point as it helps separate issues of service provision from the necessity of a diagnosis, at least if looked at it from a lay perspective.…”

Section: Discussionmentioning

confidence: 53%

Perception of depressive symptoms by the Sardinian public: results of a population study

et al. 2013

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BackgroundWith the exception of bereavement, the diagnosis of major depressive disorder in the DSM-IV does not take into account the context in which symptoms occur. Recent criticism has maintained that common sense suggests making a distinction between depression as mental disorder and sorrow as ‘normal’ reaction to social stress. Results of a study from Vienna support this view. This study sets out to examine whether these results can be replicated in a different cultural setting.MethodsIn 2012, a population-based survey was conducted by phone in Sardinia (n = 1,200). A fully structured interview was carried out which began with the presentation of a vignette depicting a diagnostically unlabeled case of depression, with or without provision of information about preceding stressful life events.ResultsIn general, as compared to the people from Vienna, the Sardinian public was much less prone to define depressive symptoms as expression of mental illness and more reluctant to recommend professional help. However, similar to Vienna, respondents presented with vignettes containing information on loss events were less likely to define depressive symptoms as indication of a psychiatric illness. They were also less willing to recommend professional help and relied more on self-help and support by family members and close friends.ConclusionsWe were able to replicate the result of the previous study that the public tends to perceive depressive symptoms differently depending on the context in which they occur. This lets us conclude that the divide between the public’s view of what depression is and the view of DSM-IV is not limited to a particular culture but seems to represent a more general phenomenon. In consequence, one might rethink the diagnostic criteria for major depressive disorder in order to reconcile both views.

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The Lay Concept of Conduct Disorder: Do Nonprofessionals Use Syndromal Symptoms or Internal Dysfunction to Distinguish Disorder from Delinquency?

Abstract: The dysfunction requirement appears to reflect a widely shared lay and professional concept of disorder.

Cited by 27 publications

References 20 publications

Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth?

Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth?

Lessons from the Use of Vignettes in the Study of Mental Health Service Disparities

Perception of depressive symptoms by the Sardinian public: results of a population study

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