IB Psychology Clinical Biases in Diagnosis Notes

Clinicians' unconscious biases and stereotypes systematically distort diagnosis, leading to misidentification and inequitable treatment of psychological disorders.

1. Clinical biases are systematic errors in judgment where clinicians' preexisting beliefs, stereotypes, or expectations unconsciously influence diagnosis and treatment decisions.
2. These biases undermine diagnostic validity by creating misdiagnosis, false positives (diagnosing a disorder when none exists), and false negatives (missing a disorder that is present).
3. Four major types of clinical bias include confirmation bias, cultural bias, gender bias, and anchoring bias.

Confirmation Bias in Diagnosis

1. Confirmation bias is the tendency to seek, interpret, and remember information that confirms an initial diagnosis while ignoring disconfirming evidence.
2. Once a clinician forms an initial impression (e.g., 'this client has depression'), they tend to notice symptoms consistent with depression and overlook symptoms suggesting other diagnoses.
3. Clinicians may interpret ambiguous behaviors through the lens of their hypothesis; tiredness is seen as depressive anhedonia rather than insomnia from another cause.
4. Once a diagnostic label is applied, it becomes self-fulfilling; the label influences how clinicians perceive and record subsequent behavior, strengthening the bias.

Cultural Bias in Diagnosis

1. Cultural bias occurs when clinicians from one cultural background misinterpret or pathologize behaviors that are normal within another culture.
2. Clinicians often apply diagnostic criteria developed in Western contexts to culturally diverse clients, leading to overdiagnosis in non-Western populations.
3. Research documents significant cultural disparities: African American and Hispanic clients are diagnosed with schizophrenia and severe mental illness at higher rates than White clients with identical symptoms.
4. Cultural differences in symptom expression are often misinterpreted; somatic complaints (body aches, headaches) common in many non-Western cultures may be pathologized as somatization disorder.
5. Clinicians' stereotypes about race, ethnicity, and immigration status unconsciously influence diagnosis; clients from marginalized groups receive more severe diagnoses for identical symptoms.