Factors affecting diagnostic judgments of manifest dream content in schizophrenia.

Abstract

Judges with diverse professional training and experience were asked to discriminate the dreams of hospitalized schizophrenics from those of hospitalized nonschizophrenics, a task which proved to be subjectively and objectively extraordinarily difficult. Performing barely above chance expectation as a group, judges tended to be misled by an invalid assumption that material depicting loss of body integrity would be more frequent in the dreams of schizophrenics and relatively insensitive to a valid clue, indications of thought disorder. When judges of similar experience were compared, lengthier experience was unrelated to more accurate judgments. However, when judges with different kinds of experience were contrasted, the kind of experience was strikingly related to accuracy. Judges familiar with dreams and psychotic patients (therapists) were most accurate, judges familiar with psychotic patients but typically not dreams (hospital professionals) were next most accurate while nonprofessionals were least accurate. The importance of attending to the kind of judges' experience—as opposed to amount—in studies of the clinical judgment process was emphasized.