Gender, Race, and DSM-III: A Study of the Objectivity of Psychiatric Diagnostic Behavior

Abstract

Sociologists have long been interested in the consequences of psychiatrists' and clients' social location on diagnostic judgment. Previous research provided conflicting evidence on the effects of sex and race on diagnosis, but it has been suggested that with the institution of a formalized diagnostic system, The Diagnostic and Statistical Manual for Mental Disorders (Third Edition), the effects of gender and race on diagnosis have become minimal. We assess the accuracy of this claim using an analogue approach in which 290 psychiatrists evaluate two case studies. Case studies are manipulated so that approximately one-fifth of the clinicians, using DSM-III-derived criteria, evaluate a white male, a white female, a black male, a black female, or a client whose sex and race are not disclosed. Results indicate that sex and race of client and psychiatrist influence diagnosis even when clear-cut diagnostic criteria are presented. We conclude that it is premature to close the question of the influence of sex and race on diagnostic assessments.