Influence of Race and Symptom Expression on Clinicians’ Depressive Disorder Identification in African American Men

Abstract

Studies show that depressed African Americans are more likely to be misdiagnosed than are depressed Caucasians. A randomized sample of 239 California licensed clinical social workers and licensed marriage and family therapists were shown experimentally designed clinical videos and asked to make diagnostic judgments. Clinicians were randomly assigned to view 1 of 4 videos of 2 young adult male actors, 1 African American and 1 Caucasian, playing the part of a depressed client engaging in a first-time therapy session. Each actor played 2 roles: a depressed man with classic symptoms of a major depressive disorder (MDD) and a depressed man displaying symptoms that meet the MDD criteria described in the literature as African American cultural expressions of depression. Results indicate statistically significant differences in the identification of mood disorder; licensed clinicians under diagnosed unipolar mood disorder more frequently when clients of either race presented with culturally expressed depression symptoms. Implications for clinical social work and mental health practice with African American males are discussed.