Is diagnostic judgment influenced by a bias to see pathology?

Abstract

The clinical judgment literature suggests that clinicians are biased to see psychopathology. The social cognition literature shows that people can be biased to search for information relevant only to the hypothesis under test and to ignore information relevant to the alternative. In light of these biases, we asked practicing clinicians (N = 106 respondents) in three conditions to read 1 of 9 biographical essays. The conditions called for the clinicians to judge the writer of the essay as (a) psychologically healthy or not, (b) psychologically healthy or unhealthy, or (c) experiencing psychopathology or not The latter condition was expected to produce the highest frequency of negative judgments. The opposite result was obtained. To determine if this was due to the extreme wording in the "psychopathology" condition, 30 additional practicing clinicians assessed whether the writer of the essay was psychologically unhealthy or not. A comparison of these data with those from the two less extreme conditions showed no bias. The results were interpreted as an appropriate level of conservativism in clinical judgment with respect to the extreme diagnosis implied by the term psychopathology.