Sex Differences in Diagnosis and Treatment Recommendations for Antisocial Personality and Somatization Disorders

Abstract

This study investigated the influence of patient sex on clinicians' diagnostic and treatment decisions for two disorders, antisocial personality and somatization disorder. These disorders have substantial differences in prevalence rates for females and males. One hundred-nineteen licensed clinical psychologists each received case histories depicting antisocial personality and somatization disorders. Half of the subjects received cases describing females; half received cases describing males. The clinicians were less likely to diagnose antisocial personality correctly for female than for male patients. Patient sex did not influence correct diagnosis of somatization disorder. Across diagnoses, females received more favorable prognoses, recommendations for lengthier treatment, and stronger endorsements for nondirective therapy. Males were recommended more strongly for group therapy. Clinicians were more likely to recommend individual psychotherapy, nondirective therapy, and an insight-oriented approach for women than for men in the antisocial personality vignettes. Clinicians were also more likely to recommend legal constraints for males than for females in antisocial personality vignettes.