Therapists’ prototypes of common mental disorders – An empirical identification

Abstract

BackgroundAlthough earlier studies concluded that clinicians' prototypes of patients with mental disorders can influence diagnostic decisions, it remains unclear how presumably more or less prototypical features were identified in these studies. Therefore, the aim of the current study was to empirically identify therapists’ prototypes of major depression, generalized anxiety disorder, borderline personality disorder, and bipolar disorder. MethodPsychotherapists (N = 69) filled out an online survey and answered questions on the most common thoughts, feelings, behaviors, appearance, life circumstances, age, and gender of a typical person with each disorder. Additionally, they rated the DSM-5 criteria according to how much they think about each criterion when picturing a typical person with the respective disorder. ResultsThe most frequently mentioned features are reported and associations between features are visualized by means of network analyses. Besides some exceptions, therapists’ responses were mostly in line with the DSM-5 criteria and prevalence rates in patients with each disorder. LimitationsThe main limitation is the fact that categorization of therapists’ responses into features depended on subjective decisions. Despite efforts to make this process as objective as possible, replication could lead to slightly different results. ConclusionTherapists' prototypes might be helpful to make diagnostic decisions in typical situations but could lead to incorrectly diagnosing or overlooking a disorder in less typical situations. The results of the current study should inform further research on the influence of prototypes on diagnostic decisions. Additionally, the current findings should be used to increase therapists’ awareness of prototypes of different mental disorders and the importance of accurate diagnosis.