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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Steven J. Trierweiler, PhD, Program for Research on Black Americans, Research Center for Group Dynamics, University of Michigan, Institute for Social Research, 426 Thompson Street, Ann Arbor, MI 48106-1248, (734) 764-9397, stevtri@umich.edu
Literature suggests that African Americans receive the diagnosis of major mood disorder less and schizophrenia more than European Americans. Such diagnostic discrepancies can have major impact on the long term care of African American patients. Differences may originate in clinicians' failure to grasp African American cultural expressions related to major mood disorder, confusing them with the negative (deficit) symptoms of schizophrenia such as blunted affect. Prior research suggests that clinicians conducting standard clinical interviews tend to link attributions of negative symptoms to the schizophrenia diagnosis -- and away from major mood disorder -- more strongly for African Americans than for European Americans. Would similar biases exist if clinicians applied DSM criteria in a more structured manner? The present research examines symptom attributions and diagnostic decisions using semi-structured, instrument-based diagnostic interviews. Logistic regression models show that patterns of symptom attribution and diagnosis continued to differ between races; the diagnostic instrument did not eliminate the tendency to judge African Americans in terms of schizophrenia and European Americans in terms of mood disorder. This research clarifies that race differences in culture and communication that may impact clinical judgments need to be addressed at the symptom level. Session attendees will be able to: 1) articulate the complexity of symptom attribution and diagnoses in real clinical contexts; 2) recognize the measurement problems associated with a complex interpersonal interaction like the diagnostic interview; and 3) discuss the ways cultural issues are embedded in the inquiry and judgment of mental disorder.
Learning Objectives: Session attendees will be able to
Keywords: Decision-Making, Ethnic Minorities
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.