 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
|
| The 131st Annual Meeting (November 15-19, 2003) 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 Whites. 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. Diagnostic agreement is the empirical cornerstone of the DSM nosology. There is some evidence that the confusion of schizophrenia and mood disorders in diagnoses of African Americans leads to lower rates of diagnostic agreement for that group as compared to Whites. Which symptoms are involved in diagnostic agreements or disagreements for African Americans? As part of an ongoing detailed examination of clinical judgment issues in the diagnosis of African American inpatients, this study explores how particular symptom attributions made by clinicians during standard diagnostic interviews facilitate or inhibit diagnostic agreements with existing hospital diagnoses. Results from logistic regression models suggest that attributions of negative symptoms and thought disorder play complex differential roles in patterns of diagnostic agreement for African American and White patients. 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 some of the measurement problems associated the diagnostic interview; and 3) discuss the ways cultural issues are embedded in the judgment of mental disorder.
Learning Objectives:
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.