The 130th Annual Meeting of APHA

3071.0: Monday, November 11, 2002 - 9:30 AM

Abstract #49261

Race, situational attributions, and clinicians: Diagnostic decisions of schizophrenic type disorders and mood type disorders

Jordana Muroff, MSW, School of Social Work, University of Michigan, 1080 South University, Ann Arbor, MI 48109-1106, (734) 647-7627, jmuroff@umich.edu

Social hierarchy, diagnostic tendencies, error rates, and the severe and stigmatizing nature of schizophrenia have prompted questions and concerns regarding the high rates of schizophrenia diagnoses among African Americans. One explanation for the difference in rates between Whites and African Americans diagnosed with schizophrenia and mood disorders is misdiagnosis. Mental health practitioners have often been found to make dispositional attributions based on clients problems and overlook situational and environmental contributors. The use of specific attributions and the disregard of other critical information may contribute to differential diagnosis or misdiagnosis. The present study examined clinicians' consideration of socio-cultural factors in the diagnostic decision of mood versus schizophrenic type disorders among 293 psychiatric inpatients from a predominantly low-income, African American community. Following a Clinician Structured Diagnostic Interview (CSDI), clinicians completed an open-ended questionnaire that described their diagnostic decision-making process. Logistic regression analyses suggested differential application of a diagnostic standard among African American and Non-African American clinicians. African American clinicians mentioned situation information more than Non-African American clinicians but this practice was not associated with a specific diagnostic decision. Non-African American clinicians' consideration of situational attributions contributed to a mood type diagnostic decision. Public health social work participants will be able to: 1) articulate an understanding of the naturalistic diagnostic process; 2) describe findings from presented research on how the consideration of situational attributions influences the diagnostic process; and 3) discuss how clinician characteristics and subjectivity may influence clinical decision making.

Learning Objectives: Public health social work participants will be able to

Keywords: Depression, Decision-Making

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.

The Role of the Social Worker In Eliminating Health Disparities

The 130th Annual Meeting of APHA