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Effect of patient sex, clinician sex, and sex role on the diagnosis of Antisocial Personality Disorder: Models of underpathologizing and overpathologizing biases
Author(s) -
Crosby Jeremy Paul,
Sprock June
Publication year - 2004
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.10235
Subject(s) - psychology , antisocial personality disorder , personality , clinical psychology , injury prevention , poison control , social psychology , medical emergency , medicine
This study examined the influence of patient sex and clinician sex and sex role for a case, meeting minimum diagnostic criteria for Antisocial Personality Disorder, in which patient sex was varied. The purpose was to provide an in‐depth evaluation of the process by which patient sex and characteristics of clinicians may contribute to bias in personality disorder diagnoses. Psychologists ( N = 167) read two cases, including the target case, and provided symptom ratings and diagnoses. A sex‐unspecified condition served as a baseline to assess for over‐ and underpathologizing bias, and diagnoses based on the symptom ratings were compared to assigned diagnoses. Clinician sex role was assessed using the Bem Sex Role Inventory‐Short Form. Results revealed that bias occurred when the patient's sex (female) was inconsistent with the gender weighting of the symptoms in the case (masculine), but the direction of the bias was consistent with sex roles (underdiagnosis of sex‐role‐inconsistent diagnoses, overdiagnosis of sex‐role‐consistent diagnoses). Path models of over‐ and underdiagnostic bias were developed using structural equation modeling. Patient sex had a direct effect on diagnostic ratings whereas clinician sex role had an indirect effect through symptom ratings. © 2004 Wiley Periodicals, Inc. J Clin Psychol.