Sunday 12 May 2013

Gender biases in DIAGNOSING DYSFUNCTIONAL BEHAVIOUR

The DSM-IV (soon to be DSM-V) and ICD-10 are intended to make diagnoses as valid and reliable as possible. But there's still only 50% agreement between clinicians in diagnoses, which suggests that subjectivity plays a significant part in diagnoses.

Thus far, we've seen from Rosenhan and Seligman that diagnosing dysfunctional behaviour is fairly subjective and ethnocentric. 

But diagnoses of disorders can also be affected by gender. Gender biases in diagnoses leads to poor reliability and validity, and could actually be life-threatening if someone is treated for the wrong disorder; and even if it wasn't, prescribing medication or therapy for a misdiagnosis is not desirable

One piece of research into gender bias is Ford and Widiger (1989). They aimed to find out if clinical psychologists were gender stereotyping when it came to diagnosing certain disorders, namely histrionic personality disorder and anti-social personality disorder.

Histrionic personality disorder (HPD) is a personality disorder which is characterised by seductive, manipulative behaviour, shallow expression of emotions and attention-seeking. For this reason, it's often stereotyped as a "female" disorder as it fits in with common stereotypes of women. Anti-social personality disorder (ASPD) is characterised by aggressive behaviour and impulsivity, and thus is often stereotyped as a "male" disorder. N.B both genders can have either personality disorder.

A sample of 266 clinical psychologists made diagnoses based on the information given to them, thus it was an experiment using self-report measures. The IV was the gender of the patient, and the DV was the diagnosis given. 

Participants were given anonymous case studies with the only detail being gender and were asked to identify the disorder. The case studies documented cases of HPD, ASPD, and patients with symptoms from the two disorders in an equal mix. 

ASPD was correctly documented in males considerably more than with females (42% to 15%), and the reverse was found in HPD as females were correctly diagnosed with HPD considerably more often than males (76% to 44%). This suggested that clinical psychologists, even with considerable clinical experience, gender stereotype certain disorders, and also that males were perhaps taken more seriously rather than being judged negatively for their gender, as they were misdiagnosed less often. 

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