Cross-cultural clinical judgment bias in personality disorder diagnosis by forensic psychiatrists in the UK: A case-vignette study

Journal of Personality Disorders

Volumn 21, Issue 4, 2007, Pages 400-417

  Mikton, Christopher ^a   Grounds, Adrian ^b  

^a Centre for Forensic Mental Health   (United Kingdom)

^b UNIVERSITY OF CAMBRIDGE   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; AVOIDANT PERSONALITY DISORDER; BORDERLINE STATE; CONTROLLED STUDY; DEPENDENT PERSONALITY DISORDER; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; FEMALE; FORENSIC PSYCHIATRY; HISTRIONIC PERSONALITY DISORDER; HUMAN; MALE; NARCISSISM; OBSESSIVE COMPULSIVE DISORDER; PARANOIA; PERSONALITY DISORDER; PERSONALITY DISORDER NOT OTHERWISE SPECIFIED; PSYCHOPATHY; SCHIZOIDISM; SCHIZOTYPAL PERSONALITY DISORDER; UNITED KINGDOM;

ADULT; AFRICAN AMERICANS; BIAS (EPIDEMIOLOGY); CLINICAL COMPETENCE; CROSS-CULTURAL COMPARISON; DIAGNOSIS, DIFFERENTIAL; EUROPEAN CONTINENTAL ANCESTRY GROUP; FEMALE; FORENSIC PSYCHIATRY; GREAT BRITAIN; HUMANS; MALE; MIDDLE AGED; PERSONALITY ASSESSMENT; PERSONALITY DISORDERS; PROFESSIONAL-PATIENT RELATIONS; PSYCHOMETRICS;

EID: 34548011691     PISSN: 0885579X     EISSN: 0885579X     Source Type: Journal    
DOI: 10.1521/pedi.2007.21.4.400     Document Type: Article

References (93)

1. Abramowitz, C. W., & Dokecki, P. R. (1977). The politics of judgment: Early empirical returns. Psychological Bulletin, 84, 460-476.
2. Abramowitz, S., & Herrera, H. (1981). On controlling for patient psychopathology in naturalistic studies of sex bias: A methodological demonstration. Journal of Consulting and Clinical Psychology, 49, 597-603.
3. Abreu, J. M. (1999). Conscious and nonconscious African-American stereotypes: Impact on first impression and diagnostic ratings by therapists. Journal of Consulting and Clinical Psychology, 67, 387-393.
4. Alarcon, R. D., Foulks, E. F., & Vakkur, M. (1998). Personality disorders and culture: Clinical and conceptual interactions. New York: Wiley.
5. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text revision). Washington, DC: American Psychiatric Association.
6. Austad, C. S., & Aronson, H. (1987). The salience of sex role instructions to mental health professionals. Sex Roles, 16, 323-333.
7. Bamgbose, O., Edwards, D., & Johnson, S. (1980). The effects of race and social class on clinical judgement. Journal of Clinical Psychology, 36, 605-609.
8. Becker, D., & Lamb, S. (1994). Sex bias in the diagnosis of borderline personality disorder and posttraumatic stress disorder. Professional Psychology Research and Practice, 25, 55.
9. Betancourt, H., & Lopez, S. R. (1993). The study of culture, ethnicity, and race in American psychology. American Psychologist, 48, 629.
10. Blackburn, R., Logan, C., Donnelly, J., & Renwick, S. (2003). Personality disorders, psychopathy and other mental disorders: Co-morbidity among patients at English and Scottish high security hospitals. Journal of Forensic Psychiatry and Psychology, 14, 111-137.
11. Castillo, R. J. (1997). Culture and mental illness: A client centered approach. Pacific Grove, CA: Brooks/Cole.
12. Coid, J., Kahtan, N., Gault, S., & Jarman, B. (1999). Patients with personality disorder admitted to secure forensic psychiatry services. British Journal of Psychiatry, 175, 528-536.
13. Coid, J., Kahtan, N., Gault, S., & Jarman, B. (2000). Ethnic differences in admissions to secure forensic psychiatric services. British Journal of Psychiatry, 177, 241-247.
14. Cooke, D. J., Kosson, D. S., & Michie, C. (2001). Psychopathy and ethnicity: Structural, item, and test generalizability of the Psychopathy Checklist-Revised (PCL-R) in Caucasian and African American participants. Psychological Assessment, 13, 531-542.
15. Cooke, D. J., Michie, C., Hart, S. D., & Clark, D. (2005a). Assessing psychopathy in the UK: Concerns about cross-cultural generalisability. British Journal of Psychiatry, 186, 335-341.
16. Cope, R., & Ndegwa, D. (1990). Ethnic differences in admission to a Regional Secure Unit. Journal of Forensic Psychiatry, 1, 365-378.
17. Cooke, D. J., Michie, C., Hart, S. D., & Clark, D. (2005b). Searching for the pan-cultural core of psychopathic personality disorder. Personality and Individual Differences, 39, 283-295.
18. Cope, R., & Ndegwa, D. (1990). Ethnic differences in admission to a Regional Secure Unit. Journal of Forensic Psychiatry, 1, 365-378.
19. Davidson, C. V., & Abramowitz, S. E. (1980). Sex bias in clinical judgment: Later empirical returns. Psychology of Women Quarterly, 4, 377-395.
20. Department of Health. (2003a). Delivering race equality: A framework for action. London: Department of Health.
21. Department of Health. (2003b). Personality disorder no longer a diagnosis of exclusion: Policy implementation guidance for the development of services for people with personality disorder: Department of Health.
22. Department of Health. (2003c). Inside outside: Improving the mental health services for Black and minority ethnic communities in England. London: Department of Health.
23. Department of Health. (2004). Developing and sustaining services for people with personality disorder: Department of Health.
24. Department of Health. (2005). Delivering race equality in mental health care: An action plan for reform inside and outside services and the government response to the independent inquiry into the death of David Bennet. London: Department of Health.
25. Eastman, N. (2006). Reforming the mental health law in England and Wales. BMJ, 332(1 April), 737-738.
26. Everitt, B. S., & Wessely, S. (2004). Clinical trials in psychiatry. Oxford: Oxford University Press.
27. Fabrega, H. (1996). Cultural and historical foundations of psychiatric diagnosis. In J. E. Mezzich, A. Kleinman, H. Fabrega, & D. L. Parron (Eds.), Culture and psychiatric diagnosis: A DSM-IV perspective (pp. 3-14). Washington, DC: American Psychiatric Press.
28. Flanagan, E. H., & Blashfield, R. K. (2003). Gender bias in the diagnosis of personality disorders: The roles of base rates and social stereotypes. Journal of Personality Disorders, 17, 431-446.
29. Ford, M., & Widiger, T. A. (1989). Sex bias in the diagnosis of histrionic and antisocial personality disorders. Journal of Consulting and Clinical Psychology, 2, 301-305.
30. Foulks, E. F. (1996). Culture and personality disorders. In J. E. Mezzich, A. Kleinman, H. Fabrega, & D. L. Parron (Eds.), Culture and psychiatric diagnosis: A DSM-IV perspective (pp. 243-252). Washington, DC: American Psychiatric Press.
31. Gallop, R., Lancee, W. J., & Garfinkel, P. (1989). How nursing staff respond to the label of borderline personality disorder. Hospital and community psychiatry, 40, 815-819.
32. Garb, H. N. (1997). Race bias, social class bias, and gender bias in clinical judgment. Clinical Psychology: Science and Practice, 4, 99-120.
33. Garb, H. N. (1998). Studying the clinician: Judgement research and psychological assessment. Washington, DC: American Psychological Association.
34. Hare, R. D. (1991). The Hare Psychopathy Checklist - Revised. Toronto, Ontario: Multi-Health Systems.
35. Hare-Mustin, R. T. (1983). An appraisal of the relationship between women and psychotherapy: 80 years after the case of Dora. American Psychologist, 38, 593-601.
36. Heverly, M., Fitt, D., & Newman, F. (1984). Contructing case vignettes for evaluating clinical judgment: An empirical model. Evaluation and Program Planning, 7, 45-55.
37. Hildebrand, M., de Ruiter, C., & Nijman, H. (2004). PCL-R psychopathy predicts disruptive behavior among male offenders in a Dutch Forensic Psychiatric Hospital. Journal of Interpersonal Violence, 19, 13-29.
38. Home Office, H.M. Prison Service, Department of Health. (2005). DSPD Programme. Retrieved 11 April 2005.
39. Home Office. (2005). Population in custody: Quarterly brief, April to June 2005, England and Wales. London: Home Office.
40. Hosmer, D., & Lemeshow, S. (2000). Applied logistic regression (2nd ed.). New York: Wiley.
41. Iwamasa, G. Y., Larrabee, A. L., & Merritt, R. D. (2000). Are personality disorder criteria ethnically biased? A card-sort analysis. Cultural Diversity and Ethnic Minority Psychology, 6, 284-296.
42. Kazdin, A. (1978). Evaluating the generality of findings in analogue therapy research. Journal of Consulting and Clinical Psychology, 46, 673-686.
43. Kazdin, A. (2003). Research design in clinical psychology (4th ed.). Boston: Allyn and Bacon.
44. Kirmayer, L. J., Rousseau, C., Jarvis, G. E., & Guzder, J. (2003). The cultural context of clinical assessment. In A. Tasman, J. Kay, & J. A. Lieberman (Eds.), Psychiatry (2nd ed.). Chichester: John Wiley & Sons.
45. Kosson, D. S., Smith, S. S., & Newman, J. P. (1990). Evaluating the construct validity of psychopathy in black and white male inmates: Three preliminary studies. Journal of Abnormal Psychology, 3, 250-259.
46. Lelliott, P., Audini, B., & Duffett, R. (2001). Survey of patients from an inner London health authority in medium secure psychiatric care. British Journal of Psychiatry, 178, 62-66.
47. Lewis, G., Croft, C., & David, A. (1990). Are British psychiatrists racist? British Journal of Psychiatry, 157, 410-415.
48. Lewis-Fernandez, R., & Kleinman, A. (1995). Cultural psychiatry: Theoretical, clinical and research issues. Psychiatric Clinics of North America, 18, 433-448.
49. Littlewood, R. (1992). Psychiatric diagnosis and racial bias: Empirical and interpretive approaches. Social Science and Medicine, 34, 141-149.
50. Lopez, S. R. (1983). The study of psychotherapy bias: Some conceptual issues and some concluding comments. In J. Murray & P. R. Abramson (Eds.), Bias in psychotherapy. New York: Praeger.
51. Lopez, S. R. (1989). Patient variable biases in clinical judgment: Conceptual overview and methodological considerations. Psychological Bulletin, 106, 184-203.
52. Lopez, S. R., Smith, A., Wolkenstein, B. H., & Charlin, V. (1993). Gender bias in clinical judgment: An assessment of the analogue method's transparency and social desirability. Sex Roles, 28, 35.
53. Loring, M., & Powell, B. (1988). Gender, race, and DSM-III: A study of the objectivity of psychiatric diagnosic behavior. Journal of Health and Social Behavior, 29, 1-22.
54. Mack, G. I. (1999). Effects of race on the clinical assessment of antisocial personality disorder and psychopathy. Unpublished doctoral dissertation, St. John's University, New York.
55. Malgady, R. G. (1996). The question of cultural bias in the assessment and diagnosis of ethnic minority clients: Let's reject the null hypothesis. Professional Psychology Research and Practice, 27, 73-77.
56. Maslin, A., & Davis, J. L. (1975). Sex-role stereotyping as a factor in mental health standards among counselors-in-training. Journal of Counseling Psychology, 22, 87-91.
57. Mezzich, J. E., Kleinman, A., Fabrega, H., & Parron, D. L. (Eds.). (1996). Culture and psychiatric diagnosis: A DSM-IV perspective. Washington: American Psychiatric Press.
58. Milton, J. (2000). A postal survey of the assessment procedure for personality disorder in forensic settings. Psychiatric Bulletin, 24, 254-257.
59. Minnis, H., McMillan, A., Gillies, M., & Smith, S. (2001). Racial stereotyping: Survey of psychiatrists in the United Kingdom. BMJ, 323, 905-906.
60. Mukherjee, S., Shukla, S., Woodle, J., Rosen, A. M., & Olarte, S. (1983). Misdiagnosis of schizophrenia in bipolar patients: A multiethnic comparison. American Journal of Psychiatry, 140, 1571-1574.
61. Murray, K. (1996). The use of beds in NHS medium secure units in England. Journal of Forensic Psychiatry, 7, 504-524.
62. Naismith, L., & Coldwell, J. (1990). A comparison of male admissions to a special hospital 1970-71 and 1987-88. Medical Science and the Law, 30, 301-308.
63. Ndegwa, D. (2003). Personality disorder in African and African-Caribbean people in the UK: National Institute for Mental Health in England.
64. Nehls, N. (1998). Borderline personality disorder: Gender stereotypes, stigma, and limited system of care. Issues in Mental Health Nursing, 19, 97-112.
65. Neighbors, H. W., Jackson, J. S., Campbell, L., & Williams, D. (1989). The influence of racial factors on psychiatric diagnosis: A review and suggesetions for research. Community Mental Health Journal, 25, 301-311.
66. Neighbors, H. W., Trierweiler, S. J., Munday, C., Thompson, E. E., Jackson, J. S., & Binion, V. J. (1999). Psychiatric diagnosis of African Americans: Diagnostic divergence in clinician-structured and semistructured interviewing conditions. Journal of the National Medical Association, 91, 601-612.
67. Norris, M. (1984). Integration of special hospital patients into the community. Aldershot: Gower.
68. Nuckolls, C. (1992). Toward a cultural history of the personality disorder. Social Science of Medicine, 35, 37-47.
69. Nuckolls, C. (1997). Allocating value to gender differences in official American psychiatry, part I: The cultural construction of the personality disorder classification system. Anthropology and Medicine, 4, 45-66.
70. Nyquist Potter, N. (2006). What in manipulative behaviour, anyway? Journal of Personality Disorders, 20, 139-156.
71. Pavkov, T. W., Lewis, D. A., & Lyons, J. S. (1989). Psychiatric diagnoses and racial bias: An empircal investigation. Professional Psychology Research and Practice, 20, 364-368.
72. Pfohl, B. (1996). Nosological comments on culture and personality disorders. In J. E. Mezzich, A. Kleinman, H. Fabrega, & D. L. Parron (Eds.), Culture and psychiatric diagnosis: A DSM-IV perspective (pp. 263-265). Washington: American Psychiatric Press, Inc.
73. Pham, T. H., Philippot, R., & Rime, B. (2000). Subjective and autonomic responses to emotion induction in psychopaths. L'Encephale, 26, 435-441.
74. Poulou, M. (2001). The role of vignettes in research of emotional and behavioural difficulties. Emotional and Behavioural Difficulties, 6, 50-62.
75. Robinson, F. Y. (1994). The influence of stereotypic attitudes on the diagnosis, prognosis, and treatment recommendations of African American patients: Border-line versus antisocial personality disorders. Unpublished doctoral dissertation, Adelphi University, New York, NY.
76. Schrover, L. R. (1981). Male and female therapists' responses to male and female client sexual material: An analogue study. Archives of Sexual Behavior, 10, 477-492.
77. Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasiexperimental designs for generalized casual inference. Boston: Houghton Mifflin Company.
78. Shubsachs, A.P.W., Huws, R. W., Close, A. A., Larkin, E. P., & Falvey, J. (1995). Male Afro-Caribbean patients admitted to Rampton hospital between 1977 and 1986 - A control study. Medical Science and the Law, 35, 336-346.
79. Simon, R. J., Fleiss, J. L., Gurland, B. J., Stiller, P. R., & Sharpe, L. (1973). Depression and schizophrenia in hospitalized black and white patients. Archives of General Psychiatry, 28, 509-512.
80. Singleton, N., Meltzer, H., Gatward, R., Coid, J., & Deasy, D. (1998). Psychiatric morbidity among prisoners in England and Wales. London: The Stationary Office.
81. Stolte, J. F. (1994). The context of satificing in vignette research. Journal of Social Psychology, 134, 727-733.
82. Stowell-Smith, M., & McKeown, M. (1999). Race, psychopathy and the self: A discourse analytic study. British Journal of Medical Psychology, 72, 459-470.
83. Sue, S. (1999). Science, ethnicity, and bias: Where have we gone wrong? American Psychologist, 54, 1070-1077.
84. Sullivan, E. A., & Kosson, D. S. (2006). Ethnic and cultural variation in psychopathy. In C. Patrick (Ed.), Handbook of psychopathy (pp. 437-458). New York: Guilford.
85. Taylor, P., Leese, M., Williams, D., Butwell, M., Daly, R., & Larkin, E. (1998). Mental disorder and violence: A special hospital study. British Journal of Psychiatry, 172, 218-226.
86. Thornquist, M., & Zuckerman, M. (1995). Psychopathy, passive-avoidance learning and basic dimensions of personality. Personality and Individual Differences, 19, 525-534.
87. Tom, B.D.M., Melzer, D., Brugha, T., Fryers, T., Gatward, R., & Grounds, A. (2002). Access to medium secure psychiatric care in England and Wales: 4. Differences among the ethnic groups assessed for admission. Unpublished manuscript.
88. Tyrer, P., Merson, S., Onyett, S., & Johnson, T. (1994). The effects of personality disorder on clinical outcome, social networks and adjustment: A contolled clinical trial of psychiatric emergencies. Psychological Medicine, 24, 731-740.
89. Van de Vijver, F., & Leung, K. (1997). Methods and data analysis for cross-cultural research. Thousand Oaks: Sage.
90. Van de Vijver, F., & Tanzer, N. K. (2004). Bias and equivalence in cross-cultural assessment: An overview. Revue Européenne de Psychologie Appliquée, 47, 119-135.
91. Warner, R. (1979). Racial and sexual bias in psychiatric diagnosis. Journal of Ner vous and Mental Disease, 167, 303-310.
92. Widiger, T. A. (2001). Official classification systems. In W. J. Livesley (Ed.), Handbook of personality disorders: Theory, research, and treatment (pp. 60-83). New York: The Guilford Press.
93. World Health Organization. (1992). ICD-10: Classification of mental and behavioural disorders. Geneva: World Health Organization.