Issues of bias in diagnosis
Bias in diagnosis
Culture bias in diagnosis
Classification systems Inevitaby, these are based on cultural assumptions about what counts as normal or abnormal behaviour. For example, in the West it is regarded as abnormal to think you are hearing voices. This is not tru for all cultural or subcultural groups; soem religious groups may even regard it as desirable to hear voices. One of the key methods of defining mental illness is in terms of social norms (such as hearing voices or feelings of worthlessness) which inevitably means that Western classification systems are culturally biased. This means that members of other cultural groups may be identified as ill when they exhibit behaviours or describe feelings that are considered normal within their own culture.
Psychological tests Part of the diagnostic process often involves the use of personality or intelligence tests. Such tests have been devised by Western psychologists based on Western ideas about personality and intelligence, and these tests are standardised on Western populations. All of this means that non-Western individuals are likely to be assessed less accurately on such tests.
Research evidence Certain cultural and subcultural groups are treated differently. For example, Cochrane and Sashidharan (1995) found that black Afro-caribbean immigrants in the UK are up to seven times more likely to be diagnosed with schizophrenia than white people. Blake (1973) has also found that when clinicians were given a case study, they were more likely to diagnose schizophrenia if the individual was described as Afro-American. In terms of subcultural bias, Johnstone (1989) found that lower-class patients were more likely to spend longer in hospital , be prescribed physical rather than psychological treatments, and have a poorer prognosis.
Gender bias in diagnosis
Classification systems The practice of psychiatry has, until recently, been male dominated, which means that male bahviours are the standard by which all behaviours are measured. The result is that 'normal' female behaviours are often seen as signs of illness. For example, the clinical characteristics for anorexia nervosa include amenorrhea (cessation of the menstrual cycle). This assumes that all sufferes are female.
Rates of diagnosis There are signifcant differences in the rates of diagnosis for men and women for certain disorder, for example, women are more likely to be diagnosed with depression and specific phobias, whereas men are more likely to be diagnosed with alcohol abuse or anti-social conduct (Robins et al, 1984). There are no significant differences with disorders such as schizophrenia and bipolar disorder. Why do differences exist with some disorder and not others? One possibility is bias based on gender stereotypes. Ford and Widiger…