Open Access Dissertation
Date of Award
DIAGNOSING MENTAL ILLNESS
Advisor: Dr. Janet R. Hankin
Major: Medical Sociology
Degree: Doctor of Philosophy in Sociology
A convenience snowball sample of 228 mental health practitioners were surveyed and administered two vignettes of persons with mental illness and a 12-question survey that included occupational background and attitudinal questions about diagnosing mental illness. The gender and race of the patients were randomly altered, while the symptoms and characteristics of mental illness remained constant for each vignette. Each practitioner assigned a DSM-IV diagnostic label for axis I and axis II on both vignettes. The surveys were coded to represent the accurate diagnosis for each axis of each vignette and the acceptable diagnosis for each axis of each vignette. Practitioner diagnosis choices were then analyzed by matches between patients and practitioners on gender and/or race on each axis of both vignettes for both the accurate and acceptable diagnosis to see if the match on gender and/or race resulted in significant finding based on the match. Bivariate and multivariate Logistic Regression was ran on the matches on gender and/or race by the diagnosis with control measures of occupational, attitudinal and age of the practitioner variables.
Results indicated that only one axis of two vignettes; a vignette of co-morbid substance abuse and mental illness yielded a significant finding based on the match of race between the patient and practitioner and the match on gender and race. Whites were 2.6 times more likely to diagnose accurately than Blacks, White females were 3 times more likely to diagnose acceptably when diagnosing White females and Whites were more likely to diagnose accurately at a rate of 2 to 1 than blacks. The measure of age of the practitioner provided further information on how the diagnosis of mental illness was impacted. This measure indicated that the youngest quadroon of practitioners significantly diagnosed more accurately than the oldest quadroon of practitioners.
Johnson, Kevin, "A Vignette Study Examining The Accuracy Of Diagnosis: The Role Of Patient And Practitioner Gender And Race Match" (2010). Wayne State University Dissertations. Paper 91.