Explanation Effects Override Formal Category Definitions In Clinical Experts’ Diagnostic Judgments

Abstract

Having a plausible life-event explanation for a person’s disordered symptoms leads clinicians to judge those symptoms to be less abnormal than if their cause was unknown (Ahn et al., 2003). Yet the American Psychiatric Association’s official Diagnostic and Statistical Manual of Mental Disorders formally states that only bereavement-related life events should exclude a client from a diagnosis of depression, and this bereavement exclusion criterion is slated to be eliminated altogether from the next edition (under development) of the manual. We asked whether clinicians make diagnoses in the context of life-event explanations in direct opposition to these formal prescriptive definitions. We asked clinical psychologists to give diagnostic and other clinical judgments for realistic case study vignettes including a bereavement event, negative non-bereavement event, neutral event, or no event. Both bereavement and non-bereavement life events normalized clinicians’ perceptions of depression, indicating a clear departure from both the current and proposed DSM.


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