Healthy Skepticism Library item: 5755

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Publication type: Journal Article

Commisso JT.
Errors and biases in clinical judgment
Dissertation-Abstracts-International:-Section-B:-The-Sciences-and -Engineering. 1995 Jul 1; 56:(1-B):

Abstract:

The study of clinical judgment has been an area of concern to
researchers and practitioners for over three decades. Accurate clinical judgment
is
crucial to the appropriate and effective treatment of patients and clients in
the counseling setting as the initial impression or diagnosis will often
dictate the course of treatment. The following study investigated clinical
judgment and the errors and biases which effect accurate therapeutic
decision-making. Theories and hypothesis have been developed to explain these errors
and
biases and include the following: Anchoring effects, the adjustment
hypothesis, confirmatory bias, and the mitigation hypothesis. The emphasis in
this
study was placed on how the timing of a client’s disclosure of important
information influenced clinical judgment and the degree of adjustment as new
information was presented. It was the degree of adjustment which was paramount in
this study as the differences in adjustment are what distinguish the
theories
from one another in explaining errors and biases in clinical judgment. A
group
of 133 mental health professionals, including doctoral level
psychologists,
master level counselors and social workers, and psychiatrists were presented
with
a vignette of an actual clinical case. They rated the client after each
of
the five synopses of therapy sessions. The ratings addressed the clients’
level of functioning (GAF), prognosis, and the subjects’ confidence in their
ratings. The research questions addressed the impact of initial judgments on
later judgments and the effect of the timing of presented information on
final impressions of the client. The results of this study revealed that
subjects did not appear to bias their ratings of the client as they relate to the
timing of the presentation of information. Thus, disconfirming evidence was
found in
the investigation of anchoring, confirmatory bias, and the mitigation
hypothesis. Subjects appeared to adjust appropriately to new information
presented (PsycINFO Database Record © 2005 APA, all rights reserved)