title: An Investigation of Diagnostic Accuracy and Confidence Associated with Diagnostic Checklists as Well as Gender Biases in Relation to Mental Disorders.
abstract: This study examines the utility of checklists in attaining more accurate diagnoses in the context of diagnostic decision-making for mental disorders. The study also aimed to replicate results from a meta-analysis indicating that there is no association between patients' gender and misdiagnoses. To this end, 475 psychotherapists were asked to judge three case vignettes describing patients with Major Depressive Disorder (MDD), Generalized Anxiety Disorder, and Borderline Personality Disorder. Therapists were randomly assigned to experimental conditions in a 2 (diagnostic method: with using diagnostic checklists vs. without using diagnostic checklists) × 2 (gender: male vs. female case vignettes) between-subjects design. Multinomial logistic and linear regression analyses were used to examine the association between the usage of diagnostic checklists as well as patients' gender and diagnostic decisions. The results showed that when checklists were used, fewer incorrect co-morbid diagnoses were made, but clinicians were less likely to diagnose MDD even when the criteria were met. Additionally, checklists improved therapists' confidence with diagnostic decisions, but were not associated with estimations of patients' characteristics. As expected, there were no significant associations between gender and diagnostic decisions.
authors.affiliation: Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum Bochum, Germany.
authors.forename: Jan C
authors.initials: JC
authors.lastname: Cwik
authors.affiliation: Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum Bochum, Germany.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Papen
authors.affiliation: Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum Bochum, Germany.
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Lemke
authors.affiliation: Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum Bochum, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Margraf
keywords: decision-making; diagnostic accuracy; diagnostic checklist; diagnostic confidence; gender bias; misdiagnosis; therapeutic decisions