title: Information order effects in clinical psychological diagnoses.
abstract: Despite the wide application and long history of diagnostic systems, several sources of diagnostic errors remain in the criterion-based diagnosing of mental disorders. The aim of this study was to investigate whether the presentational order of diagnosis-relevant information and pretreatment reports predict diagnostic errors. One hundred twenty psychotherapists participated in the present online study. The study employed a 2 (symptom presentation: core symptoms at vignette's beginning vs. core symptoms at the end of the case vignette) × 2 (pretreatment report: receiving a pretreatment report with an incongruent diagnosis to the case vignette vs. receiving no pretreatment report) between-subjects experimental design, with random assignment. Participants were asked to make diagnoses after reading three case vignettes describing patients with different disorder constellations. Additionally, participants rated their confidence in the diagnoses and their estimation of the severity of each diagnosed condition. Results indicated that order of symptom descriptions predicted the correctness of diagnostic decisions, with a recency effect causing more fully correct diagnostic decisions in cases where diagnostic information was presented last. Receiving incongruent pretreatment reports was predictive for diagnostic errors. In conclusion, the results of this study indicate that diagnoses of mental disorders can depend on the way symptoms are presented or reported.
  
  
  CONCLUSIONS
  Therapists' diagnostic decisions are not influenced by pretreatment reports. Diagnostic decisions are affected by information order effects. Diagnostic accuracy of psychotherapists is debatable. High rate of misdiagnoses in case vignette with comorbid disorders.
authors.affiliation: Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany.
authors.forename: Jan Christopher
authors.identifier: http://orcid.org/0000-0002-2290-353X
authors.initials: JC
authors.lastname: Cwik
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
mesh_terms: D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D011613:Psychotherapy / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Decoy Effect; Diagnostic Accuracy; Diagnostic Errors; Pretreatment Report; Recency Effect