Issues of bias in diagnosis

Major bias in regards to people from African descent - especially disorders like schizophrenia

Cochrane and Sashidharan (1995) - black Afro-carribean immigrants in UK 7 times more likely to be diagnosed with schizphrenia than white people - however doesn't tell us whether there is cultural divide in diagnosis or whether there is a genuine difference in rates of schizophrenia

Blake (1973) - more likely to diagnose Afro-American as schizophrenic

Type 1/2 errors-

Malgady (1996) considered consequences of over/under diagnosis in terms of type1/2 errors

Argued if clinician believe there is no cultural bias and this is a mistaken belief they are doing a disservice to their minority clients by failing to recognise and treat their problem - mistakently accepting null hypothesis

Result in misdirection of healthy individuals to mental health servicdesystem

Malgady believes type 2 error is more serious and so it is desirable to accept that there is a cultural bias

Based on cultural assumptions about what counts as normal/abnormal behaviour 

West - abnormal to hear voices leading to diagnosis however desirable in religious groups 

Look at social norms to define mental illness - classification system based only on norms of Western culture - members of other cultures diagnosed as ill when exhibt behaviours normal within their own culture 

To be recognised as mentally ill - must display 5 symptoms of disorder for 2 weeks

Diagnoses made using classification system that lists all possible symptoms - helps eliminaye bias by having set criteria

However, systems such as DSM IV mran certain people/groups more likely to be classed as having particular disorder

2 main types of bias - cultural and gender

Overdiagnosis-

Possible diagnosis of disorder in certain subgroups is due to genetic difference rather than bias 

Might be that black Afro-carribeans have greater genetic vulnerability to schizophrenia

. However, rates of diagnosis in Afro-carribeans isn't as high elsewhere in world as it is in UK

Alternative explanation for high rates in UK - members of minority ethnic groups in Britain have more stressful life leading them to disorder - difference due to social/environmental diagnosis

Use personality test as part of diagnostic process 

Devised by Western psychologists on own ideas about personality and standardised on western populations 

 Non-western assessed less accurately on tests