Predictors of trauma-related diagnostic overshadowing bias

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2025-01-01 DOI:10.1016/j.brat.2024.104651

Katherine E. Wislocki, Alyson K. Zalta

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Abstract

Diagnostic overshadowing occurs when healthcare professionals misattribute an individual's presenting symptoms to other features of an individual's clinical presentation. Mental health providers may incorrectly diagnose and treat trauma-exposed individuals due to trauma-related diagnostic overshadowing bias. No research has investigated provider factors associated with this bias. Mental health provider background and training characteristics were examined as predictors of trauma-related diagnostic overshadowing in a sample of mental health providers (N = 210). Hierarchical regression modeling was used to evaluate predictors related to trauma-related diagnostic overshadowing in diagnostic and treatment decision-making. Providers with diagnostic responsibilities in their professional role were significantly less likely to demonstrate bias in some diagnostic and treatment decisions. Older mental health providers and providers with more clients experiencing traumatic stress demonstrated greater bias in some diagnostic responses. Providers with doctoral degrees, compared to all other degree types, demonstrated less bias through some diagnostic and treatment responses. Bias in diagnostic decisions strongly predicted bias in treatment decision-making. Findings suggest that factors related to clinical experience may be important in predicting trauma-related diagnostic overshadowing. Future work should extend this research to understand which factors affect trauma-related diagnostic overshadowing in real-world settings.

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创伤相关诊断阴影偏差的预测因子。

当医疗保健专业人员错误地将个人的表现症状归因于个人临床表现的其他特征时，就会出现诊断上的阴影。由于与创伤相关的诊断偏见，心理健康提供者可能会错误地诊断和治疗创伤暴露个体。没有研究调查与这种偏见相关的提供者因素。心理健康提供者背景和培训特征作为心理健康提供者样本中创伤相关诊断阴影的预测因素进行了研究（N = 210）。采用层次回归模型评价诊断和治疗决策中与创伤相关的诊断阴影相关的预测因子。在专业角色中承担诊断责任的提供者在某些诊断和治疗决策中表现出偏见的可能性显著降低。年龄较大的心理健康提供者和有更多客户经历创伤压力的提供者在一些诊断反应中表现出更大的偏见。与所有其他学位类型相比，具有博士学位的提供者在一些诊断和治疗反应中表现出较少的偏见。诊断决策偏差强烈预测治疗决策偏差。研究结果表明，与临床经验相关的因素可能是预测创伤相关诊断阴影的重要因素。未来的工作应该扩展这项研究，以了解哪些因素影响现实世界中与创伤相关的诊断阴影。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.