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A Two-Stage Method for the Study of Cultural Bias in the Diagnosis of Schizophrenia in African Americans

Hogg Foundation for Mental Health, The University of Texas at Austin awhaley{at}mail.utexas.edu

Reasons for diagnostic bias in psychiatric evaluations of African Americans fall into two basic categories: clinician bias, which is the lack of adherence to diagnostic criteria during psychiatric evaluations, and cultural bias, which is true ethnic/racial differences in symptom expression being overlooked or misinterpreted by diagnosticians. The ideal method of studying cultural biases in the psychiatric diagnosis of African Americans is a two-stage procedure with the first stage controlling for clinician bias and the second stage addressing cultural bias. This study evaluated a two-stage procedure that first considers clinician bias by a structured clinical interview followed by a best estimate diagnosis by a mental health clinician who is a cultural expert. The method was developed and evaluated for its reliability and validity in the Culturally Sensitive Diagnostic Interview Research Project. Data from 24 psychiatric inpatients were used to evaluate this diagnostic approach. Several hypotheses were tested, but not all were supported.

Key Words: African American • bias • cultural expert • paranoid schizophrenia • psychiatric diagnosis

Journal of Black Psychology, Vol. 30, No. 2, 167-186 (2004)
DOI: 10.1177/0095798403262062


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