The influence of context on categorization decisions for mental health disorders

Abstract

Mental health clinicians engage in an important form of real world categorization as they diagnose their patients with mental disorder diagnoses. How are clinicians affected by the context within which diagnostic criteria of a patient present when making diagnostic evaluations? The classification system clinicians are instructed to use is structured around a statistical approach to assessing diagnosis and does allow for the interpretation of criterial features through influences like context. The following experiment tests whether clinicians are affected by the context within which non-diagnostic information about a patient is presented. We tested clinician’s diagnostic judgments for symptoms of Conduct Disorder that were presented either in a context that should be perceived as being associated with Conduct Disorder or in a context that should not be perceived as being associated with Conduct Disorder. We found that clinicians were influenced by context, but in surprising ways. Clinicians lowered their diagnostic judgments for symptoms presented in a low associative context but did not change their estimates for high associative contexts as compared to baseline. The effect of context was also found to vary over the criterial symptoms that were presented, and this variation was associated with clinicians’ idiosyncratic ratings of the criterial symptoms. These results have interesting implications for how clinicians view their patients and for how context affects categorization more generally.