Order of psychiatric diagnoses may influence how clinicians identify symptoms
2012-11-29
(Press-News.org) The diagnostic system used by many mental health practitioners in the United States -- known as the Diagnostic and Statistical Manual of Mental Disorders -- assumes that symptoms of two disorders that occur at the same time are additive and that the order in which the disorders are presented doesn't matter. But new research suggests that order actually plays a significant role in determining how clinicians think about psychiatric disorders.
In an article published in Clinical Psychological Science, a journal of the Association for Psychological Science, researchers Jared Keeley, Chafen DeLao, and Claire Kirk of Mississippi State University draw from existing research on conceptual combination to investigate how clinicians diagnose psychiatric disorders that occur together.
They predicted that for disorders with overlapping symptoms — such as major depressive disorder (MDD) and generalized anxiety disorder (GAD) — clinicians would describe the disorders pretty much the same way, regardless of which disorder was presented first.
But for two disorders that are quite different — such as generalized anxiety disorder (GAD) and antisocial personality disorder (ASPD) — the researchers predicted that the order in which symptoms are presented would significantly influence clinicians' descriptions of the disorders.
Keeley and colleagues also predicted that the features of one disorder would overshadow the features of another, providing evidence for a "dominance" effect.
In two different studies, the researchers asked clinicians to identify the symptoms that would describe each of three disorders individually (MDD, GAD, ASPD) and the symptoms that would describe paired combinations of the three disorders.
In both studies, the clinicians were inconsistent in their descriptions of disorder pairs — for example, the symptoms they identified for a combination of MDD + ASPD were not necessarily the same as those identified for a combination of ASPD + MDD.
And in one of the two studies, the researchers found that the order of symptoms mattered more for clinicians' descriptions of disorders that were different than for disorders that overlapped, partially confirming their original hypothesis.
Together, these results seem to contradict the assumption that order doesn't matter in psychiatric diagnoses.
Findings from a third study indicated that clinicians' descriptions of the symptoms involved in GAD were dominated by their descriptions of both MDD and ASPD, while symptoms of ASPD and MDD had equal weight.
Keeley and colleagues offer several possible explanations for their findings. Clinicians could be straying from the additive guidelines of the Diagnostic and Statistical Manual of Mental Disorders. Alternatively, their clinical experiences may have led to "rater drift," such that the criteria that they use to evaluate symptoms have drifted over time.
But it's also possible that practitioners are actually ahead of the curve. Keeley, DeLao, and Kirk argue that clinicians could be "accurately modeling an aspect of psychopathology that our current diagnostic system has yet to accommodate."
While it remains to be seen whether these findings have implications for the actual treatment of psychiatric disorders, Keeley and colleagues believe that these three studies may help researchers and practitioners in trying to bring the classification of psychiatric disorders and actual clinical practice closer together.
###
For more information about this study, please contact: Jared W. Keeley at jkeeley@psychology.msstate.edu.
Clinical Psychological Science is APS's newest journal. For a copy of the article "The Commutative Property in Comorbid Diagnosis: Does A + B = B + A?" and access to other Clinical Psychological Science research findings, please contact Anna Mikulak at 202-293-9300 or amikulak@psychologicalscience.org.
END
ELSE PRESS RELEASES FROM THIS DATE:
2012-11-29
Boulder, Colo., USA – Geosphere articles posted online 16 November 2012 cover a variety of topics, such as the geophysics of the Hogri fault zone, 5 km offshore of the Diablo Canyon nuclear power plant; using web-based GIS technologies and readily available global remote sensing datasets for investigations of arid land; the structure and evolution of the U.S. Sierra Nevada; the ANDRILL McMurdo Ice Shelf and Southern McMurdo Sound Drilling Projects; and climate-tectonic interactions in the southern Alaskan orogen.
Abstracts for these and other Geosphere papers are available ...
2012-11-29
Tropical Storm Bopha continues to intensify in the western North Pacific Ocean as it heads toward Yap State, triggering more warnings and watches. Infrared imagery from NASA's Aqua satellite captured over two days revealed that the storm had consolidated, intensified and developed a large band of strong thunderstorms south of the center, that resemble a tail.
Infrared images of Tropical Storm Bopha were taken by the AIRS instrument on NASA's Aqua satellite on Nov. 27 at 1505 UTC when Bopha had maximum sustained winds near 45 mph, and on Nov. 28 at 0329 UTC when Bopha's ...
2012-11-29
Data from NASA's Cassini spacecraft tie a shift in seasonal sunlight to a wholesale reversal, at unexpected altitudes, in the circulation of the atmosphere of Saturn's moon Titan. At the south pole, the data show definitive evidence for sinking air where it was upwelling earlier in the mission. So the key to circulation in the atmosphere of Saturn's moon Titan turned out to be a certain slant of light. The paper was published today in the journal Nature.
"Cassini's up-close observations are likely the only ones we'll have in our lifetime of a transition like this in action," ...
2012-11-29
Berkeley — The primary source of light for more than a billion people in developing nations is also churning out black carbon at levels previously overlooked in greenhouse gas estimates, according to a new study led by researchers at the University of California, Berkeley, and the University of Illinois.
Results from field and lab tests found that 7 to 9 percent of the kerosene in wick lamps — used for light in 250-300 million households without electricity — is converted to black carbon when burned. In comparison, only half of 1 percent of the emissions from burning ...
2012-11-29
Driven by the strong demand for high-definition video, digital health services, the Internet of Things, and virtual reality, broadband, ubiquitous and convergent information access has become the most important engine to drive the development of the modern information society. With increasing numbers of information-based interactions among humans, machines and objects, especially as new services, new terminals and new needs emerge, the networks are required to provide flexible, energy-efficient, safe and broadband access services anywhere at any time, and therefore wideband ...
2012-11-29
Lanthanides comprise a unique and dominant resource of China. The increase in contact for populations through lanthanide mining and the wide applications for industry, agriculture, and medicine have raised great public concern regarding the metal toxicity of lanthanides, particularly on the issue of whether lanthanides are toxic to the human nervous system.
In the past decade, major progresses have been made toward elucidating the mechanisms of the biological actions of lanthanides. A recently published review by researchers at Peking University [Xia et al., Sci. China ...
2012-11-29
The origin and dispersal of modern humans and modern human behavior are key interests in Paleolithic archaeology and anthropology. Engraved objects are usually seen as a hallmark of cognition and symbolism, which are viewed as important features of modern human behavior. In recent years, engraved ochre, bones and ostrich eggs unearthed from various Paleolithic sites in Africa, the Near East and Europe have attracted the attention of many scholars. However, such items are rarely encountered at Paleolithic sites in East Asia. Here, we report a very important discovery of ...
2012-11-29
WASHINGTON, DC, November 26, 2012 — Organizations using fear and anger to spread negative messages about Muslims have moved from the fringes of public discourse into the mainstream media since the Sept. 11 attacks, according to new research by a University of North Carolina at Chapel Hill sociologist.
Titled, "The Fringe Effect: Civil Society Organizations and the Evolution of Media Discourse about Islam since the September 11th Attacks," the study appears in the December issue of the American Sociological Review.
Christopher Bail, an assistant professor of sociology ...
2012-11-29
WASHINGTON, DC, November 26, 2012 — Behavior problems, not depression, are linked to lower grades for depressed adolescents, according to a study in the December issue of the Journal of Health and Social Behavior.
"Behavior problems including attention issues, delinquency, and substance use are associated with diminished achievement, but depression is not," said the study's lead author Jane D. McLeod, a sociology professor and an associate dean at Indiana University. "Certainly, there are depressed youths who have trouble in school, but it's likely because they are also ...
2012-11-29
WASHINGTON, DC, November 27, 2012 — Employers are often more focused on hiring someone they would like to hang out with than they are on finding the person who can best do the job, suggests a study in the December issue of the American Sociological Review.
"Of course, employers are looking for people who have the baseline of skills to effectively do the job," said study author Lauren A. Rivera, an assistant professor of management and organizations and sociology at Northwestern University. "But, beyond that, employers really want people who they will bond with, who they ...
LAST 30 PRESS RELEASES:
[Press-News.org] Order of psychiatric diagnoses may influence how clinicians identify symptoms
