Question

In your future role in the field of psychology, you might consider how a client's cultural, gender, and developmental background influences his or her diagnosis. Awareness of a client's background may assist in your understanding of how the client’s symptoms, signs, and behaviors are experienced and expressed. As the DSM states, disorders are defined relative to culture, social, and familial norms and values. In addition, the causes and expression of many disorders are influenced by sex and gender differences.

Understanding this perspective may lead psychologists to develop an accurate diagnosis for a client with a similar background or inaccurately diagnosis a client with a dissimilar background. Although an understanding of the client’s background may assist with the development of an accurate diagnosis, psychologists must be careful that personal biases about that background do not shape diagnosis.

For this Discussion, review the case study of "Marvin" Learning Resources. Objectively, consider the client's cultural identity and how this might contribute to diagnosis. If you were working with Marvin, how might your personal biases play a role in his diagnosis? Consider ways you might mitigate, or reduce, the appearance of personal biases in diagnosis.

Consider the following case: Marvin, a 45 year-old African American male, has come to your office because of feelings of anger about his recent firing as a mid-level corporate executive. He held this position for fifteen years, but was ostensibly let go as part of a larger organizational restructuring. Marvin shared with you, however, that he is skeptical of this explanation because he has had several incidents where co-workers were overheard making various racially-charged epithets toward various employees. He noted that the “biggest racist of them all” became his direct supervisor two years ago, and shortly after he received the first of two disciplinary reports. As he mentioned, he had never experienced problems with work prior to these reports; as a result, these reports were “bogus complaints” and upset him. Marvin is quite animated and communicates his anger about what has happened very clearly to you. He notes that this is not the kind of thing that would bring him to a therapist’s office – “I’m not crazy!” Rather, he came in to placate his wife. She complains that Marvin is not only angry and unkind toward her and the children, but that he sits around all day and has no interest in much of anything except videogames. Marvin’s wife, who attended the first part of this session, noted that they have not had sex in three months, he has stopped going to the gym (something he did daily), and he seems “very pessimistic” about this poor mark on his record. She noted that while Marvin has always had some of these tendencies, they gotten significantly worse since he was let go from his job.

With these thoughts in mind:

1. Post an explanation of how the client's culture, gender, developmental, or lifespan background may contribute toward personal biases and diagnosis.

2. Then explain how your personal biases might influence the client's diagnosis.

3. Finally, explain three ways you, as a future professional in the field, might mitigate or reduce the appearance of biases in diagnosis.

Answer 1

Answer 1. Marwin as stated in the case history was an African American, male for him it would have been difficult to get adapted to American culture and work ethics so it is quiet possible that he was racially discriminated at his work place, was fired from his position,and so secondary to this stress he had symptoms of anger, irritability,became pessimistic and had problems in his personal life too.That suggest he had depressive episode. If as a therapist I do not take his cultural background into consideration I will not be able to know his stressor on the other hand it's quiet possible that the ideas expressed by him about getting discriminated may be taken as being suspicious and thus considered to be a delusion arriving to diagnosis of delusional disorder with secondary depression.

Answer 2. As a expert if I do not consider all the variables it's quiet possible that I judge the person on my own ideas which will lead to number of biases. As in case of Marwin not knowing clients cultural background I may judge that no one was passing racial comments but it was Marwin who had this delusional thinking ,

not knowing cleints working environment, may lead me to infer he did not share healthy bond with other colleagues which led to the paranoia,

Not considering his sociodemographic details may lead to biases and wrong diagnosis.

Answer 3- biases in diagnosis can be reduced by taking detailed history and information about the client sociodemographic details,his family history, occupational history, knowing his cultural background and beliefs. Secondly by corroborating the information received from the patient and the informant with some other reliable informant. Thirdly to avoid the biases further longitudinal history is to be taken rather than giving importance to crosssectional history or information received.Also detailed mental status examination is utmost important to arrive to a diagnosis along with that serial mental status examinations are to arrive to a accurate diagnosis.