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Gender and Culture Bias in Schizophrenia Diagnosis (Julia Longenecker et…
Gender and Culture Bias in Schizophrenia Diagnosis
Julia Longenecker et al. (2010) reviewed studies of the prevalence of schizophrenia
Concluded that since the 1980s, men have been diagnosed with schizophrenia more often than women.
This may be because men are more genetically vulnerable to developing schizophrenia than women.
However, another possible explanation is gender bias in the diagnosis of schizophrenia.
Appears that female patients typically function better than men, being more likely to work and have good family relationships.
This high functioning may explain why some women have not been diagnosed with schizophrenia where men with similar symptoms may have been
Their better interpersonal functioning may bias practitioners to under diagnose schizophrenia
Either because symptoms are masked altogether or because the quality of interpersonal functioning makes the case seem too mild.
Loring and Powell (1988) randomly selected 290 male and female psychiatrists to read two case articles of patients behaviour and then asked them to offer their judgement on these individuals using standard diagnostic criteria.
When the patients were described as male or there was no information given about the gender, 56% of the patients were given a diagnosis of schizophrenia.
When the patients were described as female, only 20% of them were given a diagnosis of schizophrenia.
This bias did not appear to be present among female psychiatrists
This suggests that the diagnosis is both influenced by the gender of the patient and the gender of the clinician.
Gender bias also occurs due to clinicians not considering that males are more likely to suffer negative symptoms compared to women, and will have higher levels of substance abuse
They can also ignore that there are different predisposing factors between males and females.
Due to this, they have different vulnerability levels at different points in life, which can possibly explain the gender difference in the onset of schizophrenia
Also, they do not consider that females have better recovery rates and lower rates of relapse
Harrison et al. (1984)
Suggested that people of West Indian origin were over-diagnosed with schizophrenia, by white doctors in Bristol, because of their ethnic background
Copeland et al. (1971)
Gave a description of a patient to 134 US and 194 British psychiatrists
69% of the US psychiatrists diagnosed the patient with schizophrenia but only 2% of the British psychiatrists did the same
No research found a cause for this, which suggests that the symptoms of ethic minorities are misinterpreted.
This questions the reliability of diagnoses as patients can display identical symptoms but the diagnosis will be different due to ethnic background
Certain behaviours that are considered symptoms of schizophrenia can also be a problem due to cultural bias of what is 'normal' in different countries
For example, symptoms like hallucinations may be more accepted in certain cultures, like African cultures, due to the beliefs that culture holds and they are therefore more likely to consider these experiences 'normal'
If these experiences were reported to a psychiatrist from another culture, they may be seen as irrational due the the cultural bias of the psychiatrist and they are therefore
ethnocentric
Escobar (2012)
Pointed out that white psychiatrists may tend to over interpret the symptoms of black patients during diagnosis.
This can be due to certain factors like
Cultural differences in languages and mannerisms
Difficulties in relating between black patients and white therapists
The myth that black people rarely suffer from affective disorders
Therefore, clinicians and researchers must pay more attention to the effects of cultural differences on diagnosis
Culture Bias
Gender Bias