American Journal of Social Science Research
Articles Information
American Journal of Social Science Research, Vol.1, No.1, Apr. 2015, Pub. Date: Apr. 8, 2015
Differences in Clinician Anxiety and Bipolar Disorder Diagnoses According to Client Race
Pages: 52-56 Views: 1559 Downloads: 992
[01] Robert C. Schwartz, School of Counseling, University of Akron, Akron Ohio, USA.
[02] Kevin P. Feisthamel, Counseling, Health and Disability Services, Hiram College, Hiram Ohio, USA.
[03] Symphonie D. Smith, School of Counseling, University of Akron, Akron Ohio, USA.
Prior research indicates that African Americans are more often assigned severe mental disorder diagnoses (e.g., schizophrenia) compared to Euro-Americans. Mental disorder diagnoses can impact personal perceptions (e.g., self-stigma), social interactions (e.g., prejudice and discrimination), intimate relationships, and occupational opportunities, and treatment-related decisions. However, little research has investigated racial disparities among anxiety and bipolar disorder diagnoses. This study evaluated whether licensed diagnosticians disproportionately diagnosed Euro-Americans or African Americans with anxiety and bipolar disorders. Chi square analyses of a community mental health center’s initial diagnoses over a continuous 12-month period (N=1,648) revealed that Euro-American clients were more often diagnosed with an anxiety disorder (p< .05). No differences in bipolar disorder diagnoses were found (p = .08). These results support the contention that specific mental disorder diagnoses are assigned disproportionately to persons of certain races. Implications of these findings are discussed, including recommendations for reducing potential diagnostician bias and increasing assessment-related objectivity.
Bipolar Disorder, Anxiety Disorder, Race, Diagnosis, Mental Disorder
[01] American Psychiatric Association: Diagnostic and statistical manual of mental disorders (4th ed., text revision).Washington, DC, Author, 2000.
[02] American Psychiatric Association: Diagnostic and statistical manual of mental disorders(5th ed.). Washington, DC: Author, 2013.
[03] Arnold LM,Keck PE, Collins J, Wilson R, Fleck DE, Corey KB, Amicone J, Adebimpe VR, StrawkowskiSM: Ethnicity and first-rank symptoms in patients with psychosis. Schizophr Res 2004, 67: 207-212.
[04] Asnaani A, Gutner CA, Hinton DE, & Hofmann SG: Panic disorder, panic attacks and panic attack symptoms across race-ethnic groups: Results of the collaborative psychiatric epidemiology studies. CNS Neuroscience & Therapeutics 2009, 15: 249-254.
[05] Asnaani A, Richey JA, Dimaite R, Hinton DE, Hofman SG: A Cross-Ethnic Comparison of lifetime prevalence rates of anxiety disorders. J Nerv Ment Dis 2010, 198: 551-555.
[06] Barnes A: Race and hospital diagnoses of schizophrenia and mood disorders. Soc Work 2008, 53: 77-83.
[07] Breslau J, Aguilar-Gaxiola S, Kendler KS, Maxwell S, Williams D, Kessler RC:Specifying race-ethnic differences in risk for psychiatric disorder in a US national sample. Psychol Med 2006, 36: 57-68.
[08] Brown DR, Keith VM: In and out of our right minds. New York: Columbia University Press, 2003.
[09] Chapman KL, Williams SR, Mast BT, Woodruff-Borden J: A confirmatory factor analysis of the Beck Anxiety Inventory in African American and European American young adults. J Anxiety Disord 2009, 23: 387-392.
[10] Cohen J: Quantitative methods in psychology: A power primer. Psychol Bull 1992, 112: 155-159.
[11] Cook EP, Warnke M, Dupuy P: Gender bias and the DSM-III-R. Counselor Education and Supervision 1993, 32: 311-322.
[12] Engels DW: The professional counselor: Portfolio, competencies, performance guidelines, and assessment. Alexandria, VA, American Counseling Association, 2004.
[13] Feisthamel KP, Schwartz RC: Racial bias in diagnosis: Practical implications for psychotherapists. Annals of the American Psychotherapy Association 2006,9:11-14.
[14] First MB, Spitzer RL, Gibbon M, Williams JB: Structured clinical interview for Axis I DSM-IV disorders. State Psychiatric Institute, New York, NY, 1995.
[15] Haeri S, Williams J, Kopeykina I, Johnson J, Newmark A, Cohen L, & Galynker I:Disparities in diagnosis of bipolar disorder in individuals of African and European descent: A review. J Psychiatr Practice 2011, 17: 394-403.
[16] Himle JA, Baser RE, Taylor RJ, Campbell RD, Jackson JS: Anxiety disorders among African Americans, blacks of Caribbean descent, and non-hispanic whites in the United States. J Anxiety Disord 2009, 23: 578-590.
[17] Hunter LR, Schmidt LR, Norman B: Anxiety psychopathology in African American adults: Literature review and development of an empirically informed sociocultural model. Psychol Bull 2010, 13: 211-235.
[18] Kennedy N, Boydell J, van Os J, Murray RM: Ethnic differences in first clinical presentation of bipolar disorder: results from an epidemiological study. J Affect Disord 2004, 83: 161-168.
[19] Kilbourne AM, Bauer MS, Pincus H, Wilford WO, Kirk GF, Beresford T: Clinical, psychosocial, and treatment differences in minority patients with bipolar disorder. Bipolar Disorders 2005, 7:89-97.
[20] Kupfer DJ, Grocjocinski FE, Houck PR, Brown C: African American participants in a bipolar disorder registry: Clinical and treatment characteristics. Bipolar Disorders 2005, 7: 82-88.
[21] Lewis KM, Byrd DA, Ollendick TH: Anxiety symptoms in African- American and Caucasian youth: Relations to negative life events, social support and coping. J Anxiety Disord 2012, 26:32-39.
[22] Lewis G, Croft-Jeffreys C, David A: Are British psychiatrists racist? Br J Psychiatry 1990, 157: 410-415.
[23] Neighbors HW, Trierweiler SJ, Ford BC, Muroff JR: Racial differences in DSM diagnosis using a semi-structured instrument: The importance of clinical judgment in the diagnosis of African Americans. J Health Soc Behav 2003, 43:237-256.
[24] Ritsher JB, Struening EL, Hellman F, Guardino M: Internal validity of an anxiety disorder screening instrument across five ethnic groups. Psychiatry Res 2002, 111:199-213.
[25] Roberts AL, Gilman SE, Breslau J, Breslau N, Koenen KC: Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment seeking for post-traumatic stress disorder in the United States. Psychol Med 2011, 41:71-83.
[26] Schwartz RC, Blankenship DM: Racial disparities in psychotic disorder diagnosis: A review of empirical literature. World J of Psychiatr 2014, 22: 133-140.
[27] Schwartz RC, Feisthamel KP: Disproportionate diagnosis of mental disorders among African American versus Euro-American clients: Implications for counseling theory, research and practice. Journal of Counseling and Development 2009, 87:295-301.
[28] Schwartz RC, Lent J, Geihsler J: Gender and diagnosis of mental disorders: Implications for mental health counseling. Journal of Mental Health Counseling 2011, 33: 347-358.
[29] Siegel S, Castellan NJ: Nonparametric statistics for the behavioral sciences. New York, McGraw-Hill, 1998.
[30] Smithson M: Confidence intervals. Thousand Oaks, California, Sage, 2003.
[31] Sohler NL, Bromet EJ: Does racial bias influence psychiatric diagnoses assigned at first hospitalization? Soc Psychiatry Psychiatr Epidemiol 2003, 38:463-472.
[32] Strakowski SM, Keck PE, Arnold LM, Collins J, Wilson RM, Fleck DE, Corey KB,
[33] Amicone J, Adebimpe VR: Ethnicity and diagnosis in patients with affective disorders. J Clin Psychiatry 2003, 64:747-754.
[34] Thomas A, Sillen T: Racism and psychiatry. New York, Citadel Press, 1972.
[35] Trusty J, Thompson B, Petrocelli JV: Practical guide for reporting effect size in quantitative research in the Journal of Counseling and Development.Journal of Counseling and Development 2004, 82: 107-110.
[36] U.S. Department of Commerce: United States Census 2010. Retrieved September 10, 2013 from
[37] U.S. Department of Health and Human Services: Mental Health: Culture, Race, and Ethnicity - A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD, U.S. Department of Health and Human Services, 2001.
[38] U.S. Department of Health and Human Services: U.S. Surgeon General Report on Mental Illness.Washington, DC, U.S. Government Printing Office, 2003.
[39] Woodward AT, Bullard KM, Taylor RJ, Chatters LM, Baser RE, Perron BE, Jackson JS: Complementary and alternative medicine for mental disorders among African Americans, Black Caribbeans, and Whites. Psychiatr Serv 2009, 60:1342-1349.
MA 02210, USA
AIS is an academia-oriented and non-commercial institute aiming at providing users with a way to quickly and easily get the academic and scientific information.
Copyright © 2014 - 2017 American Institute of Science except certain content provided by third parties.