How do practising clinicians and students apply newly learned causal information about mental disorders?
Version of Record online: 26 OCT 2011
© 2011 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Volume 19, Issue 1, pages 112–117, February 2013
How to Cite
de Kwaadsteniet, L., Kim, N. S. and Yopchick, J. E. (2013), How do practising clinicians and students apply newly learned causal information about mental disorders?. Journal of Evaluation in Clinical Practice, 19: 112–117. doi: 10.1111/j.1365-2753.2011.01781.x
- Issue online: 25 JAN 2013
- Version of Record online: 26 OCT 2011
- Accepted for publication: 28 July 2011
- causal knowledge;
- clinical expertise;
- clinical reasoning;
- continuing education;
- mental disorders
Rationale, aims and objectives New causal theories explaining the aetiology of psychiatric disorders continuously appear in the literature. How might such new information directly impact clinical practice, to the degree that clinicians are aware of it and accept it? We investigated whether expert clinical psychologists and students use new causal information about psychiatric disorders according to rationalist norms in their diagnostic reasoning. Specifically, philosophical and Bayesian analyses suggest that it is rational to draw stronger inferences about the presence of a disorder when a client's presenting symptoms are from disparate locations in a causal theory of the disorder than when they are from proximal locations.
Method In a controlled experiment, we presented experienced clinical psychologists and students with recently published causal theories for different disorders; specifically, these theories proposed how the symptoms of each disorder stem from a root cause. Participants viewed hypothetical clients with presenting proximal or diverse symptoms, and indicated either the likelihood that the client has the disorder, or what additional information they would seek out to help inform a diagnostic decision.
Results Clinicians and students alike showed a strong preference for diverse evidence, over proximal evidence, in making diagnostic judgments and in seeking additional information. They did not show this preference in the control condition, in which they gave their own opinions prior to learning the causal information.
Conclusion These findings suggest that experienced clinical psychologists and students are likely to use newly learned causal knowledge in a normative, rational way in diagnostic reasoning.