The Role of Clinical Features in the Diagnostic Reasoning of Psychologists

Abstract

Across health and medical domains, experts rely on idiosyncratic case-based pattern recognition to rapidly and accurately identify significant features that define a case. Understanding how clinical psychologists use features to form a diagnosis can provide valuable insights into changes in diagnostic performance as a function of experience. Previous studies examining the diagnostic accuracy of Clinical Psychologists have demonstrated that practicing Clinical Psychologists are no more accurate at diagnosing mental health conditions than Undergraduate psychology students. This study aimed to explore how the interpretation and use of clinical features develops with experience to facilitate diagnostic reasoning. Undergraduate psychology students (n = 24), Clinical Masters students (n = 2) and Clinical Psychologists (n = 10) were presented with eight mental health case studies. The case studies contained a combination of seven features: those shared between the possible diagnoses and those unique to the primary diagnosis and contextual features. Participants were prompted to give primary and secondary diagnoses for the case studies then asked to rate the extent to which each of the seven features supported the primary and secondary diagnoses. On average, Clinical Psychologists displayed the best diagnostic accuracy. Additionally, tertiary education predicted diagnostic accuracy and the use of unique features but clinical experience was predictive of neither. Rather, clinical experience predicted the use of contextual features (i.e. the character’s age or occupation). Future research should extend on these findings using real-life case studies and non-aggregated feature acquisition data.