Citation

Whaley AL. J. Black Psychol. 2011; 37(4): 387-406.

Copyright

(Copyright © 2011, Association of Black Psychologists, Publisher SAGE Publishing)

DOI

10.1177/0095798410387133

PMID

unavailable

Abstract

A two-stage culturally sensitive diagnostic procedure allows for the assessment of cultural factors in paranoid symptom expression among African Americans. The first stage eliminates clinician bias by ensuring that diagnosticians adhere to DSM criteria. The second stage removes cultural bias by having cultural experts (i.e., African American mental health professionals) give best-estimate diagnoses using the same symptom data along with cultural knowledge. The present study uses the culturally sensitive diagnostic interview paradigm and structural equation modeling to examine the effects of demographic background, patients' self-report of paranoid symptoms, and patients' self-report of cultural mistrust on clinicians' ratings of cultural mistrust for a sample of 116 Black psychiatric inpatients. Full and reduced models were tested using structural equation modeling, and the reduced model was the best fit to the data. The results suggest that clinicians can identify cultural mistrust in Black psychiatric patients. Implications for cultural competence training to prevent psychiatric misdiagnosis are discussed.