ABSTRACT
Clinicians who minimize the significance of emotional disorders in persons with mental retardation may be displaying the diagnostic overshadowing judgmental bias. A meta-analysis of the existing literature on this bias was conducted to determine its reliability, the size of its effect, and its potential clinical significance. Results show the effect to be reliable across studies; the size of the effect was small to moderate. Interpretation of the clinical significance of these results is clouded by the absence of in vivo studies. Additional concerns include insufficient attention given to clinician and situational variables moderating the presence of diagnostic overshadowing.
Subject(s)
Intellectual Disability/diagnosis , Intellectual Disability/psychology , HumansABSTRACT
The robustness of the diagnostic overshadowing bias was examined by (a) testing the relation of overshadowing to level of mental retardation, (b) reexamining the effect of clinical experience in a more sensitive analysis, and (c) extending previous results to rehabilitation counselors. Diagnostic overshadowing was found with individuals with an IQ of 58, but did not generalize to those with IQs 70 or 80. This finding does not support the saliency hypothesis proposed by Reiss and his colleagues. In contrast to earlier studies, experience was related to overshadowing, although results were mixed. Experience measured by number of clients seen was not significant, whereas longevity in the field of mental retardation was associated with increased overshadowing.
