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12 - Critical Thinking in Clinical Inference

Published online by Cambridge University Press:  05 June 2012

Thomas F. Oltmanns
Affiliation:
Washington University in St. Louis
E. David Klonsky
Affiliation:
Stony Brook University
Robert J. Sternberg
Affiliation:
Yale University, Connecticut
Henry L. Roediger III
Affiliation:
Washington University, St Louis
Diane F. Halpern
Affiliation:
Claremont McKenna College, California
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Summary

OVERVIEW

Every day, health professionals make decisions about issues that affect the well-being of their patients. These decisions can be called clinical inferences. This chapter explains how psychologists reach the conclusions they do, including a critical look at the validity of clinical inferences.

What types of inferences do psychologists make? Two common inferences involve diagnosis and treatment selection. Psychologists make decisions about the types of problems experienced by their clients, and they select interventions that are likely to be effective for treating these conditions. Psychologists make other important clinical inferences as well. In a criminal case, a judge or lawyer may ask a psychologist to predict whether a defendant will engage in violent behavior if released from custody. A patient recovering from alcoholism may want information about the probability that he or she will relapse. Diagnosis, treatment selection, violence prediction, and prognostic forecasting are all examples of clinical inferences made by psychologists in the course of clinical practice.

Critical thinking refers to the use of skills and strategies that make desirable outcomes more likely (see Chapter 1, this volume). In the context of clinical practice, desirable outcomes include the formulation of accurate diagnoses, effective treatments, and accurate predictions about future behavior. Valid clinical inferences can substantially improve people's lives, whereas invalid inferences can lead to prolonged psychological distress. Critical thinking is essential for achieving desirable clinical outcomes.

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Publisher: Cambridge University Press
Print publication year: 2006

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References

Acklin, M. W. (1999). Behavioral science foundations of the Rorschach Test: Research and clinical applications. Assessment, 6, 319–326.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Barlow, D. H. (2004). Psychological treatments. American Psychologist, 59, 869–877.CrossRefGoogle ScholarPubMed
Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7–18.CrossRefGoogle ScholarPubMed
Chambless, D., & Ollendick, T. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.CrossRefGoogle ScholarPubMed
Cronbach, L. J., & Meehl, P. E. (1955). Construct validity in psychological tests. Psychological Bulletin, 52, 281–302.CrossRefGoogle ScholarPubMed
Exner, J. E. (1993). The Rorschach: A comprehensive system, volume 1: Basic foundations. New York: Wiley.Google Scholar
Ford, M. R., & Widiger, T. A. (1989). Sex bias in the diagnosis of histrionic and antisocial personality disorders. Journal of Consulting and Clinical Psychology, 57, 301–305.CrossRefGoogle Scholar
Garb, H. N. (1996). The representativeness and past-behavior heuristics in clinical judgment. Professional Psychology: Research and Practice, 27, 272–277.CrossRefGoogle Scholar
Garb, H. N. (1997). Race bias, social class bias, and gender bias in clinical judgment. Clinical Psychology: Science & Practice, 4, 99–120.Google Scholar
Garb, H. N. (1998). Studying the clinician: Judgment research and psychological assessment. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Garb, H. N. (2005). Clinical judgment and decision making. Annual Review of Clinical Psychology, 55, 3.1–3.23.Google Scholar
Garb, H. N. Florio, C. M., & Grove, , W. M. (1998). The validity of the Rorschach and the Minnesota Multiphasic Personality Inventory: Results from meta-analyses. Psychological Science, 9, 402–404.CrossRefGoogle Scholar
Garske, J. P., & Anderson, T. (2003). Toward a science of psychotherapy research: Present status and evaluation. In Lilienfeld, S. O., Lynn, S. J., & Lohr, J. M. (Eds.), Science and pseudoscience in clinical psychology (pp. 145–175). New York: Guilford Press.Google Scholar
Gorenstein, E. E. (1992). The science of mental illness. San Diego: Academic Press.Google Scholar
Jacobson, N. S., & Christensen, A. (1996). Studying the effectiveness of psychotherapy: How well can clinical trials do the job?American Psychologist, 51, 1031–1039.CrossRefGoogle Scholar
Kahneman, D., & Tversky, A. (1973). On the psychology of prediction. Psychological Review, 80, 237–251.CrossRefGoogle Scholar
Kendell, R. E. (2002). Five criteria for an improved taxonomy of mental disorders. In Helzer, J. E. and Hudziak, J. J. (Eds.), Defining psychopathology in the 21st century (pp. 3–17). Washington, DC: American Psychiatric Press.Google Scholar
Klonsky, E. D. (2000). The DSM classification of personality disorder: Clinical wisdom or empirical truth?Journal of Clinical Psychology, 56, 1615–1621.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Kolar, D. W., Funder, D. C., & Colvin, C. R. (1996). Comparing the accuracy of personality judgments by the self and knowledgeable others. Journal of Personality, 64, 311–337.CrossRefGoogle ScholarPubMed
Krueger, R. F. (2002). Psychometric perspectives on comorbidity. In Helzer, J. E. and Hudziak, J. J. (Eds.), Defining psychopathology in the 21st century (pp. 41–54). Washington, DC: American Psychiatric Press.Google Scholar
Lilienfeld, S. O., Wood, J. M., & Garb, H. N. (2000). The scientific status of projective techniques. Psychological Science in the Public Interest, 1, 27–66.CrossRefGoogle ScholarPubMed
Livesley, W. J. (1998). Suggestions for a framework for an empirically based classification of personality disorder. Canadial Journal of Psychiatry, 43, 137–147.CrossRefGoogle ScholarPubMed
Lopez, S. R., & Guarnaccia, P. J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51, 571–598.CrossRefGoogle ScholarPubMed
Manschreck, T. C. (2001). Placebo studies: Lessons from psychiatric research. Psychiatric Annals, 31, 130–136.CrossRefGoogle ScholarPubMed
McFall, R. M. (1991). Manifesto for a science of clinical psychology. The Clinical Psychologist, 44, 75–88.Google Scholar
McNiel, D. E., & Binder, R. L. (1995). Correlates of accuracy in the assessment of psychiatric inpatients' risk of violence. American Journal of Psychiatry, 152, 901–906.Google Scholar
Meehl, P. E. (1972). Specific genetic etiology, psychodynamics, and therapeutic nihilism. International Journal of Mental Health, 1, 10–27.CrossRefGoogle Scholar
Meehl, P. E. (1973). Why I do not attend case conferences. In Psychodiagnosis: Selected papers (pp. 225–302). Minneapolis: University of Minnesota Press.Google Scholar
Nathan, P. E., Stuart, S. P., & Dolan, S. L. (2000). Research on psychotherapy efficacy and effectiveness: Between Scylla and Charybdis?Psychological Bulletin, 126, 964–981.CrossRefGoogle ScholarPubMed
Neale, J. M., & Oltmanns, T. F. (1980) Schizophrenia. New York: Wiley.
Pavkov, T. W., Lewis, D. A., & Lyons, J. A. (1989). Psychiatric diagnoses and racial bias: An empirical investigation. Professional Psychology: Research and Practice, 20, 364–368.CrossRefGoogle Scholar
Sedgwick, P. (1981). Illness – Mental and otherwise. In , A. L. Caplan, , H. T. Engelhardt, and , J. J. McCartney (Eds), Concepts of health and disease: Interdisciplinary perspectives (pp. 119–129). Addison-Wesley: Reading, MA.Google Scholar
Seligman, M. E. P. (1995). The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist, 50, 965–974.CrossRefGoogle ScholarPubMed
Simon, R. J., Fleiss, J. L., Gurland, B. J., Stiller, P. R., & Sharpe, L. (1973). Depression and schizophrenia in hospitalized Black and White mental patients. Archives of General Psychiatry, 28, 509–512.CrossRefGoogle ScholarPubMed
Stack, L. C., Lannon, P. B., & Miley, A. D. (1983). Accuracy of clinicians' expectancies for psychiatric rehospitalization. American Journal of Community Psychology, 11, 99–113.CrossRefGoogle ScholarPubMed
Turk, D. C., Salovey, P., & Prentice, D. A. (1988). Psychotherapy: An information processing perspective. In D. C. Turk, & , P. Salovey (Eds.), Reasoning, inference, and judgment in clinical psychology (pp. 1–14). New York: The Free Press.Google Scholar
Turk, D. C., & Salovey, P. (Eds.) (1988). Reasoning, inference, and judgment in clinical psychology. London: Free Press.Google Scholar
Turkheimer, E. T. (1998). Heritability and biological explanation. Psychological Review, 105, 782–791.CrossRefGoogle ScholarPubMed
Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47, 373–388.CrossRefGoogle ScholarPubMed
Wakefield, J. C. (1999). Evolutionary versus prototype analyses of the concept of disorder. Journal of Abnormal Psychology, 108, 374–399.CrossRefGoogle ScholarPubMed
Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004). The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130, 631–663.CrossRefGoogle ScholarPubMed
Widiger, T. A., & Clark, L. A. (2000). Toward DSM-V and the classification of psychopathology. Psychological Bulletin, 126, 946–963.CrossRefGoogle ScholarPubMed
Woods, J. M., Nezworski, M. T., Garb, H. N., & Lilienfeld, S. O. (2001). The misperception of psychopathology: Problems with norms of the Comprehensive System for the Rorschach. Clinical Psychology: Science & Practice, 8, 350–373.Google Scholar
Wood, J. M., Nzworski, M. T., Lilienfeld, S. O., & Garb, H. N. (2003). What's wrong with the Rorschach? San Francisco, CA: Jossey-Bass.Google Scholar
World Health Organization. (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptors and Diagnostic Guidelines. Geneva, Switzerland: Author.
Zimmerman, M. (2003). What should the standard of care for psychiatric diagnostic evaluations be?Journal of Nervous and Mental Disease, 191, 281–286.CrossRefGoogle Scholar

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