Are personality disorder criteria ethnically biased? A card-sort analysis

Area of Science:

• Psychiatry
• Clinical Psychology
• Sociology

Background:

• Previous research identified sex bias in personality disorder (PD) diagnoses.
• The Diagnostic and Statistical Manual of Mental Disorders (3rd ed., Rev.) criteria for PDs warrant examination for other biases.
• Ethnicity as a criterion for bias in PD diagnoses has not been extensively studied.

Purpose of the Study:

• To investigate ethnicity criterion bias in personality disorder diagnoses.
• To examine both ethnicity and sex as potential sources of bias in PD diagnoses.
• To determine if specific ethnic groups are disproportionately diagnosed with particular PDs.

Main Methods:

• A card-sort analysis was employed using undergraduate college students as sorters.
• Methodology was adapted from previous studies on sex criterion bias.
• Data were analyzed to identify systematic patterns in PD diagnosis assignment across different ethnic groups.

Main Results:

• Significant ethnicity criterion bias was found for all PDs.
• African Americans were disproportionately diagnosed with antisocial and paranoid PDs.
• Asian Americans received diagnoses of schizoid PD, Native Americans of schizotypal PD, and European Americans of other PDs. Latinos received no PD diagnoses through this sorting process.

Conclusions:

• Ethnicity significantly influences the application of PD diagnostic criteria.
• Clinicians must be aware of potential ethnic biases in diagnosis.
• Future research should address these diagnostic disparities and refine assessment tools.