Diagnostic Labeling

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Abstract
The use of four broad diagnostic categories (normality, personality trait disorder, sociopathy, and psychiatric disturbance) was examined for four mental health clinicians conducting presentence evaluations of 560 felony offenders (140 cases per clinician). Although these four groups of subjects did not differ on age, offense severity, number of prior convictions, IQ, or MMPI performance, clinicians nonetheless varied widely both in their relative frequencies of use of these categories and their utilization of information in making diagnostic discriminations. Furthermore, labels and sentencing recommendations were related to each other in such a way that the attribution of normality was accompanied by a predominance of recommendations for placement on probation, while classification as a sociopath was associated with recommendations for long-term, involuntary confinement in an institutional setting. Those clinicians with the most highly deviant recommendation rates also exhibited the most extreme differences in their use of the normal and sociopathic categories and made judgments that were minimally related to objectively assessed characteristics of offenders. It was concluded that biases in the definition and assignment of labels might be reduced by means of a combined clinical-statistical approach to gathering and utilizing diagnostic information.

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