Social context and social workers' judgment of mental disorder

We examine biases in social workers' assessment of antisocial youths based on the responses of 250 MSW students to clinical case vignettes describing youths engaging in antisocial behavior, all of whom satisfied the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria for conduct disorder. Respondents were to judge whether the described youth had a psychiatric or mental disorder. We manipulated the content of the vignettes to suggest either internal dysfunction (i.e., disorder) or a normal response to a difficult environment (i.e., nondisorder) as the cause of the antisocial behavior. Contrary to the claims of critics, respondents generally appropriately distinguished, based on contextual information, between disordered and nondisordered youth. However, a minority of students did appear to display bias, primarily in the direction of underdiagnosis of disorder.