Jensen-Doss Amanda, Weisz John R
Department of Educational Psychology, Texas A&M University, College Station, TX 77845, USA.
J Consult Clin Psychol. 2008 Oct;76(5):711-22. doi: 10.1037/0022-006X.76.5.711.
Several studies have documented low rates of agreement between clinician- and researcher-generated diagnoses. However, little is known about whether this lack of agreement has implications for the processes and outcomes of subsequent treatment. To study this possibility, the authors used diagnostic agreement to predict therapy engagement and outcomes for 197 youths treated in 5 community mental health clinics. Diagnostic agreement predicted better therapy engagement, with the agree group having fewer therapy no-shows and cancellations and a decreased likelihood of therapy dropout. Additionally, support for a link between agreement and treatment outcomes was found, as the agree group obtained larger reductions in parent-reported internalizing problems during treatment. These findings suggest that diagnostic accuracy may be an important precursor to successful treatment and highlight the importance of future research to find ways to incorporate standardized diagnostic procedures into clinical care settings.
多项研究记录了临床医生与研究人员得出的诊断之间的低一致性率。然而，对于这种缺乏一致性是否会对后续治疗的过程和结果产生影响，人们知之甚少。为了研究这种可能性，作者利用诊断一致性来预测在5家社区心理健康诊所接受治疗的197名青少年的治疗参与度和治疗效果。诊断一致性预测了更好的治疗参与度，一致性组的治疗无故缺席和取消情况较少，治疗退出的可能性降低。此外，研究发现了对一致性与治疗结果之间联系的支持，因为一致性组在治疗期间家长报告的内化问题减少幅度更大。这些发现表明，诊断准确性可能是成功治疗的重要前提，并凸显了未来研究找到将标准化诊断程序纳入临床护理环境的方法的重要性。
