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An Investigation of the Influence of Case and Clinician Gender in Clinical Decision-Making

The present study was intended to assess the reliability of clinician judgments, with a particular interest in how such judgments vary by the gender of the case vignette and clinician. A national sample of 123 mental health professionals (57.7% male) provided clinical judgments on 12 case vignettes primarily representing personality pathology; two identical versions of each vignette were prepared, with the only difference being the use of masculine or feminine pronouns identifying the client. Clinical judgments included evaluations of adaptive functioning, long-term prognostic assessments, short-term risk evaluations, and treatment recommendations. Analyses included intraclass correlations between clinicians to assess reliability, as well as an examination of the variance of clinical judgments as a function of the identified gender of the case and the gender of the participating clinician. No significant two-way interactions were found between case gender and clinician gender in predicting the clinical judgments. A significant main effect of case gender in predicting vocational functioning was observed, such that female cases were rated as having better estimated vocational functioning than male cases. In addition, a significant main effect of clinician gender in predicting aggression and violence risk was found, such that ratings by female clinicians were higher than ratings by male clinicians. Results offer little if any evidence to suggest the influence of client or clinician gender on the majority of clinical judgments made in the present study. However, these results bear replication, particularly in light of the two significant main effects that did emerge.