The effect of overshadowing bias on individual decision making and referral pathways

Lewendon, Jane (2004) The effect of overshadowing bias on individual decision making and referral pathways. University of Southampton, Doctoral Thesis.

Record type: Thesis (Doctoral)

Abstract

Research has presented diagnostic overshadowing as a robust cognitive bias, which alters clinicians’ diagnosis and treatment recommendations for individuals with learning disability and concurrent mental health problem. It refers to the tendency of clinicians to overlook a comorbid condition in the face of a more salient condition such as learning disability, hearing impairment and life-limiting illness. Although the literature has focused on the clinical realm, the overshadowing bias may equally be applied to the non-clinical sphere, where decisions are commonly made about individuals who may present with concurrent conditions. This thesis has two main aims:

Firstly it will review the existing diagnostic overshadowing literature. The strengths and weaknesses of this research will be considered and the validity of the bias assessed. Future research direction will be considered.

Secondly, it will empirically test the validity of the overshadowing bias by: assessing the effect manipulation of methodology has on overshadowing; exploring the generalisability of overshadowing for a non-clinical population making decisions about children with Asperger Syndrome and concurrent challenging behaviour; and finally exploring the relationship between overshadowing and cognitive complexity and causal attributions.

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