Understanding how clinicians and laypeople make critical decisions related to the assessment, diagnosis, and treatment of mental health is an important step toward improving mental healthcare. This Special Section features new research that, collectively, leverages interdisciplinary approaches from basic psychological science to enhance our understanding of clinical decision making. In this “Introduction to the Special Section,” we illustrate how three tasks integral to clinical decision making (assessment, diagnosis, and treatment selection) can be reframed as specific examples of more basic cognitive processes. We conclude by highlighting challenges to conducting interdisciplinary research on clinical decision making, by providing an overview of the contributions in this Special Section, and by presenting a list of essential readings on clinical decision making.
AchenbachT. M. (2017). Future directions for clinical research, services, and training: Evidence-based assessment across informants, cultures, and dimensional hierarchies. Journal of Clinical Child and Adolescent Psychology, 46, 159–169. doi:10.1080/15374416.2016.1220315
2.
AhnW.FlanaganE. H.MarshJ. K.SanislowC. A. (2006). Beliefs about essences and the reality of mental disorders. Psychological Science, 17, 759–766. doi:10.1111/j.1467-9280.2006.01779.x
3.
AhnW.KimN. S. (2001). The causal status effect in categorization: An overview. In MedinD. L. (Ed.), The psychology of learning and motivation: Advances in research and theory, Vol. 40 (pp. 23–65). San Diego, CA: Academic Press.
4.
AhnW.KimN. S.LassalineM. E.DennisM. J. (2000). Causal status as a determinant of feature centrality. Cognitive Psychology, 41, 361–416. doi:10.1006/cogp.2000.0741
5.
AhnW.MarshJ. K.LuhmannC. C.LeeK. (2002). Effect of theory-based feature correlations on typicality judgments. Memory & Cognition, 30, 107–118. doi:10.3758/BF03195270
6.
AhnW.NovickL. R.KimN. S. (2003). Understanding behavior makes it more normal. Psychonomic Bulletin & Review, 10, 746–752. doi:10.3758/BF03196541
7.
AhnW.TaylorE. G.KatoD.MarshJ. K.BloomP. (2013). Causal essentialism in kinds. The Quarterly Journal of Experimental Psychology, 66, 1113–1130. doi:10.1080/17470218.2012.730533
8.
ArkesH. R.WortmannR. L.SavilleP. D.HarknessA. R. (1981). Hindsight bias among physicians weighing the likelihood of diagnoses. Journal of Applied Psychology, 66, 252–254. doi:10.1037/0021-9010.66.2.252
9.
AschS. E. (1946). Forming impressions of personality. The Journal of Abnormal and Social Psychology, 41, 258–290. doi:10.1037/h0055756
10.
BloomP. (2004). Descartes’ baby: How the science of child development explains what makes us human. New York, NY: Basic Books.
11.
BoshuizenH. P. A.SchmidtH. G. (1992). On the role of biomedical knowledge in clinical reasoning by experts, intermediates and novices. Cognitive Science, 16, 153–184. doi:10.1207/s15516709cog1602_1
12.
BrooksL. R.LeBlancV. R.NormanG. R. (2000). On the difficulty of noticing obvious features in patient appearance. Psychological Science, 11, 112–117. doi:10.1111/1467-9280.00225
13.
BrooksL. R.NormanG. R.AllenS. W. (1991). Role of specific similarity in a medical diagnostic task. Journal of Experimental Psychology-General, 120, 278–287. doi:10.1037/0096-3445.120.3.278
14.
BuehnerM. J.MayJ. (2002). Knowledge mediates the timeframe of covariation assessment in human causal induction. Thinking & Reasoning, 8, 269–295. doi:10.1080/13546780244000060
15.
ChamblessD. L.OllendickT. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716. doi:10.1146/annurev.psych.52.1.685
16.
ChapmanG. B.LiM.VietriJ.IbukaY.ThomasD.YoonH.GalvaniA. P. (2012). Using game theory to examine incentives in influenza vaccination behavior. Psychological Science, 23, 1008–1015. doi:10.1177/0956797612437606
17.
ChiM. T. H. (2006). Two approaches to the study of experts’ characteristics. In EricssonK. A.CharnessN.FeltovichP. J.HoffmanR. R. (Eds.), The Cambridge handbook of expertise and expert performance (pp. 21–30). New York, NY: Cambridge University Press.
18.
CooperJ. A.MarshJ. K. (2015). The influence of expertise on essence beliefs for mental and medical disorder categories. Cognition, 144, 67–75. doi:10.1016/j.cognition.2015.07.016
19.
DawesR. M. (1996). House of cards: Psychology and psychotherapy built on myth. New York, NY: Free Press.
20.
de KwaadstenietL.HagmayerY.KrolN. P. C. M.WittemanC. L. M. (2010). Causal client models in selecting effective interventions: A cognitive mapping study. Psychological Assessment, 22, 581–592. doi:10.1037/a0019696
21.
De Los ReyesA.AugensteinT. M.WangM.ThomasS. A.DrabickD. A. G.BurgersD.RabinowitzJ. (2015). The validity of the multi-informant approach to assessing child and adolescent mental health. Psychological Bulletin, 141, 858–900. doi:10.1037/a0038498
22.
De Los ReyesA.KazdinA. E. (2006). Conceptualizing changes in behavior in intervention research: The range of possible changes model. Psychological Review, 113, 554–583. doi:10.1037/0033-295X.113.3.554
23.
De Los ReyesA.ThomasS. A.GoodmanK. L.KundeyS. M. A. (2013). Principles underlying the use of multiple informants’ reports. Annual Review of Clinical Psychology, 9, 123–149. doi:10.1146/annurev-clinpsy-050212-185617
24.
DjulbegovicB.van den EndeJ.HammR. M.MayrhoferT.HozoI.PaukerS. G.& the International Threshold Working Group (ITWG). (2015). When is rational to order a diagnostic test, or prescribe treatment: The threshold model as an explanation of practice variation. European Journal of Clinical Investigation, 45, 485–493. doi:10.1111/eci.12421
25.
DurlakJ. A. (1979). Comparative effectiveness of paraprofessional and professional helpers. Psychological Bulletin, 86, 80–92. doi:10.1037/0033-2909.86.1.80
ElsteinA. S.SchwarzA. (2002). Clinical problem solving and diagnostic decision making: Selective review of the cognitive literature. BMJ: British Medical Journal, 324, 729. doi:10.1136/bmj.324.7339.729
28.
EricssonK. A.LehmannA. C. (1996). Expert and exceptional performance: Evidence of maximal adaptation to task constraints. Annual Review of Psychology, 47, 273–305. doi:10.1146/annurev.psych.47.1.273
29.
FaustD.ZlotnickC. (1995). Another dodo bird verdict: Revisiting the comparative effectiveness of professional and paraprofessional therapists. Clinical Psychology & Psychotherapy, 2, 157–167. doi:10.1002/cpp.5640020303
30.
FeltovichP. J.PrietulaM. J.EricssonK. A. (2006). Studies of expertise from psychological perspectives. In EricssonK. A.CharnessN.FeltovichP. J.HoffmanR. R. (Eds.), The Cambridge handbook of expertise and expert performance (pp. 41–67). New York, NY: Cambridge University Press.
31.
FloresA.CobosP. L.LópezF. J.GodoyA.González-MartínE. (2014). The influence of causal connections between symptoms on the diagnosis of mental disorders: Evidence from online and offline measures. Journal of Experimental Psychology: Applied, 20, 175–190. doi:10.1037/xap0000025
32.
ForstmannM.BurgmerP. (2015). Adults are intuitive mind-body dualists. Journal of Experimental Psychology: General, 144, 222–235. doi:10.1037/xge0000045
33.
GarbH. N. (1989). Clinical judgment, clinical-training, and professional experience. Psychological Bulletin, 105, 387–396. doi:10.1037/0033-2909.105.3.387
34.
GarbH. N. (1996). The representativeness and past-behavior heuristics in clinical judgment. Professional Psychology-Research and Practice, 27, 272–277. doi:10.1037//0735-7028.27.3.272
35.
GarbH. N. (1998). Studying the clinician: Judgment research and psychological assessment. Washington, DC: American Psychological Association.
36.
GarbH. N. (2005). Clinical judgment and decision making. Annual Review of Clinical Psychology, 1, 67–89. doi:10.1146/annurev.clinpsy.1.102803.143810.
37.
GarbH. N. (2006). The conjunction effect and clinical judgment. Journal of Social and Clinical Psychology, 25, 1048–1056. doi:10.1521/jscp.2006.25.9.1048
38.
GelmanS. A. (2003). The essential child: Origins of essentialism in everyday thought. New York, NY: Oxford University Press.
39.
HagmayerY.SlomanS. A. (2009). Decision makers conceive of their choices as interventions. Journal of Experimental Psychology: General, 138, 22–38. doi:10.1037/a0014585
40.
HagmayerY.SlomanS. A.LagnadoD. A.WaldmannM. R. (2007). Causal reasoning through intervention. In GopnikA.SchulzL. E. (Eds.), Causal learning: Psychology, philosophy, and computation (pp. 86–100). New York, NY: Oxford University Press.
41.
HagmayerY.WaldmannM. R. (2002). How temporal assumptions influence causal judgments. Memory and Cognition, 30, 1128–1137. doi:10.3758/BF03194330
42.
HammR. M.ZubialdeJ. (1995). Physicians’ expert cognition and the problem of cognitive biases. Primary Care, 22, 181–212.
43.
HardingT. P. (2007). Clinical decision-making: How prepared are we?Training and Education in Professional Psychology, 1, 95–104. doi:10.1037/1931-3918.1.2.95
44.
HashemA.ChiM. T. H.FriedmanC. P. (2003). Medical errors as a result of specialization. Journal of Biomedical Informatics, 36, 61–69. doi:10.1016/s1532-0464(03)00057-1
45.
HogarthR. M.EinhornH. J. (1992). Order effects in belief updating: The belief-adjustment model. Cognitive Psychology, 24, 1–55. doi:10.1016/0010-0285(92)90002-J
HunsleyJ.MashE. J. (2007). Evidence-based assessment. Annual Review of Clinical Psychology, 3, 29–51. doi:10.1146/annurev.clinpsy.3.022806.091419
48.
JensenA.WeiszJ. R. (2002). Assessing match and mismatch between practitioner-generated and standardized interview-generated diagnoses for clinic-referred children and adolescents. Journal of Consulting and Clinical Psychology, 70, 158–168. doi:10.1037//0022-006X.70.1.158
49.
Jensen-DossA.HawleyK. M. (2011). Understanding clinicians’ diagnostic practices: Attitudes toward the utility of diagnosis and standardized diagnostic tools. Administration and Policy in Mental Health and Mental Health Services Research, 38, 476–485. doi:10.1007/s10488-011-0334-3
50.
KahnemanD.KleinG. (2009). Conditions for intuitive expertise: A failure to disagree. American Psychologist, 64, 515–526. doi:10.1037/a0016755
51.
KazdinA. E. (2017). Addressing the treatment gap: A key challenge for extending evidence-based psychosocial interventions. Behaviour Research and Therapy, 88, 7–18. doi: 10.1016/j.brat.2016.06.004
52.
KazdinA. E.BlaseS. L. (2011). Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspectives on Psychological Science, 6, 21–37. doi:10.1177/1745691610393527
53.
KesslerR.StaffordD. (2008). Primary care is the de facto mental health system. In KesslerR.StaffordD. (Eds.), Collaborative medicine case studies: Evidence in practice (pp. 9–21). New York, NY: Springer New York. doi:10.1007/978-0-387-76894-6_2
54.
KimN. S.AhnW. (2002). Clinical psychologists’ theory-based representations of mental disorders predict their diagnostic reasoning and memory. Journal of Experimental Psychology-General, 131, 451–476. doi:10.1037//0096-3445.131.4.451
55.
KimS.RehderB. (2011). How prior knowledge affects selective attention during category learning: An eyetracking study. Memory & Cognition, 39, 649–665. doi:10.3758/s13421-010-0050-3
56.
KlaymanJ.HaY. (1987). Confirmation, disconfirmation, and information in hypothesis testing. Psychological Review, 94, 211–228. doi:10.1037/0033-295X.94.2.211
57.
KlaymanJ.HaY. (1989). Hypothesis testing in rule discovery: Strategy, structure, and content. Journal of Experimental Psychology: Learning, Memory, and Cognition, 15, 596. doi:10.1037/0278-7393.15.4.596
58.
KravitzR. L.EpsteinR. M.FeldmanM. D.FranzC. E.AzariR.WilkesM. S., . . . FranksP. (2005). Influence of patients’ requests for direct-to-consumer advertised antidepressants: A randomized controlled trial. Journal of the American Medical Association, 293, 1995–2002. doi:10.1001/jama.293.16.1995
59.
LayardR.ClarkD. M. (2014). Thrive: The power of evidence-based psychological therapies. London, UK: Penguin.
60.
LeBoeufR. A.NortonM. I. (2012). Consequence-cause matching: Looking to the consequences of events to infer their causes. Journal of Consumer Research, 39, 128–141. doi:10.1086/662372
61.
LewinsohnP. M.MunozR. F.YoungrenM. A.ZeissA. M. (1986). Control your depression. New York, NY: Prentice Hall.
62.
LiM.ChapmanG. B. (2009). “100% of anything looks good”: The appeal of one hundred percent. Psychonomic Bulletin & Review, 16, 156–162. doi:10.3758/PBR.16.1.156
63.
LilienfeldS. O.RitschelL. A.LynnS. J.CautinR. L.LatzmanR. D. (2013). Why many clinical psychologists are resistant to evidence-based practice: Root causes and constructive remedies. Clinical Psychology Review, 33, 883–900.
64.
LombrozoT. (2006). The structure and function of explanations. Trends in Cognitive Sciences, 10, 464–470. doi:10.1016/j.tics.2006.08.004
65.
LuhmannC. C.AhnW. (2011). Expectations and interpretations during causal learning. Journal of Experimental Psychology: Learning, Memory, and Cognition, 37, 568–587. doi:10.1037/a0022970
66.
MamedeS.van GogT.van den BergeK.van SaaseJ. L. C. M.van GuldenerC.SchmidtH. G. (2010). Effect of availability bias and reflective reasoning on diagnostic accuracy among internal medicine residents. Journal of the American Medical Association, 304, 1198–1203. doi:10.1001/jama.2010.1276
67.
MarshJ. K.AhnW. (2006). Order effects in contingency learning: The role of task complexity. Memory & Cognition, 34, 568–576. doi:10.3758/BF03193580
68.
MarshJ. K.AhnW. (2009). Spontaneous assimilation of continuous values and temporal information in causal induction. Journal of Experimental Psychology: Learning, Memory, and Cognition, 35, 334–352. doi:10.1037/a0014929
69.
MarshJ. K.AhnW. (2012). Memory for patient information as a function of experience in mental health. Applied Cognitive Psychology, 26, 462–474. doi:10.1002/acp.2832
70.
MarshJ. K.RomanoA. L. (2016). Lay judgments of mental health treatment options. MDM Policy & Practice, 1, 1–12. doi:10.1177/2381468316669361
71.
MarshJ. K.ShanksL. L. (2014). Thinking you can catch mental illness: How beliefs about membership attainment and category structure influence interactions with mental health category members. Memory & Cognition, 42, 1011–1025. doi:10.3758/s13421-014-0427-9
MedinD. L.SchafferM. M. (1978). Context theory of classification learning. Psychological Review, 85, 207–238. doi:10.1037/0033-295X.85.3.207
74.
MichotteA. (1946). The perception of causality (MilesT. R. Trans.). London, UK: Methuen & Co.
75.
MurphyG. L. (2002). The big book of concepts. Cambridge, MA: The MIT Press.
76.
MurphyG. L.MedinD. L. (1985). The role of theories in conceptual coherence. Psychological Review, 92, 289–316. doi:10.1037/0033-295X.92.3.289
77.
MylopoulosM.RegehrG. (2007). Cognitive metaphors of expertise and knowledge: Prospects and limitations for medical education. Medical Education, 41, 1159–1165. doi:10.1111/j.1365-2923.2007.02912.x
78.
NickersonR. S. (1998). Confirmation bias: A ubiquitous phenomenon in many guises. Review of General Psychology, 2, 175–220.
79.
NisbettR. E.RossL. (1980). Human inference: Strategies and shortcomings of social judgment. Englewood Cliffs, NJ: Prentice-Hall.
80.
NormanG. R.CoblentzC. L.BrooksL. R.BabcookC. J. (1992). Expertise in visual diagnosis: A review of the literature. Academic Medicine, 67, S78–S83.
81.
NormanG. R.EvaK.BrooksL.HamstraS. (2006). Expertise in medicine and surgery. In EricssonK. A.CharnessN.FeltovichP. J.HoffmanR. F. (Eds.), The Cambridge handbook of expertise and expert performance (pp. 339–353). New York, NY: Cambridge University Press.
82.
NormanG. R.YoungM.BrooksL. (2007). Non-analytical models of clinical reasoning: The role of experience. Medical Education, 41, 1140–1145. doi:10.1111/j.1365-2923.2007.02914.x
83.
PapaF. J.EliesonB. (1993). Diagnostic accuracy as a function of case prototypicality. Academic Medicine, 68, S58–S60.
84.
PatelV. L.GroenC. J.PatelY. C. (1997). Cognitive aspects of clinical performance during patient workup: The role of medical expertise. Advances in Health Sciences Education, 2, 95–114. doi:10.1023/A:1009788531273
85.
ProffittJ. B.ColeyJ. D.MedinD. L. (2000). Expertise and category-based induction. Journal of Experimental Psychology: Learning, Memory, and Cognition, 26, 811–828. doi:10.1037/0278-7393.26.4.811
86.
ProninE.LinD. Y.RossL. (2002). The bias blind spot: Perceptions of bias in self versus others. Personality and Social Psychology Bulletin, 28, 369–381. doi:10.1177/0146167202286008
87.
RedelmeierD. A.ShafirE. (1995). Medical decision-making in situations that offer multiple alternatives. Journal of the American Medical Association, 273, 302–305. doi:10.1001/jama.1995.03520280048038
88.
RedelmeierD. A.TanS. H.BoothG. L. (1998). The treatment of unrelated disorders in patients with chronic medical diseases. New England Journal of Medicine, 338, 1516–1520. doi:10.1056/NEJM199805213382106
89.
RedelmeierD. A.TverskyA. (1990). Discrepancy between medical decisions for individual patients and for groups. New England Journal of Medicine, 322, 1162–1164. doi:10.1056/NEJM199004193221620
90.
RehderB. (2015). The role of functional form in causal-based categorization. Journal of Experimental Psychology: Learning, Memory, and Cognition, 41, 670–692. doi:10.1037/xlm0000048
91.
RoschE.MervisC. B. (1975). Family resemblances: Studies in the internal structure of categories. Cognitive Psychology, 7, 573–605. doi:10.1016/0010-0285(75)90024-9
92.
SchmidtH. G.BoshuizenH. P. (1993). On acquiring expertise in medicine. Educational Psychology Review, 5, 205–221. doi:10.1007/BF01323044
93.
SchynsP. G.GoldstoneR. L.ThibautJ. P. (1998). The development of features in object concepts. Behavioral and Brain Sciences, 21, 1–54. doi:10.1017/S0140525X98000107
94.
ShaftoP.ColeyJ. A.BaldwinD. (2007). Effects of time pressure on context-sensitive property induction. Psychonomic Bulletin and Review, 14, 890–894. doi:10.3758/BF03194117
95.
ShultzT. R.RavinskyF. B. (1977). Similarity as a principle of causal inference. Child Development, 48, 1552–1558. doi:10.2307/1128518
96.
TentlerA.SilbermanJ.PaternitiD. A.KravitzR. L.EpsteinR. M. (2008). Factors affecting physicians’ responses to patients’ requests for antidepressants: Focus group study. Journal of General Internal Medicine, 23, 51–57. doi:10.1007/s11606-007-0441-8
97.
TraceyT. J. G.WampoldB. E.LichtenbergJ. W.GoodyearR. K. (2014). Expertise in psychotherapy: An elusive goal?American Psychologist, 69, 218–229. doi:10.1037/a0035099
98.
WasonP. C. (1960). On the failure to eliminate hypotheses in a conceptual task. The Quarterly Journal of Experimental Psychology, 12, 129–140. doi:10.1080/17470216008416717
99.
WeiszJ. R.Jensen-DossA.HawleyK. M. (2006). Evidence-based youth psychotherapies versus usual clinical care: A meta-analysis of direct comparisons. American Psychologist, 61, 671–689. doi:10.1037/0003-066X.61.7.671
100.
WisniewskiE. J.MedinD. L. (1994). On the interaction of theory and data in concept learning. Cognitive Science, 18, 221–281. doi:10.1207/s15516709cog1802_2
101.
WittemanC. L. M.HarriesC.BekkerH. L.Van AarleE. J. M. (2007). Evaluating psychodiagnostic decisions. Journal of Evaluation in Clinical Practice, 13, 10–15. doi:10.1111/j.1365-2753.2006.00689.x
102.
WittemanC. L. M.TollenaarM. S. (2012). Remembering and diagnosing clients: Does experience matter?Memory, 20, 266–276. doi:10.1080/09658211.2012.654799
103.
WittemanC. L. M.van den BerckenJ. H. L. (2007). Intermediate effects in psychodiagnostic classification. European Journal of Psychological Assessment, 23, 56–61. doi:10.1027/1015-5759.23.1.56
104.
WoodJ. M.GarbH. N.LilienfeldS. O.NezworskiM. T. (2002). Clinical assessment. Annual Review of Clinical Psychology, 53, 519–543. doi:10.1146/annurev.psych.53.100901.135136
105.
YoungstromE. A. (2013). Future directions in psychological assessment: Combining evidence-based medicine innovations with psychology’s historical strengths to enhance utility. Journal of Clinical Child and Adolescent Psychology, 42, 139–159. doi:10.1080/15374416.2012.736358
