Observation of Psychopathology: The Performance of Corpsmen Compared to Experienced Clinicians

摘要

As the sole member of the medical department, corpsmen board submarines may be called on to make decisions about the advisability of treatment, or evacuation of crewmembers who appear to be suffering from behavioral disorders. This study investigates the corpsmens's skill in observing behaviors that are indicative of psychopathology. Twenty corpsmen watched videotaped interviews with 12 psychiatric patients and rated the patients on 10 categories of behavior and on their overall level of mental health. The corpsmen's responses were compared to those made by a group of experienced psychiatrists and psychologists. There was a relatively high level of agreement between the judgments of the corpsmen and those of the experts. Accuracy (agreement between the corpsmen and experts) was found to be highest for behaviors determined to be absent by the consensus of the experts (92%), although it was still quite impressive for behaviors judged to be present (61%). Accuracy differed among the 10 categories of behavior that were examined. The corpsmen's judgments were most accurate on the more overt, objective behavior categories, such as motor activity and vocal tone. It dropped significantly for categories requiring more subjective judgments, such as verbal content and though content. While the corpsmen's perception of the patient's overall level of mental health was strongly related to that of the experts, the corpsmen evaluated each of the patients as more normal that did the experts. The kinds of error made by the corpsmen suggest that they underestimate the presence of abnormality in patients.