Sex-role attitudes and clinical appraisal in psychiatry residents

Objective: To measure sex-role beliefs of psychiatry residents and to examine bias in clinical appraisal. Method: Residents (45 female, 51 male) evaluated 1 of 4 possible clinical case histories-a female or male patient with histrionic personality disorder (HPD) or antisocial personality disorder (APD)-and completed the Sex-Role Egalitarianism Scale (SRES). Results: As predicted, female residents were more egalitarian than male residents (P < 0.03) according to the SRES. As expected, significantly more male than female patients received the diagnosis of APD (P < 0.00002). Although it was predicted that female patients would move often be given the HPD diagnosis than males, no significant gender differences were found. Sex of resident was not found to influence clinical behaviour significantly. Conclusions: These results highlight differential sex-role attitudes, as measured by the SRES, between female and male residents and suggest that residents' sex-role biases affect the diagnosis of APD. These results have implications for psychiatric assessment and treatment. Further understanding of these issues is critical to the development of educational tools to address sex biases in psychiatry.