Preconceived Expectations
Research Related to Preconceived Expectations
At LitigatorsHandbook.com we consider a 1929 study examined the opinions of 12 interviewers who interviewed 2000 homeless men, attempting to ascertain the reasons for their homelessness.[1] Co‑workers described one of the interviewers as an ardent socialist. By an almost three to one margin, the “socialist” interviewer concluded the homelessness of the men he interviewed reflected economic conditions beyond their control (lay‑offs, plant closings, etc.). Another interviewer was described as a strong prohibitionist. Again by an almost three to one margin, the “prohibitionist” interviewer attributed homelessness to alcohol abuse. While relying on their clinical judgments, these interviewers demonstrated a remarkable facility for finding evidence consistent with their preconceived expectations.
Despite 70 years elapsing since this landmark study, the problems associated with clinical judgment continue to persist. Curiously enough, professional identity is unrelated to the accuracy of clinical judgment. The judgments of psychiatrists, psychologists, and other mental health professionals are all equally unreliable because they commit the same kinds of errors. To belabor the obvious, the patients they see in treatment exhibit problems more often than effective adjustment. This skewed exposure to maladjustment results in mental health professionals developing an exaggerated sensitivity to psycho-pathology.
In a 1968 study, for example, psychologists and psychiatrists listened to the tape‑recorded interview of a patient who, in fact, was not psychotic.[2] Before listening to the audiotape, a well‑respected clinician ‑ cooperating as a confederate with the experimenter ‑ told some of the psychologists and psychiatrists that the patient was “a very interesting man because he looked neurotic but actually was quite psychotic.” The other group of psychologists and psychiatrists did not encounter this misinformation. When asked to diagnose this patient 60% of the psychiatrists, and 28% of the psychologists, in the “misinformed group” labeled him as psychotic. None of the psychologists or psychiatrists in the “not misinformed group” regarded the patient as this disturbed. The expectations of the misinformed group led them to look for serious pathology of psychotic proportions; and, they found what they looked for.
At LitigatorsHandbook.com we look to a 1980 study that further demonstrated the powerful effects of interviewer expectations.[3] In this study, psychiatric residents reviewed written descriptions of people described as: (1) interested undergraduate students taking a psychology course, or (2) undergraduate students recently evaluated for psychiatric hospitalization. Except for these labels ‑ interested student vs. candidate for hospitalization ‑ the written descriptions of these people were exactly the same. Nevertheless, the residents reviewing the cases labeled “candidates for hospitalization” found significantly more evidence of psycho-pathology than the other group.
The researchers explained that the characterization, “candidate for hospitalization,” influenced the thinking of the residents more than any other information they reviewed. As a result, they interpreted the remaining information about these individuals to conform with what they considered most informative. When people engage in these processes of selective information processing, they remember more clearly what seems consistent with their expectations more.[4] They respond to information inconsistent with their expectations by: (1) discounting it as a mere accident or anomaly, (2) reinterpreting it so it becomes expectation consistent, and/or (3) simply forgetting or overlooking the inconsistency.
At LitigatorsHandbook.com we know that when an expert’s pre-conceived notions result in overlooking important data, courts typically rely on a rule 703 analysis. A recent example found the federal court excluding an expert’s entire examination because the facts and data upon which the expert relied were:
“....critically inaccurate or incomplete, as determined by what other experts would or would not be willing to base opinions upon.” Christophersen v. Allied-Signal Corp., 939 F.2d 1106 (5th Cir. 1991), cert. denied, 112 S. Ct.1280 (1992).
In another recent example, a Michigan court noted an expert’s failure to reasonably consider contrary evidence. The expert’s analysis was also inconsistent with the driver’s testimony. When questioned about these inconsistencies, the only response of the expert was to disparage the witness's powers of observation, demonstrating that pre-conceived notions die hard.[5]
Commentators Bonnie and Slobogin note:
“Many clinicians are not sensitive to the limitations of their own disciplines; if they are not researchers, they focus on what they think they know rather than what they do not know. More important, many clinicians are entirely untrained in, and insensitive to, the purposes and limitations of the legal process.”[6]
Emphasis added
At LitigatorsHandbook.com we teach that mental health professionals can be effectively cross‑examined regarding their preconceived expectations in the following manner.
Cross‑examination Related to Preconceived Expectations
1. Dr. X, in evaluating Mr. Smith, you sought to answer one or more well‑defined questions ‑‑ Correct?
2. And what well‑defined questions were those? [record answers]
3. When reaching their opinions about some issue, people often find what they expect to find ‑‑ Correct?
4. And people find what they expect to find because they look for information consistent with their expectations ‑‑ Correct?
5. And the relevant research demonstrates that mental health professionals also frequently find what they expect to find ‑‑ Correct?
[USE THE 22 FOUNDATIONAL QUESTIONS FROM PREVIOUS POSTS
IF YOU HAVE NOT YET DONE SO]
6. The American Journal of Sociology is a generally recognized and accepted, peer‑reviewed journal ‑‑ Correct?
7. And a 1929 article in the American Journal of Sociology by Rice ‑ titled “Interviewer Bias as a Contagion” ‑ could be relevant to your opinions in this case ‑‑ Correct?
8. Concerning this research, I’d like to ask you this hypothetical question which involves these four steps:
[Consider printing these four steps on a piece of paper you can hand to the witness]
(1) This 1929 study examined how a “socialist interviewer,” and a “prohibitionist interviewer,” interviewed homeless men.
(2) These interviewers interviewed homeless men attempting to ascertain the reasons for their homelessness
(3) By a three to one margin, the socialist interviewer attributed homelessness to social conditions such as lay‑offs and plant‑closings
(4) By an almost three to one margin, the prohibitionist interviewer attributed homelessness to alcohol abuse.
Now my question: - These interviewers demonstrated a remarkable facility for finding evidence consistent with their pet hypotheses ‑‑ Correct?
9. You have not published any data in a peer‑reviewed journal necessitating that we re-consider the findings of this 1929 study ‑‑ Correct?
10. You cannot cite any data published in a peer‑reviewed journal necessitating that we reconsider the findings of this 1929 study ‑‑ Correct?
11. Without other data necessitating reconsideration of Rice's 1929 findings, those results ‑ published in a peer‑reviewed journal ‑ are regarded as generally recognized and accepted ‑‑ Correct?
12. In other words, your profession generally recognizes and accepts that interviewers can demonstrate a remarkable facility for finding evidence consistent with their pet hypotheses ‑‑ Correct?
13. The Journal of Nervous and Mental Disease is a generally recognized and accepted journal in your field ‑‑ Correct?
14. And a 1968 article by Temerlin ‑ titled “Suggestion Effects in Psychiatric Diagnosis” ‑ could be directly relevant to your opinions in this case ‑‑ Correct?
15. Concerning this research, I’d like to ask you this hypothetical question which involves these five steps:
[Consider printing these five steps on a piece of paper you can hand to the witness]
(1) In this 1968 study, the psychologists and psychiatrists listened to a tape‑recorded interview of a patient who ‑ in fact ‑ was not psychotic
(2) For purposes of this experiment, a well‑respected, senior colleague told half of these psychologists and psychiatrists that the patient was “a very interesting man because he looked neurotic but actually was quite psychotic”.
(3) The remaining psychologists and psychiatrists did not encounter this misleading information
(4) 60% of the psychiatrists, and 28% of the psychologists, in the misinformed group incorrectly diagnosed this patient as psychotic.
(5) And of the remaining group of psychologists and psychiatrists who were not misinformed, not one of them diagnosed the patient as psychotic
Now my question: - The expectations of psychiatrists and psychologists influenced their diagnostic conclusions ‑‑ Correct?
16. Have you published any data in a peer‑reviewed journal necessitating that we consider the findings of this 1968 study?
17. Can you cite any data published in a peer‑reviewed journal necessitating that we reconsider the findings of this 1968 study?
18. Without other data necessitating reconsideration of Temerlin's 1968 findings, those results ‑ published in a peer‑reviewed journal ‑ are regarded as generally recognized and accepted ‑‑ Correct?
19. In other words, your profession generally recognizes and accepts that the expectations of psychiatrists and psychologists influence their diagnostic conclusions ‑‑ Correct?
20. The Journal of Clinical Psychology is a generally recognized and accepted, peer‑reviewed journal in your field ‑‑ Correct?
21. And a 1980 study by Sattin published in the Journal of Clinical Psychology ‑ titled “Possible Sources of Error in The Evaluation of Psychopathology” ‑ could be relevant to your opinions in this case ‑‑ Correct?
22. Concerning this research, I’d like to ask you this hypothetical question which involves these three steps:
[Consider printing these three steps on a piece of paper you can hand to the witness]
(1) Psychiatric residents reviewed written descriptions of individuals described as either:
(A) an interested undergraduate student taking a psychology course, or (B) n undergraduate student recently evaluated for psychiatric hospitalization
(2) Except for these labels ‑ interested student vs. candidate for hospitalization ‑ the written descriptions of these people were exactly the same.
(3) But those psychiatric residents who thought they were reading about a “candidate for hospitalization” found substantially more evidence of psychopathology than the other group of residents.
Now my question: - This is another example of mental health professionals finding what they expect to find -- Correct?
23. You have not published any data in a peer‑reviewed journal necessitating that we consider the findings of this 1980 study -- Correct?
24. You cannot cite any data published in a peer‑reviewed journal necessitating that we reconsider the findings of this 1980 study -- Correct?
25. Without other data necessitating reconsideration of Sattin's 1980 findings, those results ‑ published in a peer‑reviewed journal ‑ should be regarded as generally recognized and accepted ‑‑ Correct?
26. In other words, your profession generally recognizes and accepts that expectations of mental health professionals influence their diagnostic conclusions ‑‑ Correct?
27. The interviewers in the 1929 study, the psychologists and psychiatrists in the 1968 study, and the psychiatric residents in the 1980 study all responded to their preconceived expectations ‑‑ Correct?
28. And when people are influenced by their preconceived expectations, they remember more clearly what seems consistent with those expectations ‑‑ Correct?
29. As a result of preconceived expectations, people respond to information inconsistent with their expectancies by discounting it as a mere accident or fluke ‑‑ Correct?
30. Or as a result of preconceived expectations, people respond to information inconsistent with their expectancies by reinterpreting the information so it’s not inconsistent ‑‑ Correct?
31. Or as a result of preconceived expectations, people respond to information inconsistent with their expectancies by simply forgetting or overlooking the inconsistency ‑‑ Correct?
32. And Dr. X, the relevant research demonstrates that your conclusions in this matter could have been influenced by your preconceived expectations ‑‑ Correct?
33. And as a result of your preconceived expectations, you could have remembered more clearly what seemed consistent with those expectations ‑‑ Correct?
34. And as a result of your preconceived expectations, you could have discounted ‑ or even forgotten ‑ information inconsistent with those expectations ‑‑ Correct?
[1]. Rice, S.A. (1929). Interviewer bias as a contagion. American Journal of Sociology, 35, 421-423.
[2]. Temerlin, M.K. (1968). Suggestion effects in psychiatric diagnosis. Journal of Nervous and Mental Disease, 147, 349-353,
[3]. Sattin, D.B. (1980). Possible sources of error in the evaluation of psycho-pathology. Journal of Clinical Psychology, 36, 99-105.
[4]. Rothbart, M., Evans, M. & Fulero, S. (1979). Recall for confirming events: Memory processes and the maintenance of social stereotypes. Journal of Personality and Social Psychology, 15, 343-355.
[5]. Green v. Jerome-Duncan Ford, Inc., 491 N.W.2d 243 (Mich. Ct. App., 1992); Also, in O'Conner v. Commonwealth Edison Co.,807 F. Supp. 1376 (C.D. 111. 1992), aff1d, 13 F.3d 1090 (7th Cir. 1994), federal district court judge Michael Milim dealt with proffered testimony from an ophthalmologist, who proposed to testify that by merely examining the plaintiff, he discovered that the plaintiff's cataracts were a result of his exposure to radiation at the defendant’s nuclear power plant. The basis the expert’s opinion was that the type of radiation to which the plaintiff was exposed could cause cataracts, and that he had observed five patients in the past who had the same type of cataracts as the plaintiff, all of which had been radiation-induced.
Judge Milim noted that the expert had committed the logical fallacy known as the “Converse Accident” (hasty generalization). Judge Mihm wrote that this occurs, when a person erroneously creates a general rule from observing too few cases. The judge noted that the expert had ignored the scientific literature that showed that the plaintiff's cataracts could have come from other sources. Judge Mihm therefore excluded the testimony.
For other examples of courts excluding causation testimony when the expert did not discount other possible causes, see Smith v. Ortho Pharmaceutical Corp., 770 F. Supp. 1561, 1581 (N.D. Ga. 1991); DeLuca v. Merrell Dow Pharmaceuticals, 791 F. Supp. 1042, 1058-59, aff1d, 6 F.3d 778 (3d Cir. 1993), cert. denied, 114 S. Ct. 691 (1994); Paoli, 706 F. Supp. at 376; In re "Agent Orange" Prod. Liab. Litig., 611 F. Supp. 1223, 1251, 1253 (E.D.N.Y. 1985), aff 'd, 818 F.2d 187 (2d Cir. 1987), cert. denied sub nom. Lombardi v. Dow Chem. Co., 487 U.S. 1234 (1988).
[6]. Bonnie, R & Slobogin, C. (1980). The role of Mental Health Professionals in the Criminal Process: The Case for Informed Speculation. 66 Virginia Law Review 427, p 457
