Diagnostic overshadowing refers to the negative bias impacting a clinician’s judgment regarding co-occurring disorders in individuals who have intellectual disabilities or other mental illness. Symptoms or behaviors that may be due to a specific mental illness are attributed to another disorder, historically Mental Retardation, without considering alternative etiology.
Reiss, Levtan, and Szyszko first coined the term “diagnostic overshadowing” to describe the tendency to assess individuals with intellectual disability less accurately (Reiss, Levitan, & McNally, 1982; Reiss, Levitan, & Szyszko, 1982; Reiss & Szyszko, 1983). Subsequent research has consistently demonstrated that the cognitive deficits displayed by an individual negatively impacted the ability of clinicians to make accurate judgments with regard to other co-occurring disorders (c.f., Jopp & Keys, 2001; White et al., 1995).
Jopp and Keys provide a review of the concept of diagnostic...
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References and Readings
Bryson, S. E., & Smith, I. (1998). Epidemiology of autism: Prevalence, associated characteristics, and implications for research and service delivery. Mental Retardation and Developmental Disabilities Research Reviews, 4, 9–103.
Charman, T., Pickles, A., Chandler, S., Wing, L., Bryson, S., Simonoff, E., et al. (2009). Commentary: Effects of diagnostic thresholds and research vs service and administrative diagnosis on autism prevalence. International Journal of Epidemiology, 38(5), 1234–1238. author reply 1243–1234.
Jopp, D. A., & Keys, C. B. (2001). Diagnostic overshadowing reviewed and reconsidered. American Journal on Mental Retardation, 106(5), 416–433.
Lotter, V. (1974). Factors related to outcome in autistic children. Journal of Autism and Childhood Schizophrenia, 4(3), 263–277.
Minnes, P., & Steiner, K. (2009). Parent views on enhancing the quality of health care for their children with fragile X syndrome, autism or Down syndrome. Child: Care, Health and Development, 35(2), 250–256.
Reiss, S., Levitan, G. W., & McNally, R. J. (1982). Emotionally disturbed mentally retarded people: An underserved population. American Psychologist, 37(4), 361–367.
Reiss, S., Levitan, G. W., & Szyszko, J. (1982). Emotional disturbance and mental retardation: Diagnostic overshadowing. American Journal of Mental Deficiency, 86(6), 567–574.
Reiss, S., & Szyszko, J. (1983). Diagnostic overshadowing and professional experience with mentally retarded persons. American Journal of Mental Deficiency, 87(4), 396–402.
Simonoff, E., Pickles, A., Charman, T., Chandler, T. L., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929.
White, M. J., Nichols, C. N., Cook, R. S., Spengler, P. M., Walker, B. S., & Look, K. K. (1995). Diagnostic overshadowing and mental retardation: A meta-analysis. American Journal on Mental Retardation, 100(3), 293–298.
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Kanne, S. (2013). Diagnostic Overshadowing. In: Volkmar, F.R. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1698-3_398
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-1697-6
Online ISBN: 978-1-4419-1698-3