The Relationship Between Clinicians' And Patients' Ratings Of Anxiety And Depression As Mediated By Self-Consciousness

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)




The purpose of the present study was to assess the accuracy of self-reports of anxiety and depression, as mediated by self-consciousness, for a psychiatric inpatient population. The accuracy of the self-reports was determined by examining the concordance between the ratings of the patients and of two clinicians on several anxiety and depression measures. It was predicted that subjects high in private self-consciousness would be more accurate self-reporters than would those low in private self-consciousness, and that levels of public self-consciousness would have no bearing on the relationship between self-reports and clinicians' judgments.Contrary to prediction, the vast majority of the correlations between the patient's and the clinicians' ratings did not differ significantly for high vs. low private self-consciousness patients; however, the high privates did achieve significantly higher concordance rates than low privates when they utilized a "global" measure of anxiety. In contrast, the low privates achieved unexpectedly higher concordance rates than high privates when they used a very structured, symptom-specific self-report measure of depression. As for public self-consciousness, no difference was found in the correspondence between self-reports and clinicians' ratings of anxiety for high vs. low publics; however, when using a symptom-specific self-report measure of depression, low publics achieved higher concordance rates than did the high publics. These results were discussed in terms of (1) the nature of the self-report measures utilized and of the constructs they assessed, and (2) the differential diagnoses of the high and low private patients and of the high and low public patients.The surprisingly high correlations between the patients' and clinicians' ratings for the entire inpatient sample were likely a function of: the highly reliable and valid self-report inventories and clinical rating scales utilized; the structured, symptom-focused, and goal-directed clinical interviews conducted; and the rapport and trust established between the patients and the clinicians.


Psychology, Clinical

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