The proposed project attempts to account for the finding reported in the literature of an overdiagnosis of schizophrenia and an underdiagnosis of depression in black psychiatric patients using epidemiological methods. Three symptom scales of the Psychiatric Epidemiology Research Interview (PERI) measure paranoia, Distrust (DST), Perceived Hostility of Others (PHO) and False Beliefs and Perceptions (FBP), and represent a range of severity from distrust to pathological delusions: the DST scale measures the mildest form, the PHO falls in the middle, and the FBP scale taps the severest type of paranoia. This study will involve primary data collection using the PERI scales of paranoia (DST, PHO, FBP), an well as the Rosenberg Self-Esteem Scale and the Fenigstein Paranoia Scale, and a measure of cultural paranoia, the Cultural Mistrust Inventory (CMI). One hundred and eighty Black patients diagnosed as having major depression or schizophrenia by means of traditional unstructured clinical interview will be reassessed with the PERI paranoia scales and other self-reported measures. In addition, culturally-sensitive rediagnoses of these black patients will be done with the Structured Clinical Interview for DSM III (SCID) followed by a """"""""best estimate"""""""" of their psychiatric diagnoses by an African American psychologist or psychiatrist. It is expected that there will be disagreement between the original chart diagnoses and the culturally-sensitive rediagnoses of these Black patients. High levels of cultural paranoia, as reflected by CMI scores, controlling for other types of self-reported paranoia should predict disagreement if misinterpretation of cultural paranoia as a clinical symptom contributes to misdiagnosis. The results of this study have implications for understanding black cultural experiences that may explain observed race differences in the psychiatric epidemiologic literature.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
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Clinical Psychopathology Review Committee (CPP)
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New York State Psychiatric Institute
New York
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Whaley, Arthur L (2012) Psychiatric and demographic predictors of memory deficits in African Americans with schizophrenia: the moderating role of cultural mistrust. Psychiatr Q 83:113-26
Whaley, Arthur L (2010) Psychiatric and psychological predictors of self-reported health of African Americans with severe mental illness. Psychiatr Serv 61:669-74
Whaley, Arthur L (2006) Effects of gender-matching and racial self-labeling on paranoia in African-American men with severe mental illness. J Natl Med Assoc 98:551-8
Whaley, Arthur L (2004) Paranoia in African-American men receiving inpatient psychiatric treatment. J Am Acad Psychiatry Law 32:282-90
Whaley, Arthur L (2004) Ethnicity/race, paranoia, and hospitalization for mental health problems among men. Am J Public Health 94:78-81
Whaley, Arthur L; Geller, Pamela A (2003) Ethnic/racial differences in psychiatric disorders: a test of four hypotheses. Ethn Dis 13:499-512
Whaley, Arthur L (2002) Symptom clusters in the diagnosis of affective disorder, schizoaffective disorder, and schizophrenia in African Americans. J Natl Med Assoc 94:313-9
Whaley, Arthur L (2002) Cultural mistrust predicts age at first hospitalization for African-American psychiatric patients. J Nerv Ment Dis 190:121-4
Whaley, Arthur L (2002) Psychometric analysis of the cultural mistrust inventory with a Black psychiatric inpatient sample. J Clin Psychol 58:383-96
Whaley, Arthur L (2002) Confluent paranoia in African American psychiatric patients: an empirical study of Ridley's typology. J Abnorm Psychol 111:568-77

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