Biases in the evaluation of self-harm in patients with disability due to spinal cord injury

The paper discusses how biases can affect a clinician's assessment of self-harm risk in patients with spinal cord injuries (SCI). These biases can lead to inaccurate perceptions, potentially harming the therapeutic relationship and patient care. Three specific biases are explored: ineffectual bias (underestimating the patient's agency), fragile friendliness bias (over or underestimating risk due to perceived fragility or saintliness), and catastrophe bias (projecting the clinician's own negative perceptions onto the patient). The authors advocate for education and clinical interventions to address these biases, emphasizing the importance of understanding one's own susceptibility and directly interacting with people with disabilities to break down stereotypes.

• 1
  Ineffectual bias leads to clinicians discounting the experiences of patients with SCI, resulting in lower quality diagnoses and conservative treatment options.
• 2
  Fragile friendliness bias can cause clinicians to either overestimate the severity of symptoms or underestimate darker sides of patients with SCI, distorting the patient-clinician interaction.
• 3
  Catastrophe bias results in clinicians projecting their own negative perceptions onto patients with SCI, leading to clinical pessimism and diminished expectations for outcomes.