Increasing Accuracy of Decision Making
Ralph Underwager, Psychology Editor
The interaction between Terence Campbell and Richard Gardner on the
issues raised by Dr. Gardner's proposal of indicators of pedophilia is
part of what the editors of this journal believe is a necessary next
step in responding to allegations of child sexual abuse.1
We believe it is time to move forward from entrenched and polarized
adversarial positions based on dogma to a common ground. The
common ground that appears in both Dr. Campbell's position and in Dr.
Gardner's response is increased accuracy of the decision-making process.
Dr. Gardner begins with the all too real clinical conundrum that we
can never wait for all the information to be in before acting.
People are being accused, charged, and imprisoned. But he is very
clear in understanding the need for as much accuracy as possible.
That's why he proposes a systematic way of gathering information and
Dr. Campbell sees the problem of validators who pursue adherence to
dogmas and ignore accuracy and pleads for increased attention to making
the best possible decisions. He emphasizes the necessity for
increasing reliability by improving the precision and specificity of
indices and draws our attention to the pitfalls of depending upon
clinical judgment. He stresses attending to base rates and notes
that the relative infrequency with which pedophilia occurs in the
general population increases the probability of false-positive errors
when ambiguous and unreliable indices are wed.
The cognitive activity of the clinician is the beginning of all
clinical decisions. What we think and the quality of that thought
is the initial arena for increasing accuracy. One clinical
behavior that works to reduce accuracy is pressure to conform to
rhetoric or dogmas and thereby produce greater subjective certainty than
is warranted (Gambrill, 1990). This is what has led to extreme
polarization (Ceci & Bruck, 1993). Yet clinicians can control
their impressions and thoughts. In controlled experiments,
changing cognitions to emphasize accuracy does have the effect of
increasing accuracy (Fiske) 1993). Here is the common ground that
Gardner and Campbell both point to in their concerns and presentations.
It is necessary to start someplace. Gardner starts with
clinical observations and subjective impressions as well as limited
scientific data relating to the construct, pedophilia. This is how
all such efforts to systematize knowledge and observations begin, in the
subjective, often intuitive, experience of the observer who develops an
hypothesis. This is Richard Gardner's métier. As Campbell
understands, Gardner's brilliant, insightful, and creative intellect
interacts with his largeness of heart and compassion to generate the
courage to take the first step and offer a systematic approach.
Science needs people with enough ability, ego, and boldness to break out
of the conventions and take first steps into new areas.
Even when some procedure aimed at producing valid and reliable
information is constructed on the basis of a criterion that may be
sloppy, weak, and subjective, it can finally end up showing greater
construct validity and increased reliability than the initial criterion
(Cronbach & Meehl, 1955). In the process, purely subjective
judgments may be wed as Binet wed teacher judgments in developing the
Binet scale for intellectual ability. Now, however, after years of
development, if the test performance does not match the teacher's
judgments so that a child seen by teachers as limited scores in the
superior range, we do not conclude it is a test miss but rather look for
factors that may have depressed the school performance (Cronbach &
Meehl, 1955). This is the "bootstraps" phenomenon
described by Dawes and Meehl (1966). The approach of mixed group
validation is what allows a psychologist to deal with open concepts,
that is, a category for which he does not have a clear or precise idea
of what he means by the term but does not want to abandon the concept.
Campbell's compassion and clinical astuteness are evident in his
concern for greater accuracy and a way of systematically organizing
information to assist in discriminating pedophiles from
non-pedophiles. He is insightful in meticulously and carefully
examining the nature of the signs that Gardner suggests. He has
immediately grasped the major difficulty in pursuing the next step in
the development of assessment techniques for pedophiles, that is, the
problem of determining what constitutes a sign. Little attention
has been given to this issue but in a largely unknown report Meehl
(1965) suggests how to go about this task.
Few clinicians demonstrate even rudimentary awareness of the
measurement issues that Campbell clearly understands and attends to in
doing clinical work. Every clinician benefits from those few who
do seek the potential for scientific rigor that must undergird all
clinical activities. Campbell's ready grasp of the issues involved
in antecedent probabilities and his rare ability to we this concept in a
pragmatic and effective manner are both impressive and helpful.
Campbell's commitment to a scientific clinical psychology is maintained
with intellectual power and a breadth of knowledge few can match.
Both Campbell and Gardner demonstrate another quality that is almost
universally absent in current discourse within the mental health
community. The emphasis upon doing therapy and being therapists
seems to have led to a culture within which nobody ever gives anybody
else negative feedback. All actions are rewarded by friendly
attention. Meehl (1973) describes this phenomenon in his
explanation for not attending case conferences. Unfortunately when
everyone is deemed right, nobody is wrong. There is then no
challenge to anything and nothing can change. There can be no
educational progress and nothing different gets learned.
When Gardner and Campbell are both willing to be frank, admit to
irritation, and to point to something they hold to be wrong, not only
are both showing courage and forthrightness, they are creating the
necessary ground for the rest of us to learn something. Therefore
we honor both and are grateful for their cooperation in presenting this
form of scholarly, scientific discourse.
Ceci, S. J., & Bruck, M. (1993). The suggestibility of the child
witness: A historical review and synthesis. Psychological Bulletin,
Cronbach, L. J., & Meehl, P. E. (1955). Construct validity in psychological
tests. Psychological Bulletin,
Dawes, R. M., & Meehl, P. E. (1966). Mixed group validation: A
method for determining the validity of diagnostic signs without using
criterion groups. Psychological Bulletin,
Fiske, S. T. (1993). Social cognition and social perception. In L W.
Porter, & M. R. Rosenzweig (Eds.), Annual Review of
Psychology, 44 (pp.155-194). Palo Alto. CA: Annual Reviews, Inc.
Gambrill, E. (1990). Critical Thinking in Clinical Practice ().
San Francisco: Jossey-Bass
Meehl, P. E. (1965). Detecting latent clinical taxa by fallible
quantitative indicators lacking an accepted criterion. Reports from
the Research Laboratories of the Department of Psychiatry, University of
Minnesota. Report no. PR-65-2. Minneapolis, MN. University of Minnesota.
May 25, 1965.
Meehl, P. E. (1973). Why I do not attend case conferences. In Psychodiagnosis:
Selected Papers ()()
(pp. 265-302). Minneapolis. MN: University of Minnesota
|1 Dr. Gardner
was invited to prepare a final response to Dr. Campbell's second
article but declined, saying that he would stand on his original
response. He states: "Accordingly I leave it to
the readers to decide for themselves whose position seems more
credible. I recognize that this two-to-one situation in
the final publication may place me at a disadvantage, but I
believe that my basic position on these points is still the more
valuable and powerful one. My primary suggestion to the
reader is to consider both of our models: Dr. Campbell's rumor
model and the 85 criteria format that I propose. Both are
models. Both are proposals. Both are initial
offerings. Both will have to be modified. Only the
future will tell us which approach ultimately proves to be the
more successful in differentiating between true and false
sex-abuse accusations." [Back]