Experience and diagnostic anchors in referral letters

Nanon L. Spaanjaars, Marleen Groenier, Monique O.M. van de Ven, Cilia L.M. Witteman*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
3 Downloads (Pure)


The present study investigated whether diagnostic anchors, that is: diagnoses suggested in referral letters, influence judgments made by clinical psychologists with different levels of experience. Moderately experienced clinicians (N = 98) and very experienced clinicians (n = 126) were randomly assigned to reading a referral letter suggesting either depression or anxiety, or no referral letter. They then read a psychiatric report about a depressed patient, and gave a preliminary and final diagnosis. Results showed that the correctness of the diagnoses by very experienced clinicians was unaffected by the referral diagnosis. Moderately experienced clinicians did use the suggested diagnosis as anchor; when they had read a referral letter suggesting depressive complaints they were more inclined to classify the patient with a depressive disorder. In conclusion, the diagnosis in a referral letter influences the diagnostic decision made by moderately experienced clinicians
Original languageEnglish
Pages (from-to)280-286
Number of pages7
JournalEuropean journal of psychological assessment
Issue number4
Early online date10 Dec 2014
Publication statusPublished - 2015


  • clinical decision making
  • experience
  • cognitive bias
  • anchoring
  • referral letter
  • 2023 OA procedure


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