In clinical psychology, the boundary between sign and symptom can be difficult to distinguish. Signs are observable indications of a disorder, whereas symptoms are self‐report of the physical or psychological effects of a disorder. The DSM is comprised of criteria that represent experiences that either the client, or someone close to the client, reports to a clinician. Potential problems associated with relying on client self‐reporting include gender and culture differences, denial, and lack of insight. In addition, a clinician's ability to recognize the signs of psychopathology often determines whether or not a correct diagnosis is made. Potential biasing factors for clinician observation of signs include selective attention, top‐down processing, overshadowing, misattribution of behaviors, and lack of diagnostic knowledge. Most psychological tests are self‐report measures; however, some assessment tools may also involve direct observation.
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