Racial Implicit Associations in Child Psychiatry

Area of Science:

• Child and Adolescent Psychiatry
• Psychology
• Health Disparities

Background:

• Racial disparities in child psychiatric diagnoses and treatments are well-documented.
• Limited research has explored the underlying mechanisms driving these disparities, particularly provider implicit biases.
• Implicit associations may contribute to differential diagnosis rates of internalizing versus externalizing disorders in Black and White children.

Purpose of the Study:

• To examine implicit racial associations among psychiatric clinicians and medical students.
• To investigate the relationship between implicit bias and the perception of child behavioral problems.
• To identify demographic predictors of implicit racial associations in mental health professionals.

Main Methods:

• 235 psychiatrists and trainees completed an online survey.
• Two race Implicit Association Tests (IATs) were administered, pairing child faces with valenced words or behavioral problem types (internalizing/externalizing).
• Demographic data were collected to identify predictors of implicit associations.

Main Results:

• Psychiatrists and trainees demonstrated a moderate-to-strong association between Black child faces and negative words (44.3%) compared to positive words (6.4%).
• A similar bias was observed between Black child faces and externalizing words (41.7%) versus internalizing words (7.2%).
• Being female, Black, or an attending physician predicted decreased association between Black child faces and negative valence/externalizing words.

Conclusions:

• Psychiatric clinicians and trainees exhibit implicit biases associating Black children with negative attributes and externalizing behaviors.
• These findings highlight the need to address implicit bias in child psychiatry to reduce racial inequities.
• Future research should focus on generalizable samples, the link between IATs and clinical behavior, and interventions to mitigate bias.