Objective

Racial and ethnic disparities are well documented in psychiatry, yet suboptimal understanding of underlying mechanisms of these disparities undermines diversity, inclusion, and education efforts. Prior research suggests that implicit associations can affect human behavior, which may ultimately influence healthcare disparities. This study investigated whether racial implicit associations exist among medical students and psychiatric physicians and whether race/ethnicity, training level, age, and gender predicted racial implicit associations.

Methods

Participants completed online demographic questions and 3 race Implicit Association Tests (IATs) related to psychiatric diagnosis (psychosis vs. mood disorders), patient compliance (compliance vs. non-compliance), and psychiatric medications (antipsychotics vs. antidepressants). Linear and logistic regression models were used to identify demographic predictors of racial implicit associations.

Results

The authors analyzed data from 294 medical students and psychiatric physicians. Participants were more likely to pair faces of Black individuals with words related to psychotic disorders (as opposed to mood disorders), non-compliance (as opposed to compliance), and antipsychotic medications (as opposed to antidepressant medications). Among participants, self-reported White race and higher level of training were the strongest predictors of associating faces of Black individuals with psychotic disorders, even after adjusting for participant’s age.

Conclusions

Racial implicit associations were measurable among medical students and psychiatric physicians. Future research should examine (1) the relationship between implicit associations and clinician behavior and (2) the ability of interventions to reduce racial implicit associations in mental healthcare.

中文翻译：

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精神病学诊断、治疗和依从性期望中的种族隐含关联

 目的

种族和民族差异在精神病学中得到了很好的记录，但对这些差异的潜在机制的不理想理解破坏了多样性、包容性和教育工作。先前的研究表明，隐性关联会影响人类行为，这最终可能会影响医疗保健差异。本研究调查了医学生和精神科医生之间是否存在种族隐性关联，以及种族/民族、培训水平、年龄和性别是否预测了种族隐性关联。

 方法

参与者完成了与精神病诊断（精神病与情绪障碍）、患者依从性（依从性与不依从性）和精神科药物（抗精神病药与抗抑郁药）相关的在线人口统计问题和 3 项种族内隐关联测试 （IAT）。线性和 logistic 回归模型用于确定种族隐含关联的人口统计学预测因子。

 结果

作者分析了 294 名医学生和精神科医生的数据。参与者更有可能将黑人的面孔与精神障碍（相对于情绪障碍）、不依从性（相对于依从性）和抗精神病药物（与抗抑郁药物相反）相关的词配对。在参与者中，自我报告的白人种族和更高水平的训练是将黑人个体的面孔与精神障碍联系起来的最强预测因素，即使在调整参与者的年龄后也是如此。

 结论

在医学生和精神科医生中，种族隐性关联是可以测量的。未来的研究应检查 （1） 内隐关联与临床医生行为之间的关系，以及 （2） 干预措施减少心理健康中种族内隐关联的能力。