Racial disparities in diagnosis and treatment are prevalent in child psychiatry, including disparate diagnosis rates of internalizing and externalizing disorders in Black and White children. However, limited research has investigated mechanisms that contribute to these disparities. This study examined child racial implicit associations in psychiatric clinicians and medical students to address this gap. Psychiatrists and trainees completed an online survey including 2 race Implicit Association Tests (IATs) pairing child faces to words with either positive or negative valence, and words related to internalizing or externalizing behavioral problems. Psychiatrists and trainees’ demographic predictors of implicit associations were also investigated. Data were analyzed from 235 psychiatrists and trainees (112 child and adolescent psychiatrists and fellows) who met inclusion criteria. Psychiatrists and trainees demonstrated greater moderate-to-strong association between Black child faces and “bad” (ie, negatively valenced) words (44.3%) vs “good” (ie, positively valenced) words (6.4%), and between externalizing words (41.7%) vs internalizing words (7.2%). Psychiatrists and trainees’ demographic characteristics including being female (β = −0.12; 95% CI = −0.23 to −0.01; < .05), Black (β = −0.36; 95% CI = −0.54 to −0.18; < .001), or an attending physician (β = −0.26; 95% CI = −0.45 to −0.06; = .01) were significant predictors of decreased association between Black child faces and negative valence words. Being female was a significant predictor of decreased association between Black child faces and externalizing words (β = −0.26; 95% CI = −0.45 to −0.06; = .01). Participating psychiatrists and trainees demonstrated bias toward associating Black rather than White child faces with negative words and externalizing behavioral problems. Future research should examine the following: racial implicit associations in a more generalizable sample; the relationship between race IATs and provider behavior; and interventions to reduce racial inequities in psychiatry, including individual and systemic solutions. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science.

中文翻译：

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儿童精神病学中的种族隐性关联


诊断和治疗方面的种族差异在儿童精神病学中普遍存在，包括黑人和白人儿童内化和外化疾病的诊断率不同。然而，有限的研究调查了造成这些差异的机制。这项研究检查了精神科临床医生和医学生的儿童种族隐性关联，以解决这一差距。精神病学家和学员完成了一项在线调查，包括 2 项种族内隐联想测试 (IAT)，将儿童面孔与具有正价或负价的单词以及与内化或外化行为问题相关的单词配对。精神科医生和受训者的隐性关联的人口预测因素也受到了调查。对符合纳入标准的 235 名精神科医生和实习生（112 名儿童和青少年精神科医生和研究员）的数据进行了分析。精神病学家和学员证明，黑人儿童面孔与“坏”（即负价）词语（44.3％）与“好”（即正价）词语（6.4％）之间以及外化词语之间存在更大的中等到强关联(41.7%) 与内化词语 (7.2%)。精神科医生和实习生的人口统计特征，包括女性（β = -0.12；95% CI = -0.23 至 -0.01；< .05）、黑人（β = -0.36；95% CI = -0.54 至 -0.18；< .001 ）或主治医生（β = -0.26；95% CI = -0.45 至 -0.06；= .01）是黑人儿童面孔与负价词之间关联性降低的显着预测因子。女性身份是黑人儿童面孔与外化词语之间关联性下降的重要预测因素（β = -0.26；95% CI = -0.45 至 -0.06；= .01）。 参与的精神病学家和受训者表现出偏向于将黑人而不是白人儿童的面孔与负面言语和外化行为问题联系起来。未来的研究应该检查以下内容：更普遍的样本中的种族隐性关联；种族 IAT 与提供者行为之间的关系；减少精神病学中种族不平等的干预措施，包括个人和系统解决方案。我们努力确保招募人类参与者时的性别和性别平衡。我们努力确保招募人类参与者时的种族、民族和/或其他类型的多样性。我们努力确保研究问卷的准备具有包容性。本文的一位或多位作者自我认同为科学界一个或多个历史上代表性不足的性和/或性别群体的成员。我们积极致力于促进作者群体中的性和性别平衡。我们积极致力于促进将历史上代表性不足的种族和/或族裔群体纳入我们的作者群体中。本文的一位或多位作者自我认同为一个或多个历史上在科学领域代表性不足的种族和/或族裔群体的成员。本文的一位或多位作者得到了一项旨在增加少数群体在科学领域代表性的计划的支持。