Associations between childhood interactions with people of Black race/ethnicity and racial implicit association tasks in psychiatric providers in the United States - a cross-sectional study.

Abstract

Background: We estimated associations between psychiatric providers' self-reported amount and valence of interaction with individuals of Black race/ethnicity during childhood and three implicit association tests (IATs) scores. Valence of interaction refers to the positive or negative nature of childhood interactions, capturing whether these interactions were reported as generally favorable or unfavorable.

Methods: In a cross-sectional study, psychiatric providers and trainees reported the amount and valence of interaction with (1) individuals of Black race/ethnicity during childhood, (2) colleagues, and (3) patients of Black race/ethnicity during medical practice. Providers also completed three IATs pairing Black or White faces and terms about psychiatric diagnosis, compliance, and treatment. Linear and logistic regression models estimated relationships between IAT D-scores and ratings of interaction amount and valence with individuals of Black race/ethnicity.

Results: Among 294 providers (medical students, residents, fellows, and board-certified psychiatrists), increased self-reported amount (β_{Δ Compliance} = -.08, p < .01 and β_{Δ Treatment} = -.09, p < .001) and valence (β_{Δ Compliance} = -.08, p < .01 and β_{Δ Treatment} = -.08, p < .01) of childhood interaction with individuals of Black race/ethnicity were significantly associated with lower D-scores on IAT tasks. In contrast, ratings of amount and valence of recent interaction with colleagues and patients of Black race/ethnicity were not statistically associated with IAT D-scores.

Conclusions: While amount and valence of interaction between providers and individuals of Black race/ethnicity during childhood were associated with lower implicit association scores, recent interactions with colleagues and patients of Black race/ethnicity were not significantly associated with implicit associations. Emerging research suggest that lower IAT D-scores may be associated with more unbiased behaviors and decisions in clinical settings. Considering this, our findings suggest that early-life interactions with individuals of Black race/ethnicity may influence implicit biases in adulthood, with potential implications for reducing racial disparities in psychiatric care. However, further research is needed to confirm these relationships and fully understand their impact in clinical contexts.