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Yale University EliScholar – A Digital Platform for Scholarly Publishing at Yale Yale Medicine Thesis Digital Library School of Medicine January 2020 Exploring The Role Of Racial Associations Within Life And Psychiatry: The Dissociation Of Explicit And Implicit Dervin Junior Cunningham Follow this and additional works at: https://elischolar.library.yale.edu/ymtdl Recommended Citation Cunningham, Dervin Junior, "Exploring The Role Of Racial Associations Within Life And Psychiatry: The Dissociation Of Explicit And Implicit" (2020) Yale Medicine Thesis Digital Library 3892 https://elischolar.library.yale.edu/ymtdl/3892 This Open Access Thesis is brought to you for free and open access by the School of Medicine at EliScholar – A Digital Platform for Scholarly Publishing at Yale It has been accepted for inclusion in Yale Medicine Thesis Digital Library by an authorized administrator of EliScholar – A Digital Platform for Scholarly Publishing at Yale For more information, please contact elischolar@yale.edu Exploring the role of Racial Associations within Life and Psychiatry: The Dissociation of Explicit and Implicit A Thesis Submitted to the Yale University School of Medicine in Partial Fulfillment of the Requirements for the Degree of Doctor of Medicine by Dervin Junior Cunningham 2020 Here, silent, speak the great of other years, the story of their steep ascent from the unknown to the known, erring perchance in their best endeavor, succeeding often, where to their fellows they seemed most to fail Here, the distilled wisdom of the years, the slow deposit of knowledge gained and writ by weak, yet valorous men, who shirked not the difficult emprise; Here is offered you the record of their days and deeds, their struggle to attain that light which God sheds on the mind of man, and which we know as Truth Unshared must be their genius; it was their own; but you; be you but brave and diligent, may freely take and know the rich companionship of others’ ordered thought Lines written by George Stewart- Carved over the fireplace in Historical Library at the Yale University School of Medicine ABSTRACT EXPLORING THE ROLE OF RACIAL ASSOCIATIONS WITHIN LIFE AND PSYCHIATRY: THE DISSOCIATION OF EXPLICIT AND IMPLICIT Dervin Cunningham, BSA1; Victor J Avila-Quintero, MD1; Kathleen Malison1; Pedro Macul Ferreira de Barros, MD3; José M Flores, MPH, MD, PhD1,2; Michael H Bloch, MD, MS 1,2; Amalia Londono-Tobón, MD1* Yale Child Study Center, Yale University School of Medicine, New Haven, CT Yale Department of Psychiatry, Yale University School of Medicine, New Haven, CT Institute of Psychiatry, University of Sao Paulo, Sao Paulo, SP, Brazil Objective: In the past decade there has been increased interest in understanding racial disparities throughout the world In doing so, racial associations and biases have been found to be one potential etiology of these disparities Particularly in the medical field, trainings and institutions often have providers rely on self-reported racial associations as a means to understanding their biases However, there is little known on how explicit/self-reported associations relate to implicit associations and clinical behavior, specifically within mental healthcare This study aims to understand the relationship between explicit/self-reported statements and psychiatric providers’ implicit racial associations Methods: Psychiatric providers were asked to provide explicit/self-reported statements reflecting their views on racial associations regarding (1) compliance, (2) diagnosis, and (3) treatment They were also asked to complete race Implicit Association Tests (IATs) on the same outcomes Demographic predictors of self-reported statements were examined Linear regression models were used to estimate the association between explicit/self-reported associations and results of IATs, which served as indicators of implicit racial associations Results: We analyzed data from 294 providers who completed IATs Training level was the only demographic predictor of explicit/self-reported associations—Board-certified psychiatrists had stronger explicit/self-reported associations of Black patients with noncompliance, compared to medical students (βΔD= 0.03, P
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