Exploring The Role Of Racial Associations Within Life And Psychiatry The Dissociation Of Explicit And Implicit

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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

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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

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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*

1 Yale Child Study Center, Yale University School of Medicine, New Haven, CT

2 Yale Department of Psychiatry, Yale University School of Medicine, New Haven, CT

3 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 3 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