(PS6-90) Racial Bias in ADHD Symptom Endorsement Among Undergraduate Psychology Students

When compared to non-Hispanic White youth, African American youth with comparable behaviors are less likely to be diagnosed with attention deficit-hyperactivity disorder (ADHD) (Mandell et al., 2007; Morgan et al., 2013). ADHD is a chronic condition of executive dysfunction (APA, 2013). Misdiagnosis can limit accessibility to treatments, medications, and other supportive services. The limited accessibility is then compounded by stigma coinciding with such behavioral externalizations. Stigma and lack of appropriate services may further victimize racially minoritized youth by perpetuating extant disparities in the medical, educational, and juvenile justice systems (Fadus et al., 2020). This study examined whether the client’s race specified in identical case study vignettes of ADHD presentations would lead to differences in perception of symptom severity and endorsement. Participants (N = 749, mean age = 18.6 years, 37.8% male, 59.7% female, .7% transgender, 1.3% non-binary or third gender, .5% gender not specified, 13.2% Asian, 24.6% Black, 37.5% White, 4.1% Mixed or Biracial, 5.2% Hispanic or Latino, 15.4% Other) self-reported their perceptions and endorsement of the client’s ADHD symptoms. A one-way between-subjects ANOVA was conducted to compare the effect of race in ADHD symptom endorsement. Results demonstrated a significant effect of race in ADHD symptom endorsement, F (1,744) = 5.49, p = .01. Statistical significance was maintained between the groups when controlling for both gender and ethnicity as covariates. In addition, post-hoc exploratory factor analysis was conducted to examine the underlying dimensions of biased beliefs in the endorsement of ADHD. Based on the factors identified, one-way ANOVAs revealed significant effects of client race in beliefs relating to ‘Mental Health Treatment and Diagnosis’ (F(1,643) = 22.65, p < .001) and ‘Perceived Severity of Behaviors’ (F(1,643) = 6.31, p = .01). These results demonstrated that for the White client, there were greater beliefs relating to likelihood of mental health treatment and engagement, and greater beliefs of symptom severity and impairment. Taken together, these results suggest that simply race alone has an effect on perception of ADHD symptom endorsement. Where externalization in Black youth may be perceived as more normalized, externalization in White youth is perceived as disordered. Further, results demonstrated that when compared to White youth, Black youth with identical externalizing behaviors are perceived as less likely to receive mental health services, engage in mental health services, or receive a diagnosis. Additionally, Black youth are less likely than White youth to have their symptom presentations perceived as severely or impairing. These findings highlight the potential for under diagnosis and subsequent under treatment of Black youth suffering from ADHD. Given that this bias was present among undergraduate psychology students, continued research is needed to examine the time course of this bias. Scholarship examining whether this bias is maintained throughout a clinician’s training or career is critical.