Race and the Mental Representation of Individuals Diagnosed with Oppositional Defiant Disorder: Implications for Diagnosis

Abstract

Introduction: This research investigates the possible role of racial and gender stereotypes in diagnosing children with Oppositional Defiant Disorder (ODD). ODD is diagnosed more readily in boys and Black children, although the factors producing differential diagnosis rates are unclear. The authors conducted six studies investigating the possibility that overlap between racial and gender stereotypes with ODD diagnostic criteria might contribute to gaps in its judged prevalence across groups. Method: Participants completed reverse correlation procedures to determine whether mental representations of children expected versus unexpected to be diagnosed with ODD differed in facial characteristics. Separate participants viewed these images and judged the likelihood that each person depicted had been diagnosed with ODD. Results: Classification images (CIs) showed that the children selected as having ODD appeared more prototypically Black in facial appearance than children not chosen as having ODD. No differences emerged in the gendered appearance of the two group-level CIs. Judged rates of ODD were higher for the children who appeared to be Black. However, diagnostic judgments of clinical trainees and practitioners were unaffected by appearance factors, suggesting that formal clinical training might attenuate the influence of stereotypes on judgment. Discussion: These results indicate that an overlap in Black stereotypes and diagnostic criteria for ODD might contribute to elevated diagnosis of ODD in African American children.