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Abstract
Diagnostic delays and misdiagnoses of autism spectrum disorder (ASD) are commonly documented among minoritized racial-ethnic groups. One hypothesis for such disparities is that ASD elicits less stigma than “disruptive” disorders. To investigate this, Obeid & colleagues (2021) developed a “Disability Valence” Implicit Association Test (IAT) and “Racial Bias” IAT to assess implicit stigma and racial bias related to ASD among a sample of undergraduate participants. The Disability Valence IAT revealed heightened implicit stigma for Conduct Disorder (CD) compared to ASD, while the Racial Bias IAT showed that White participants associated images of White children with ASD and Black children with CD. Conversely, Black participants showed a trend in the opposite direction. However, CD's overtly stigmatizing characteristics may not be an ideal comparison to ASD. The current study aimed to adapt the original IATs by replacing CD with Oppositional Defiant Disorder (ODD), a subtler yet similarly stigmatized disorder that minoritized children are also more likely to be diagnosed with. In this study, among a sample of undergraduate and graduate students, both implicit and explicit stigma emerged in response to ODD compared to ASD. Additionally, Black participants were more likely to associate White with ODD and Black with ASD, suggesting in-group favoritism. Higher accuracy in identifying childhood disabilities and more positive prior ASD contact were associated with lower levels of general explicit stigma and ASD-specific stigma. These findings underscore the complex interplay between racial bias and stigma in the diagnostic process, highlighting the need for more nuanced examinations into diagnostic approaches and greater awareness of implicit biases in clinical settings.