Date of Award


Document Type


Degree Name


Organizational Unit

Morgridge College of Education, Counseling Psychology

First Advisor

Pat Garriott


Bias, Health care


Implicit bias has gathered research interest in healthcare, yet remains less directly examined in the mental health field (Merino et al., 2018). Mental health providers can continue to be influenced by implicit bias despite higher ratings of cultural competence (Boysen, 2010). The purpose of this study was to supplement the limited research examining the impact of implicit bias on the clinical judgment process. The study aimed to examine whether: 1) implicit race bias scores were related to diagnostic impressions, 2) feedback about implicit bias was related to diagnostic impressions, and 3) racial affect mediated the relationship between receiving feedback and diagnostic impressions. Participants (N = 74) completed a survey-software Race IAT (Carpenter et al., 2019; Greenwald et al., 1998) and received manufactured neutral, positive, or negative feedback about their scores. They then watched a video of a Black female client describing both anxiety and depressive symptoms and rated the degree to which they agreed with depressive and anxiety disorders and the perceived severity of the disorders. The results found partial support for the first and third hypotheses, while no support was found for the effect of feedback on clinical impression. Participants who obtained higher D-scores, indicating more bias towards Black individuals, also agreed more strongly with Generalized Anxiety Disorder for the hypothetical Black client regardless of feedback condition. Participants who received negative feedback, i.e, bias towards Black individuals, endorsed higher racial affect compared to the positive feedback and control groups. Finally, racial affect mediated the relationship between the type of feedback and perceived severity of Generalized Anxiety Disorder. Implications, limitations, and suggestions for future research are discussed.

Publication Statement

Copyright is held by the author. User is responsible for all copyright compliance.

Rights Holder

Dhriti Tiwari


Received from ProQuest

File Format




File Size

81 pgs


Counseling psychology