Clinicians' Mental Representations of Psychopathology Are More Positive and Complex Than the Lay Public but Also Stigmatize Suicide

Bias toward those with mental disorders is pervasive and consequential. We examined bias at the level of mental representation. Clinicians (comprised of graduate students in training and their supervisors; N = 34) and laypeople (comprised of undergraduate students; N = 64; Mage = 18.58; 75.0% female-identified) completed a reverse correlation procedure to generate images of their mental representations of people with stigmatized mental health conditions (i.e., schizophrenia, suicide, attention-deficit/hyperactivity disorder [ADHD]). Compared to laypeople, graduate student clinicians and supervisors generated more positive representations of all mental health conditions. However, relative to their representation of ADHD, graduate student clinicians' and supervisors' representations of suicide and schizophrenia were dehumanizing, cold, and threatening. These representations were as negative as those of laypeople, which were undifferentiated and uniformly negative. Graduate student clinicians' and supervisors' representations of suicide were especially negative and occasionally more negative than representations of schizophrenia. Although graduate student clinicians' and supervisors' mental representations of psychopathology were both more positive and complex than those of laypeople, their relatively negative mental representations of severe psychopathology suggest they may harbor subtle biases against some stigmatized mental health conditions. The negative evaluations of graduate student clinicians' and supervisors' mental representations of suicide attempters suggest that suicide is still stigmatized among potential care providers. Public Significance Statement The current work documents a subtle, nonconscious bias indicating that some clinicians have cold, negative impressions of people with severe mental health conditions (i.e., individuals who have attempted suicide and those with schizophrenia). This work is important because bias can impair treatment efficacy, and awareness of biases is essential to counteract them.