Structural Racism in Psychiatric Research Careers: Eradicating Barriers to a More Diverse Workforce.

Autor:	Widge AS; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Jordan A; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Kraguljac NV; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Sullivan CRP; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Wilson S; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Benton TD; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Alpert JE; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Carpenter LL; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Krystal JH; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Nemeroff CB; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa)., Dzirasa K; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge, Sullivan, Wilson); Department of Psychiatry, New York University Grossman School of Medicine, New York (Jordan); Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham (Kraguljac); Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia (Benton); Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center and Albert Einstein College of Medicine, New York (Alpert); Butler Hospital and Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, N.C., and Howard Hughes Medical Institute, Chevy Chase, Md. (Dzirasa).
Jazyk:	angličtina
Zdroj:	The American journal of psychiatry [Am J Psychiatry] 2023 Sep 01; Vol. 180 (9), pp. 645-659. Date of Electronic Publication: 2023 Apr 19.
DOI:	10.1176/appi.ajp.20220685
Abstrakt:	Investigators from minoritized backgrounds are underrepresented in psychiatric research. That underrepresentation contributes to disparities in outcomes of access to mental health care. Drawing on lived experience, scholarly qualitative reports, and empirical data, the authors review how the underrepresentation of minoritized researchers arises from interlocking, self-reinforcing effects of structural biases in our research training and funding institutions. Minoritized researchers experience diminished early access to advanced training and opportunities, stereotype threats and microaggressions, isolation due to lack of peers and senior mentors, decreased access to early funding, and unique community and personal financial pressures. These represent structural racism-a system of institutional assumptions and practices that perpetuates race-based disparities, in spite of those institutions' efforts to increase diversity and in contradiction to the values that academic leaders outwardly espouse. The authors further review potential approaches to reversing these structural biases, including undergraduate-focused research experiences, financial support for faculty who lead training/mentoring programs, targeted mentoring through scholarly societies, better use of federal diversity supplement funding, support for scientific reentry, cohort building, diversity efforts targeting senior leadership, and rigorous examination of hiring, compensation, and promotion practices. Several of these approaches have empirically proven best practices and models for dissemination. If implemented alongside outcome measurement, they have the potential to reverse decades of structural bias in psychiatry and psychiatric research. Competing Interests: Dr. Jordan has received funding from NIAAA, Yale University, and the private foundation FORE. Dr. Alpert has received research support from NIMH, honoraria from Belvoir Publishing and MGH Psychiatry Academy, and royalties from Cambridge University Press. Dr. Carpenter has clinical trial contracts (with Butler Hospital) with Affect Neuro, Janssen, Neuronetics, and Neurolief; she has received research equipment loans from Magstim, Neuronetics, and Nexstim; and she has served as a consultant for Affect Neuro, Janssen, Magnus Medical, Neuronetics, Neurolief, Otsuka, Sage Therapeutics, and Sunovion. Dr. Krystal has served as a consultant for Aptinyx, Biogen Idec MA, Bionomics, Boehringer Ingelheim, Epiodyne, EpiVario, Janssen Research and Development, Jazz Pharmaceuticals, Otsuka, Spring Care, and Sunovion; he has served on scientific advisory boards for Biohaven Pharmaceuticals, BioXcel Therapeutics, Cerevel Therapeutics, Delix Therapeutics, Eisai, EpiVario, Jazz Pharmaceuticals, Neumora Therapeutics, Neurocrine Biosciences, Novartis, PsychoGenics, Takeda, Tempero Bio, and Terran Biosciences; he is co-founder of Freedom Biosciences; he is a stockholder in Biohaven Pharmaceuticals, Freedom Biosciences, and Spring Health and holds stock options in Biohaven Pharmaceuticals Medical Sciences, Cartego Therapeutics, Damona Pharmaceuticals, Delix Therapeutics, EpiVario, Neumora Therapeutics, Rest Therapeutics, Tempero Bio, Terran Biosciences, and Tetricus; he serves as editor of Biological Psychiatry; he is involved in research studies for which medications are provided by AstraZeneca, Cerevel, and Novartis; and he is named on patents related to psychiatric treatment. Dr. Nemeroff has received research support from NIH; he has served as a consultant for AbbVie, ANeuroTech (division of Anima BV), BioXcel Therapeutics, Clexio, EMA Wellness, EmbarkNeuro, Engrail Therapeutics, Intra-Cellular Therapies, GoodCap Pharmaceuticals, Magstim, Ninnion Therapeutics, Pasithea Therapeutics, Sage, Senseye, Signant Health, Silo Pharma, SynapseBio, and Relmada Therapeutics; he has served on scientific advisory boards for ANeuroTech, the Anxiety and Depression Association of America (ADAA), the Brain and Behavior Research Foundation, Heading Health, the Laureate Institute for Brain Research, Pasithea Therapeutics, Sage, Signant Health, and Skyland Trail and on the boards of directors for ADAA, Gratitude America, and Lucy Scientific Discovery; he is a stockholder in Antares, Corcept Therapeutics, EMA Wellness, Naki Health, Relmada Therapeutics, and Seattle Genetics; and he is named on patents related to psychiatric treatment. The other authors report no financial relationships with commercial interests.
Databáze:	MEDLINE
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