African Americans show unusually high endorsement rates on self-report measures of contamination anxiety. The purpose of this study was to replicate this finding in a nationally representative sample and conduct a randomized experiment to determine the effect of salience of race as a causal factor. Black and White participants were given contamination items from two popular measures of obsessive-compulsive disorder, half prior to being primed about ethnic identity and half after being primed, via the administration of an ethnic identity measure. The experiment took the form of a 2 (Black and White participant) X 2 (ethnicity salient and ethnicity non-salient) double-blind design, with ethnic saliency assigned at random by computer. Participants consisted of a geographically representative US sample of African Americans supplemented with a similar sample of European Americans (N=258). Black participants scored significantly higher than White participants on contamination scales. Participants from Southern states scored higher than those from other regions. Over-endorsements by Black participants were greater when awareness of ethnic and racial identification was increased. Clinical and research implications were discussed; these measures should be used with caution in African Americans.

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The findings of high rates of use of outcomes data routinely gathered with a very brief measure are encouraging given prior reports of challenges in using such information in treatment sessions. The successful treatment of children and families requires an ongoing and effective partnership between parents and clinicians, and the results suggest how important routine conversations about the progress of children in treatment can be. Further research is needed to understand the impact of gathering and using such data on the process and outcomes of mental health treatment for children and families.

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