Abstract
BackgroundNegative attitudes towards patients with borderline personality disorder (BPD) may affect their treatment. We aimed to identify attitudes toward patients with BPD.MethodsClinicians in four psychiatric hospitals in Israel (n = 710; psychiatrists, psychologists, social workers and nurses) were approached and completed questionnaires on attitudes toward these patients.ResultsNurses and psychiatrists reported encountering a higher number of patients with BPD during the last month, and exhibited more negative attitudes and less empathy toward these patients than the other two professions. The whole sample evaluated the decision to hospitalize such a patient as less justified than the decision to hospitalize a patient with Major Depressive Disorder. Negative attitudes were positively correlated with caring for greater numbers of patients with BPD in the past month and in the past 12 months. Nurses expressed the highest interest in studying short-term methods for treating patients with BPD and a lower percentage of psychiatrists expressed an interest in improving their professional skills in treating these patients.ConclusionsThe findings show that nurses and psychiatrists differ from the other professions in their experience and attitudes toward patients with BPD. We conclude that nurses and psychiatrists may be the target of future studies on their attitudes toward provocative behavioral patterns (e.g., suicide attempts) characterizing these patients. We also recommend implementing workshops for improving staff attitudes toward patients with BPD.
Highlights
Negative attitudes towards patients with borderline personality disorder (BPD) may affect their treatment
Our main findings include the following: 1) nurses exhibited more negative cognitive attitudes toward patients with BPD and less empathy than psychologists and social workers, but not in comparison with psychiatrists. 2) the inadequacy of the decision to hospitalize a patient and the attribution of negative traits were more prominent for a patient with BPD than for a patient with major depressive disorder (MDD). 3) nurses did not attribute more negative traits to patients with BPD than to patients with MDD or generalized anxiety disorder (GAD), as opposed to the other three professions. 4) nurses and psychiatrists reported that they encountered a significantly higher number of patients with BPD during the last month, nurses expressed the highest interest in studying short term methods for treating patients with
We reconfirmed the higher negative attitudes among nurses which were found in the abovementioned studies, as well as by our research group [5], we found that as compared to psychologists and social workers, the psychiatrists held negative attitudes, and especially did not as much support the admission of these patients
Summary
Negative attitudes towards patients with borderline personality disorder (BPD) may affect their treatment. Patients with Borderline Personality Disorder (BPD) are a challenge to the mental health system [1,2,3] They engage negatively with the staff and have a bad reputation, create unconsciously hostility and violence, hurt themselves, threaten to suicide, antagonize the staff, drop out of treatment and even sue their therapists [4,5,6]. They are perceived as difficult, annoying, manipulative, and as “bad” and not “ill” [7,8].
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