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Attitudes Toward Borderline Personality Disorder: A Survey of 706 Mental Health Clinicians

  • Donald W. Black, Bruce Pfohl, Nancee Blum, Brett McCormick, Jeff Allen, Carol S. North, Katharine A. Phillips, Clive Robins, Larry Siever, Kenneth R. Silk, Janet B.W. Williams and Mark Zimmerman...

Abstract

Objective

We sought to determine attitudes toward patients with borderline personality disorder (BPD) among mental health clinicians at nine academic centers in the United States.

Methods

A self-report questionnaire was distributed to 706 mental health clinicians, including psychiatrists, psychiatry residents, social workers, nurses, and psychologists.

Results

The study showed that most clinicians consider BPD a valid diagnosis, although nearly half reported that they preferred to avoid these patients. The clinician's occupational subgroup was significantly related to attitude. Staff nurses had the lowest self-ratings on overall caring attitudes, while social workers had the highest. Social workers and psychiatrists had the highest ratings on treatment optimism. Social workers and psychologists were most optimistic about psychotherapy effectiveness, while psychiatrists were most optimistic about medication effectiveness. Staff nurses had the lowest self-ratings on empathy toward patients with BPD and treatment optimism.

Discussion

Negative attitudes persist among clinicians toward BPD, but differ among occupational subgroups. Overall, caring attitudes, empathy, and treatment optimism were all higher among care providers who had cared for a greater number of BPD patients in the past 12 months.

Conclusion

These findings hold important implications for clinician education and coordination of care for patients with BPD.

Copyright

Corresponding author

Correspondence: Donald Black, MD, Professor, University of Iowa, Carver College of Medicine, 2-126B MEB/Psychiatry Research, Iowa City, IA 52242; Tel: (319) 353-4431, Fax: (319) 353-3003; E-mail: Donald-Black@uiowa.edu

Footnotes

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Faculty Disclosures: Dr. Black has received research support from AstraZeneca and Psyadon. Dr. Blum receives royalties from sales of STEPPS CD-ROMs. Ms. Blum receives royalties from Level One Publishing-DBA Blum's Books. Dr. North is a consultant to the University of Oklahoma Health Science Center; is a consultant to Tarrant County, Texas; and has received research support from the NIAAA, the Veterans Administration, the American Psychiatric Association, the Orthopaedic Trauma Association. Dr. Phillips has received salary and grant funding from the NIMH; has received research support from the American Foundation for Suicide Prevention, the FDA, Forest Pharmaceuticals, and Transcrepts; recieves royalties from Oxford University Press; and can potentiallt recieve future royalties from the Free Press and Guilford Press. Dr. Silk's son receives a salary as an employee at Pfizer. Dr. Pfohl, Mr. McCormick, Dr. Allen, Dr. Robins, Dr. Siever, Dr. Williams, and Dr. Zimmeran report no affiliation with or financial interest in any organization that might pose a conflict of interest.

Acknowledgements: The authors wish to acknowledge the efforts of the following individuals in data collection: John Gunderson, MD, McLean Hospital, Belmont, MA, and A. John Rush, MD, University of Texas Southwestern, Dallas. We are grateful to Jo Ann Franklin and Rebecca Hansel for data collection and entry at the University of Iowa, Iowa.

Footnotes

References

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Faculty Disclosures: Dr. Black has received research support from AstraZeneca and Psyadon. Dr. Blum receives royalties from sales of STEPPS CD-ROMs. Ms. Blum receives royalties from Level One Publishing-DBA Blum's Books. Dr. North is a consultant to the University of Oklahoma Health Science Center; is a consultant to Tarrant County, Texas; and has received research support from the NIAAA, the Veterans Administration, the American Psychiatric Association, the Orthopaedic Trauma Association. Dr. Phillips has received salary and grant funding from the NIMH; has received research support from the American Foundation for Suicide Prevention, the FDA, Forest Pharmaceuticals, and Transcrepts; recieves royalties from Oxford University Press; and can potentiallt recieve future royalties from the Free Press and Guilford Press. Dr. Silk's son receives a salary as an employee at Pfizer. Dr. Pfohl, Mr. McCormick, Dr. Allen, Dr. Robins, Dr. Siever, Dr. Williams, and Dr. Zimmeran report no affiliation with or financial interest in any organization that might pose a conflict of interest.

Acknowledgements: The authors wish to acknowledge the efforts of the following individuals in data collection: John Gunderson, MD, McLean Hospital, Belmont, MA, and A. John Rush, MD, University of Texas Southwestern, Dallas. We are grateful to Jo Ann Franklin and Rebecca Hansel for data collection and entry at the University of Iowa, Iowa.

Attitudes Toward Borderline Personality Disorder: A Survey of 706 Mental Health Clinicians

  • Donald W. Black, Bruce Pfohl, Nancee Blum, Brett McCormick, Jeff Allen, Carol S. North, Katharine A. Phillips, Clive Robins, Larry Siever, Kenneth R. Silk, Janet B.W. Williams and Mark Zimmerman...

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