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Can teaching staff about the neurobiological underpinnings of borderline personality disorder instigate attitudinal change?

Published online by Cambridge University Press:  03 July 2014

Charlotte J. Clark ,
Emily Fox  and
Clive G. Long
Charlotte J. Clark*
Affiliation:
St Andrew’s Northampton, UK
Emily Fox
Affiliation:
St Andrew’s Northampton, UK
Clive G. Long
Affiliation:
St Andrew’s Academic Centre, Kings College London Institute of Psychiatry, Northampton, UK University of Northampton, UK
*
Correspondence to: Charlotte Clark, St Andrew's Healthcare Northampton, Billing Rd, Cliftonville, Northampton NN1 5DG. E-mail: Charlotte.J.Clark@hotmail.co.uk
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Abstract

Background

There is an abundant literature on the unfavourable attitudes held by staff working in mental health care settings towards patients with borderline personality disorder. The aim of this study was to assess whether attendance at a training session about the neurobiological underpinnings of borderline personality disorder could improve knowledge and produce positive attitudinal change within staff members working in a low secure inpatient setting.

Method

Staff knowledge and attitudes (Mental Health Locus of Origin, Empathic Concern and Perspective Taking) were assessed at baseline, post-training attendance and at an eight-week follow up.

Results

Attendance at the training session was associated with significant increases in theoretical knowledge, Perspective Taking and Locus of Origin scores. However, there were no changes observed in Empathic Concern scores.

Conclusion

This research suggests that a relatively brief training session, that utilises the neurobiological framework, can be effective in facilitating knowledge and attitudinal change for those working with borderline personality disorder. The implications of the findings are discussed along with suggestions for further research.

Keywords

Secure servicesemotionally unstable personality disorderstaff trainingMental Health Locus of OriginInterpersonal Reactivity Index
Type
Original Research Articles
Information
Journal of Psychiatric Intensive Care , Volume 11 , Issue 1 , April 2015 , pp. 43 - 51
Copyright
© NAPICU 2014 

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References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington DC: American Psychiatric Association.Google Scholar
Banerjee, P., Duggan, C., Huband, N. and Watson, N. (2006) Brief psychoeducation for people with personality disorder: a pilot study. Psychology & Psychotherapy: Theory, Research and Practice. 79: 385–394.CrossRefGoogle ScholarPubMed
Batson, C.D. and Ahmed, N.Y. (2009) Using empathy to improve intergroup attitudes and relations. Social Issues and Policy Review. 3: 141–177.Google Scholar
Becker, D. (2000) When she was bad: borderline personality disorder in a posttraumatic age. American Journal of Orthopsychiatry. 70(4): 422–432.CrossRefGoogle Scholar
Bodner, E., Cohen-Fridel, S. and Iancu, I. (2011) Staff attitudes towards patients with borderline personality disorder. Comprehensive Psychiatry. 52: 548–555.Google Scholar
Bowers, L. (2002) Dangerous and Severe Personality Disorder: Response and role of the psychiatric team. London: Routledge, 192 pp.Google Scholar
Brickman, P., Rabinowitz, V. C., Karuza, J. Jr., Coates, D., Cohn, E. and Kidder, L. (1982) Models of helping and coping. American Psychologist. 37: 368–384.Google Scholar
Cliffordson, C. (2001) Parents’ judgements and students’ self-judgements of empathy: the structure of empathy and agreement of judgements based in the Interpersonal Reactivity Index (IRI). European Journal of Psychological Assessment. 17: 36–47.CrossRefGoogle Scholar
Cohen, J. (1988) Statistical power analysis for the behavioural sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Commons Treloar, A.J. (2009) Effectiveness of education programs in changing clinicians’ attitudes toward treating borderline personality disorder. Psychiatric Services. 60(8): 1128–1131.CrossRefGoogle Scholar
Davis, M. H. (1980) A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology. 10: 85.Google Scholar
Department of Health (2010) See, Think, Act: Your guide to relational security. London: Department of Health, 25 pp.Google Scholar
Dowey, A., Toogood, S., Hastings, R.P. and Nash, S. (2006) Can brief workshop interventions change care staff understanding of challenging behaviours? Journal of Applied Research in Intellectual Disabilities. 20(1): 52–57.Google Scholar
Eisenberg, N. and Fabes, R.A. (1990) Empathy: conceptualization, measurement, and relation to prosocial behavior. Motivation & Emotion. 14(2): 131–149.Google Scholar
Filer, N.J. (2005) Borderline personality disorder: attitudes of mental health nurses. Mental Health Practice. 9(2): 34–36.CrossRefGoogle Scholar
Fincham, F.D. and Emery, R.E. (1998) Limited mental capacities and perceived control in attribution of responsibility. British Journal of Social Psychology. 27: 193–207.Google Scholar
Fox, E., Krawcyzk, K., Staniford, J. and Dickens, G.L (2014) A service evaluation of a 1-year dialectical behaviour therapy programme for women with borderline personality disorder in a low secure unit. Behavioural & Cognitive Psychotherapy. 13: 1–16.Google Scholar
Fraser, K. and Gallop, R (1993) Nurses’ confirming/disconfirming responses to patients diagnosed with borderline personality disorder. Archives of Psychiatric Nursing. 7(6): 336–341.Google Scholar
Gallop, R., Lancee, W.J. and Garfinkel, P (1989) How nursing staff respond to the label ‘Borderline Personality Disorder’. Hospital & Community Psychiatry. 40(8): 815–819.Google Scholar
Hill, D.J. and Bale, R.M. (1980) Development of the Mental Health Locus of Control and Mental Health Locus of Origin Scales. Journal of Personality Assessment. 44(2): 148–156.Google Scholar
Holmqvist, R. (2000) Staff feelings and patient diagnosis. Canadian Journal of Psychiatry. 45(4): 349–356.Google Scholar
James, P.D. and Cowman, S. (2007) Psychiatric nurses’ knowledge, experience and attitudes towards clients with borderline personality disorder. Journal of Psychiatric & Mental Health Nursing. 14: 670–678.Google Scholar
Kalsy, S., Health, R., Adams, D and Oliver, C (2007) Effects of training on controllability attributions of behavioural excesses and deficits shown by adults with Down syndrome and dementia. Journal of Applied Research in Intellectual Disability. 20: 64–68.CrossRefGoogle Scholar
Krawitz, R. (2004) Borderline personality disorder: attitudinal change following training. Australian & New Zealand Journal of Psychiatry. 38: 554–559.Google Scholar
Lewis, G. and Appleby, L. (1988) Personality disorder: the patients psychiatrists dislike. British Journal of Psychiatry. 153: 44–49.CrossRefGoogle Scholar
Linehan, M.M. (1993) Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: The Guilford Press, 558 pp.Google Scholar
Markham, D. (2003) Attitudes towards patients with a diagnosis of ‘borderline personality disorder’: social rejection and dangerousness. Journal of Mental Health. 12(6): 595–612.Google Scholar
Markham, D. and Trower, P. (2003) The effects of the psychiatric label ‘borderline personality disorder’ on nursing staff’s perceptions and causal attributions for challenging behaviours. British Journal of Clinical Psychology. 42: 243–256.CrossRefGoogle ScholarPubMed
McGill, P., Bradshaw, J. and Hughes, A. (2007) Impact of extended education/training in positive behaviour support on staff knowledge, causal attributions and emotional responses. Journal of Applied Research in Intellectual Disabilities. 20(1): 41–51.Google Scholar
McGrath, B. and Dowling, M. (2012) Exploring registered psychiatric nurses’ responses towards service users with a diagnosis of borderline personality disorder. Nursing Research and Practice. Article ID 601918: 10 pp, doi:10.1155/2012/601918.Google ScholarPubMed
McLeod, H.J., Deane, F.P. and Hogbin, B. (2002) Changing staff attitudes and empathy for working with people with psychosis. Behavioural and Cognitive Psychotherapy. 30: 459–470.Google Scholar
Miller, S.A. and Davenport, N.C. (1996) Increasing staff knowledge of and improving attitudes toward patients with borderline personality disorder. Psychiatric Services. 47(5): 533–535.Google Scholar
National Institute for Mental Health in England (2003) Personality Disorder: No longer a diagnosis of exclusion. London: NIMH(E), Gateway reference 1055, 54 pp.Google Scholar
Nehls, N. (1998) Borderline personality disorder: gender stereotypes, stigma, and limited system of care. Issues in Mental Health Nursing. 19(2): 97–112.CrossRefGoogle ScholarPubMed
Pfohl, B.M., Gunderson, J.G., Silk, K.R., Zimmerman, M., Williams, J.B.W., Phillips, K.A., Robins, C. and Rush, A.J. (1999) Survey of clinician attitudes towards BPD. The 152nd annual meeting of the American Psychiatric Association. Washington, DC.Google Scholar
Porr, V. (2011) Overcoming Borderline Personality Disorder: A family guide for healing and change. Oxford: Oxford University Press, 320 pp.Google Scholar
Read, J. and Law, A. (1999) The relationship of causal beliefs and contact with users of mental health services to attitudes to the ‘mentally ill’. International Journal of Social Psychiatry. 45: 216–229.Google Scholar
Shearin, E. N. and Linehan, M. M. (1992) Patient–therapist ratings and relationship to progress in dialectical behavior therapy for borderline personality disorder. Behavior Therapy. 23: 730–741.CrossRefGoogle Scholar
Skodol, A.E., Gunderson, J.G., Pfohl, B., Widiger, T.A., Livesley, W.J. and Siever, L.J. (2002) The borderline diagnosis I: psychopathology, comorbidity and personality structure. Biological Psychiatry. 51(12): 936–950.Google Scholar
SPSS (2009) PASW Statistics for Windows, version 18.0. Chicago: SPSS Inc.Google Scholar
Woolaston, K. and Hixenbaugh, P. (2008) ‘Destructive whirlwind’: nurses’ perceptions of patients diagnosed with borderline personality disorder. Journal of Psychiatric and Mental Health Nursing. 15: 703–709.Google Scholar