Re-conceiving personality disorders: Adaptations on a dimension?

Fairfax, Hamilton

doi:10.1080/09515070.2011.630589

Cited by 4 publications

(5 citation statements)

References 50 publications

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“…Several investigations in European samples (Angermeyer et al, 2015; Schomerus et al, 2016) have found framing mental illness as dimensional rather than categorical resulted in more positive attitudes toward serious mental disorders (i.e., depression and schizophrenia). While requiring empirical research, we agree conceptually with Fairfax (2011) that framing personality disorder traits from a dimensional perspective may also be less stigmatizing. As such, an open dialogue may be easier to pursue if practitioners broach issues about traits that are more present than desired from the patient’s perspective, rather than a formal, pathology-based PD diagnosis.…”

Section: Discussionsupporting

confidence: 68%

“…Several surveys of psychiatric professionals (Bowers, McFarlane, Kiyimba, Clark, & Alexander, 2000; Carr-Walker, Bowers, Callaghan, Nijman, & Paton, 2004; Lewis & Appleby, 1988) have observed particularly negative attitudes toward patients with personality disorders, who are often perceived as “difficult” (Koekkoek, van Meijel, & Hutschemaekers, 2006). Such sentiments may be expressed in a reluctance to work with these patients, as well as considerable therapeutic pessimism about their treatment outcomes (Bowers et al, 2000; Carr-Walker et al, 2004; Fairfax, 2011). Some practitioners are in fact less likely to diagnose personality disorders because of the associated negative connotations and perceptions that such disorders remain untreatable (Westen, 1998; Widiger, 2007).…”

Section: Stigma and Mental Disordersmentioning

confidence: 99%

“…Perhaps related in part to professional stigmatization, patients with personality disorders tend to have poorer working therapeutic alliances than those who do not (Andreoli, Gressot, Aapro, Tricot, & Gognalons, 1989; Bender et al, 2001). The common view that personality disorders are lifelong and not amenable to treatment likely contributes to heightened negative attitudes (Aviram et al, 2006; Bowers et al, 2000; Fairfax, 2011; Widiger, 2007), despite more recent empirical evidence to the contrary. For example, Zanarini and colleagues’ longitudinal research has clearly demonstrated positive treatment outcomes over a series of follow-up evaluations; nearly three-quarters of their patients with borderline personality disorder were in symptomatic remission after six years and 60% achieved at least a 2-year recovery over the course of 16 years of prospective follow-up (Zanarini, Frankenburg, Reich, & Fitzmaurice, 2012).…”

Section: Stigma and Mental Disordersmentioning

confidence: 99%

“…Ongoing diagnostic concerns exist over the reliability and validity of psychological assessments for personality disorders (Bornstein, 2003; Fairfax, 2011; Zimmerman, Rothschild, & Chelminski, 2005). Patients may be reluctant to divulge negatively perceived traits (e.g., manipulativeness) or problematic behaviors (e.g., volatile interactions with others), which directly limits the accuracy of diagnostic findings (Zimmerman, 1994).…”

Section: Clinical Assessment Of Personality Disordersmentioning

confidence: 99%

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Stigma experiences of patients with problematic personality traits: An investigation with the PID-5.

Williams¹,

Rogers²

2019

Stigma and Health

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Research has consistently shown that mental disorders are associated with higher levels of experienced stigmatization than those encountered for physical illness. However, few studies have systematically evaluated internalized stigma and discrimination for patients with maladaptive and socially undesirable personality traits. With the emerging DSM-5 dimensional model (i.e., Section III Alternative Model for Personality Disorders; American Psychiatric Association, 2013), patients are assessed across a wide spectrum of pathological personality traits reflecting specific or trait-specified personality disorders. This study investigated experiences of stigma in relationship to DSM-5 pathological personality traits among 100 psychiatric inpatients via the Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012). As predicted, more extensive personality pathology was associated with higher reported stigmatization. In particular, elevations on the PID-5 Detachment domain predicted seven times greater odds of patients experiencing higher levels of stigma. Such relationships may help to contextualize the negative impact of personality pathology and stigmatization on treatment adherence and serve as a potential target for therapeutic intervention. In addition, these findings illustrate the importance of assessing for both problematic personality traits and perceived stigma in tailoring effective treatment.

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Section: Discussionsupporting

confidence: 68%

Section: Stigma and Mental Disordersmentioning

confidence: 99%

Section: Stigma and Mental Disordersmentioning

confidence: 99%

Section: Clinical Assessment Of Personality Disordersmentioning

confidence: 99%

See 2 more Smart Citations

Stigma experiences of patients with problematic personality traits: An investigation with the PID-5.

Williams¹,

Rogers²

2019

Stigma and Health

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“…The label 'Personality Disorder' continues to divide opinion (Fairfax, 2011) and has become associated with negative connotations, stigma and uncertainty (Mind, 2018). This has led to a growing body of opinion seeking to challenge the terminology of personality disorder, which includes people with lived experience, campaigning groups, critical practitioners and academics.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study of the label of personality disorder from the perspectives of people with lived experience and occupational experience

Lamph

Dorothy²,

Jeynes

et al. 2021

MHRJ

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Purpose The label “Personality Disorder” continues to divide opinion. Challenges to the terminology of personality disorder led by people with lived experience and supported by critical practitioners and academics are tempered by acknowledgement of certain positive social consequences of obtaining a diagnosis. This study aims to engage service users and staff in a process of inquiry to better understand the complexities of views on the terminology of Personality Disorder. Design/methodology/approach This study set out to qualitatively explore the views of a range of people with lived, occupational and dual lived experience/occupational expertise, relating to the diagnostic label of Personality Disorder, via participatory and critical group debate. The World Café approach is an innovative methodology for participatory inquiry into subjective views suited to exploring the contested subject matter. Findings This study identified contrasting opinions towards the label of Personality Disorder and provides insight into the concerns described for both keeping and losing the label. Although many felt the words “personality” and “disorder” are not in themselves helpful, certain positive views were also revealed. Perspectives towards the label were influenced by the way in which diagnosis was explained and understood by patients and practitioners, alongside the extent to which service provision and evidence-based interventions were offered. Research limitations/implications The findings have the potential to contribute to the ongoing critical debate regarding the value of the Personality Disorder construct in the provision of care and support. Specific emphasis upon the relational framing of care provision offers a means to ameliorate some of the negative impacts of terminology. Perspectives are influenced in the way the label is understood, hence, attention is required to enhance these processes in clinical practice. There is much more study required to overcome stigmatisation, prejudice, and lack of knowledge and understanding. Further research identifying means for challenging stigma and the factors contributing to positive clinical interactions are required. Originality/value This study brings together a wide range of views and experiences of mental health professionals, individuals lived experiences and those who align to both lived and occupational expertise. A safe space was provided via the uniquely co-produced World Café research event to bring together discussion and debates from mixed perspectives makes this a novel study. The focus being on perspectives towards contested language, labelling and social impact adds to scholarship in this field.

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The Stigma of Personality Disorders

Sheehan

Nieweglowski

Corrigan

2016

Curr Psychiatry Rep

214

127

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This article reviews the recent literature on the stigma of personality disorders, including an overview of general mental illness stigma and an examination of the personality-specific stigma. Overall, public knowledge of personality disorders is low, and people with personality disorders may be perceived as purposefully misbehaving rather than experiencing an illness. Health provider stigma seems particularly pernicious for those with borderline personality disorder. Most stigma research on personality disorders has been completed outside the USA, and few stigma-change interventions specific to personality disorder have been scientifically tested. Limited evidence suggests that health provider training can improve stigmatizing attitudes and that interventions combining positive messages of recovery potential with biological etiology will be most impactful to reduce stigma. Anti-stigma interventions designed specifically for health providers, family members, criminal justice personnel, and law enforcement seem particularly beneficial, given these sources of stigma.

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Re-conceiving personality disorders: Adaptations on a dimension?

Cited by 4 publications

References 50 publications

Stigma experiences of patients with problematic personality traits: An investigation with the PID-5.

Stigma experiences of patients with problematic personality traits: An investigation with the PID-5.

A qualitative study of the label of personality disorder from the perspectives of people with lived experience and occupational experience

The Stigma of Personality Disorders

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