271771 Responding to stigma: Clinician diagnostic practices and patient responses in Borderline Personality Disorder

Tuesday, October 30, 2012 : 3:10 PM - 3:30 PM

Sandra Sulzer, PhD , Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
Annabelle Potvin , Department of Sociology, University of Wisconsin-Madison, Madison, WI
Mental health care providers lack systematic information about patient experiences with diagnosis, and are left to guess about the effectiveness of their practices. By examining how different practitioners handle the diagnostic encounter, this project documented how diagnosing patients with Borderline Personality Disorder (BPD) happens in clinical settings. Additionally, we incorporated much-needed research on patient perspectives. Primary data included in-depth interviews of mental health care providers and persons diagnosed with BPD. Interviews were coded using grounded theory and institutional ethnography. Secondary patient reports of diagnostic encounters from memoirs and online message boards were used to augment primary data collection. Clinicians used a variety of strategies to communicate the BPD diagnosis such as using euphemisms, symptom-based language or naming the diagnosis, usually with critical commentary on the category itself. Patients responded differently to the encounter depending on the kind of language used to describe the disorder and when they found out in the trajectory of their care. Generally, patient responses did not line up with clinician expectations, suggesting that hearing the patient point of view might inform how providers discuss diagnosis. What patients with BPD are told and how they are told affects their desire to stay in treatment, as well as their relationships with their providers. This research can lead to better clinical outcomes in the most prevalent personality disorder in the U.S. by helping clinicians to retain their patients through effective diagnostic communication.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
1) Explain current clinician diagnostic practices and their variations. 2) Compare clinician and patient experiences of diagnostic encounters. 3) Differentiate what practices in diagnostic communication patients find to be effective and constructive.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have had primary responsibility for all phases of this research from study design, to data collection, analysis and synthesis. I have studied clinician, adult and adult child perspectives on mental health diagnosis and stigma.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.