Online Program

Intergenerational impacts of borderline personality disorder clinical practices

Monday, November 4, 2013

Sandra Sulzer, PhD, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
Given the enormous stigma associated with the diagnosis, Borderline Personality Disorder (BPD) is an excellent case to explore how diagnostic practices can affect care. This study relied on a combination of in-depth interviews with clinicians and patients (n=32), as well as triangulated data from message board support groups for adult children with a borderline parent and for patients (n= 312). The online data from adult children examines the effects current clinical communication practice has on the subsequent generation using a cross-sectional sample. The response to the borderline diagnosis varies dramatically between these groups. Clinician and patient data established that providers frequently withheld the BPD diagnosis from patients. Interviews also confirmed that patients have a preference for knowing the diagnosis as it secures them access to treatment, and better tools for self-advocacy and research. Without knowledge of their condition, many go untreated for this particular disorder. Online data suggest adult children suffer long-term effects from the lack of sufficient mental health treatment for their parents. Furthermore, since being “an adult child with a parent who has BPD” is not a DSM category, this group must define their own subsequent health struggles through the lens of a parental diagnosis. Current clinical practices of withholding the borderline diagnosis from patients affects treatment, and the gaps in treatment that result then impact the children who grow up with under-treated parents.

Learning Areas:

Advocacy for health and health education
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Social and behavioral sciences

Learning Objectives:
Explain the relationship between clinical communication of the borderline diagnosis and patient treatment. Demonstrate the effect of clinical communication practice on adult children with a parent who has BPD. Identify intergenerational impacts of diagnostic communication through cross-sectional sampling.

Keyword(s): Personality Disorder, Barriers to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted research on Borderline Personality Disorder and Adult Children with an affected parent for four years. Among my specific interests has been the effect of daily clinical diagnostic practices on patients and their family members.
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.