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Published in: Current Psychiatry Reports 1/2016

01-01-2016 | Personality Disorders (C Schmahl, Section Editor)

The Stigma of Personality Disorders

Authors: Lindsay Sheehan, Katherine Nieweglowski, Patrick Corrigan

Published in: Current Psychiatry Reports | Issue 1/2016

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Abstract

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.
Literature
1.
go back to reference Kessler RC et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiat. 2005;62(6):617–27.PubMedCentralCrossRefPubMed Kessler RC et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiat. 2005;62(6):617–27.PubMedCentralCrossRefPubMed
2.
go back to reference Adebowale LV. Personality disorder: taking a person-centered approach. Ment Health Rev. 2010;15(4):6–9.CrossRef Adebowale LV. Personality disorder: taking a person-centered approach. Ment Health Rev. 2010;15(4):6–9.CrossRef
3.
go back to reference Trull TJ et al. Revised NESARC personality disorder diagnoses: Gender, prevalence, and comorbidity with substance dependence disorders. J Pers Disord. 2010;24(4):412–26.PubMedCentralCrossRefPubMed Trull TJ et al. Revised NESARC personality disorder diagnoses: Gender, prevalence, and comorbidity with substance dependence disorders. J Pers Disord. 2010;24(4):412–26.PubMedCentralCrossRefPubMed
4.
go back to reference American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC; 2013. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC; 2013.
5.•
go back to reference Lawn S, McMahon J. Experiences of care by Australians with a diagnosis of borderline personality disorder. J Psychiatr Ment Health Nurs. 2015;22(7):510–21. People with BPD in Australia report experiences of discrimination within the health care setting.CrossRefPubMed Lawn S, McMahon J. Experiences of care by Australians with a diagnosis of borderline personality disorder. J Psychiatr Ment Health Nurs. 2015;22(7):510–21. People with BPD in Australia report experiences of discrimination within the health care setting.CrossRefPubMed
6.
go back to reference Fairfax H. Re-conceiving personality disorders: adaptations on a dimension. Couns Psychol Q. 2011;24(4):313–22.CrossRef Fairfax H. Re-conceiving personality disorders: adaptations on a dimension. Couns Psychol Q. 2011;24(4):313–22.CrossRef
8.
go back to reference Goffman E. Stigma: notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall; 1963. Goffman E. Stigma: notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall; 1963.
9.
go back to reference Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27:363–85.CrossRef Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27:363–85.CrossRef
10.
go back to reference Corrigan PW, Kosyluk KA. Mental illness stigma: types, constructs, and vehicles for change. In: Corrigan PW, editor. The stigma of disease and disability: understanding causes and overcoming injustices. Washington, DC: American Psychological Association; 2014.CrossRef Corrigan PW, Kosyluk KA. Mental illness stigma: types, constructs, and vehicles for change. In: Corrigan PW, editor. The stigma of disease and disability: understanding causes and overcoming injustices. Washington, DC: American Psychological Association; 2014.CrossRef
11.
go back to reference Bos AER et al. Stigma: advances in theory and research. Basic Appl Soc Psych. 2013;35(1):1–9.CrossRef Bos AER et al. Stigma: advances in theory and research. Basic Appl Soc Psych. 2013;35(1):1–9.CrossRef
12.
go back to reference Corrigan PW, Calabrese JD. Strategies for assessing and diminishing self-stigma. In: Corrigan PW, editor. On the stigma of mental illness: practical strategies. Washington, DC: American Psychological Association; 2005. p. 239–56.CrossRef Corrigan PW, Calabrese JD. Strategies for assessing and diminishing self-stigma. In: Corrigan PW, editor. On the stigma of mental illness: practical strategies. Washington, DC: American Psychological Association; 2005. p. 239–56.CrossRef
13.
go back to reference Americans with Disabilities Act of 1990, Pub. L. No. 101–336, 104 Stat. 328 (1990). Americans with Disabilities Act of 1990, Pub. L. No. 101–336, 104 Stat. 328 (1990).
14.
go back to reference Schomerus G et al. Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand. 2012;125(6):440–52.CrossRefPubMed Schomerus G et al. Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand. 2012;125(6):440–52.CrossRefPubMed
15.
go back to reference Harangozo J et al. Stigma and discrimination against people with schizophrenia related to medical services. Int J Soc Psychiatry. 2014;60(4):359–66.CrossRefPubMed Harangozo J et al. Stigma and discrimination against people with schizophrenia related to medical services. Int J Soc Psychiatry. 2014;60(4):359–66.CrossRefPubMed
16.
go back to reference Parcesepe AM, Cabassa LJ. Public stigma of mental illness in the United States: a systematic literature review. Adm Policy Ment Health. 2013;40(5):384–99.CrossRefPubMed Parcesepe AM, Cabassa LJ. Public stigma of mental illness in the United States: a systematic literature review. Adm Policy Ment Health. 2013;40(5):384–99.CrossRefPubMed
17.
go back to reference Rüsch N et al. Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness. Eur Arch Psychiatry Clin Neurosci. 2014;264(1):35–43.CrossRefPubMed Rüsch N et al. Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness. Eur Arch Psychiatry Clin Neurosci. 2014;264(1):35–43.CrossRefPubMed
18.
go back to reference Drapalski AL et al. A model of internalized stigma and its effects on people with mental illness. Psychiatr Serv. 2013;64(3):264–9.CrossRefPubMed Drapalski AL et al. A model of internalized stigma and its effects on people with mental illness. Psychiatr Serv. 2013;64(3):264–9.CrossRefPubMed
19.
go back to reference Corrigan PW et al. What is the impact of self-stigma? Loss of self-respect and the “Why Try” effect. J Ment Health. In press. Corrigan PW et al. What is the impact of self-stigma? Loss of self-respect and the “Why Try” effect. J Ment Health. In press.
20.
go back to reference Corrigan PW et al. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest. 2014;15(2):37–70.CrossRefPubMed Corrigan PW et al. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest. 2014;15(2):37–70.CrossRefPubMed
21.•
go back to reference Catthoor K et al. Adolescents with personality disorders suffer from severe psychiatric stigma: evidence from a sample of 131 patients. Adolesc Health Med Ther. 2015;6:81–9. Adolescents with personality disorders experienced more stigma than those with other diagnoses and diagnosis of BPD most strongly predicted stigma.PubMedCentralCrossRefPubMed Catthoor K et al. Adolescents with personality disorders suffer from severe psychiatric stigma: evidence from a sample of 131 patients. Adolesc Health Med Ther. 2015;6:81–9. Adolescents with personality disorders experienced more stigma than those with other diagnoses and diagnosis of BPD most strongly predicted stigma.PubMedCentralCrossRefPubMed
22.
go back to reference Magallon-Neri E et al. Stigmatization, personality disorders and adolescence. Eur Psychiat. 2013;28(1). Magallon-Neri E et al. Stigmatization, personality disorders and adolescence. Eur Psychiat. 2013;28(1).
23.
go back to reference Aviram RB et al. Borderline personality disorder, stigma and treatment implications. Harv Rev Psychiatry. 2006;14(5):249–56.CrossRefPubMed Aviram RB et al. Borderline personality disorder, stigma and treatment implications. Harv Rev Psychiatry. 2006;14(5):249–56.CrossRefPubMed
24.•
go back to reference Furnham A et al. Mental health literacy and borderline personality disorder (BPD): what do the public “make” of those with BPD? Soc Psych Psych Epid. 2015;50(2):317–24. Public survey suggested limited knowledge of BPD in the general population.CrossRef Furnham A et al. Mental health literacy and borderline personality disorder (BPD): what do the public “make” of those with BPD? Soc Psych Psych Epid. 2015;50(2):317–24. Public survey suggested limited knowledge of BPD in the general population.CrossRef
25.
go back to reference Wright K, Furnham A. What is narcissistic personality disorder? Lay theories of narcissism. Psychology. 2014;5(9):1120–30.CrossRef Wright K, Furnham A. What is narcissistic personality disorder? Lay theories of narcissism. Psychology. 2014;5(9):1120–30.CrossRef
26.
go back to reference Bonnington O, Rose D. Exploring stigmatisation among people diagnosed with either bipolar disorder or borderline personality disorder: a critical realist analysis. Soc Sci Med. 2014;123:7–17.CrossRefPubMed Bonnington O, Rose D. Exploring stigmatisation among people diagnosed with either bipolar disorder or borderline personality disorder: a critical realist analysis. Soc Sci Med. 2014;123:7–17.CrossRefPubMed
27.
go back to reference Catthoor K et al. Psychiatric stigma in treatment-seeking adults with personality problems: evidence from a sample of 214 patients. Front Psychiatry. 2015;6:101. Patients referred for treatment of PD did not report more stigma than non-personality disordered individuals. Overall stigma level was relatively low and did not vary by personality disorder diagnosis.PubMedCentralCrossRefPubMed Catthoor K et al. Psychiatric stigma in treatment-seeking adults with personality problems: evidence from a sample of 214 patients. Front Psychiatry. 2015;6:101. Patients referred for treatment of PD did not report more stigma than non-personality disordered individuals. Overall stigma level was relatively low and did not vary by personality disorder diagnosis.PubMedCentralCrossRefPubMed
28.•
go back to reference Martin T, Thomas S. Police officers’ views of their encounters with people with personality disorder. J Psychiatr Ment Hlt. 2015;22(2):125–32. This qualitative study explored police experiences in serving people with PD in Australia. Results reveal frustration and lack of coordination between law enforcement and mental health system. Martin T, Thomas S. Police officers’ views of their encounters with people with personality disorder. J Psychiatr Ment Hlt. 2015;22(2):125–32. This qualitative study explored police experiences in serving people with PD in Australia. Results reveal frustration and lack of coordination between law enforcement and mental health system.
29.
go back to reference Wayland K, O’Brien SD. Deconstructing antisocial personality disorder and psychopathy: a guidelines-based approach to prejudicial psychiatric labels. Hofstraw Law Rev. 2014;42:519–88. Wayland K, O’Brien SD. Deconstructing antisocial personality disorder and psychopathy: a guidelines-based approach to prejudicial psychiatric labels. Hofstraw Law Rev. 2014;42:519–88.
30.
go back to reference Tufts A. Born to be an offender? Antisocial personality disorder and its implications on juvenile transfer to adult court in federal proceedings. Lewis & Clark L Rev. 2013;17(1):333–59. Tufts A. Born to be an offender? Antisocial personality disorder and its implications on juvenile transfer to adult court in federal proceedings. Lewis & Clark L Rev. 2013;17(1):333–59.
31.
go back to reference Wilson H. Can antisocial personality disorder be treated? A meta-analysis examining the effectiveness of treatment in reducing recidivism for individuals diagnosed with ASPD. Int J Forensic Ment Health. 2014;13:34–46.CrossRef Wilson H. Can antisocial personality disorder be treated? A meta-analysis examining the effectiveness of treatment in reducing recidivism for individuals diagnosed with ASPD. Int J Forensic Ment Health. 2014;13:34–46.CrossRef
32.
go back to reference Smith ST et al. “So, what is a psychopath?” Venireperson perceptions, beliefs, and attitudes about psychopathic personality. Law Hum Behav. 2014;38(5):490–500.CrossRefPubMed Smith ST et al. “So, what is a psychopath?” Venireperson perceptions, beliefs, and attitudes about psychopathic personality. Law Hum Behav. 2014;38(5):490–500.CrossRefPubMed
33.
go back to reference Palermo GB. Severe antisocial personality disordered and psychopathic offenders: should they be allowed to enter an insanity plea? Int J Offender Ther Comp Criminol. 2014;58(12):1412–4.CrossRefPubMed Palermo GB. Severe antisocial personality disordered and psychopathic offenders: should they be allowed to enter an insanity plea? Int J Offender Ther Comp Criminol. 2014;58(12):1412–4.CrossRefPubMed
34.
go back to reference Koutoufa I, Furnham A. Psychiatric literacy: lay beliefs of obsessive-compulsive disorder. Couns Psychol Q. 2014;27(3):277–89.CrossRef Koutoufa I, Furnham A. Psychiatric literacy: lay beliefs of obsessive-compulsive disorder. Couns Psychol Q. 2014;27(3):277–89.CrossRef
35.••
go back to reference Bodner E et al. The attitudes of psychiatric hospital staff toward hospitalization and treatment of patients with borderline personality disorder. BMC Psychiatry. 2015;15(1):2. This Israeli study found that psychiatrists and nurses had less empathy and more negative attitudes than psychologists or social workers.PubMedCentralCrossRefPubMed Bodner E et al. The attitudes of psychiatric hospital staff toward hospitalization and treatment of patients with borderline personality disorder. BMC Psychiatry. 2015;15(1):2. This Israeli study found that psychiatrists and nurses had less empathy and more negative attitudes than psychologists or social workers.PubMedCentralCrossRefPubMed
36.
go back to reference Latalova K et al. If you label me, go with your therapy somewhere! Borderline personality disorder and stigma. Eur Psychiat. 2015;30(1):1520.CrossRef Latalova K et al. If you label me, go with your therapy somewhere! Borderline personality disorder and stigma. Eur Psychiat. 2015;30(1):1520.CrossRef
37.
go back to reference Sansone RA, Sansone LA. Responses of mental health clinicians to patients with borderline personality disorder. Innov Clin Neurosci. 2013;10(5–6):39–43.PubMedCentralPubMed Sansone RA, Sansone LA. Responses of mental health clinicians to patients with borderline personality disorder. Innov Clin Neurosci. 2013;10(5–6):39–43.PubMedCentralPubMed
38.
go back to reference Scheel CN et al. Do patients with different mental disorders show specific aspects of shame? Psychiat Res. 2014;220(1):490–5.CrossRef Scheel CN et al. Do patients with different mental disorders show specific aspects of shame? Psychiat Res. 2014;220(1):490–5.CrossRef
39.
go back to reference O’Donohue W, Fowler KA, Lilienfeld SO. eds. Personality disorders: toward the DSM-V. Sage Publications;2007. O’Donohue W, Fowler KA, Lilienfeld SO. eds. Personality disorders: toward the DSM-V. Sage Publications;2007.
40.•
go back to reference Zimmerman M. Borderline personality disorder: a disorder in search of advocacy. J Nerv Ment Dis. 2015;203(1):8–12. This author argues that advocacy work to improve funding and treatment for bipolar disorder is needed for borderline personality disorder.CrossRefPubMed Zimmerman M. Borderline personality disorder: a disorder in search of advocacy. J Nerv Ment Dis. 2015;203(1):8–12. This author argues that advocacy work to improve funding and treatment for bipolar disorder is needed for borderline personality disorder.CrossRefPubMed
41.
go back to reference Paris J. Why psychiatrists are reluctant to diagnose borderline personality disorder. Psychiatry (Edgmont). 2007;4(1):35–9. Paris J. Why psychiatrists are reluctant to diagnose borderline personality disorder. Psychiatry (Edgmont). 2007;4(1):35–9.
42.••
go back to reference Egan SJ et al. Attitudes of clinical psychologists towards clients with personality disorders. Aust J Psychol. 2014;66(3):175–80. In Australian clinical psychologists, specialized training and service provision to more PD clients was connected to more positive attitudes towards people with PD.CrossRef Egan SJ et al. Attitudes of clinical psychologists towards clients with personality disorders. Aust J Psychol. 2014;66(3):175–80. In Australian clinical psychologists, specialized training and service provision to more PD clients was connected to more positive attitudes towards people with PD.CrossRef
43.
go back to reference Corrigan PW et al. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012;63:963–73.CrossRefPubMed Corrigan PW et al. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv. 2012;63:963–73.CrossRefPubMed
44.••
go back to reference Clarke S et al. Ameliorating patient stigma amongst staff working with personality disorder: randomized controlled trial of self-management versus skills training. Behav Cogn Psychoth. 2014;43(6):692–704. Healthcare staff who completed a 2-day self-management workshop had positive change in attitudes, therapeutic relationship, and social distance towards people with PD at post-test and 6-month follow-up.CrossRef Clarke S et al. Ameliorating patient stigma amongst staff working with personality disorder: randomized controlled trial of self-management versus skills training. Behav Cogn Psychoth. 2014;43(6):692–704. Healthcare staff who completed a 2-day self-management workshop had positive change in attitudes, therapeutic relationship, and social distance towards people with PD at post-test and 6-month follow-up.CrossRef
45.
go back to reference Krause-Utz A et al. The latest neuroimaging findings in borderline personality disorder. Curr Psychiatry Rep. 2014;16(3):438.CrossRefPubMed Krause-Utz A et al. The latest neuroimaging findings in borderline personality disorder. Curr Psychiatry Rep. 2014;16(3):438.CrossRefPubMed
46.
go back to reference Rossi R et al. Abnormalities in cortical gray matter density in borderline personality disorder. Eur Psychiatry. 2015;30(2):221–7.CrossRefPubMed Rossi R et al. Abnormalities in cortical gray matter density in borderline personality disorder. Eur Psychiatry. 2015;30(2):221–7.CrossRefPubMed
47.
go back to reference Schulze L et al. Gray matter abnormalities in patients with narcissistic personality disorder. J Psychiatr Res. 2013;47(10):1363–9.CrossRefPubMed Schulze L et al. Gray matter abnormalities in patients with narcissistic personality disorder. J Psychiatr Res. 2013;47(10):1363–9.CrossRefPubMed
48.
go back to reference Whalley HC et al. White matter integrity and its association with affective and interpersonal symptoms in borderline personality disorder. Neuroimage Clin. 2015;7:476–81.PubMedCentralCrossRefPubMed Whalley HC et al. White matter integrity and its association with affective and interpersonal symptoms in borderline personality disorder. Neuroimage Clin. 2015;7:476–81.PubMedCentralCrossRefPubMed
49.
go back to reference Clark CJ et al. Can teaching staff about the neurobiological underpinnings of borderline personality disorder instigate attitudinal change? J Psychiat Int Care. 2015;11(1):43–51.CrossRef Clark CJ et al. Can teaching staff about the neurobiological underpinnings of borderline personality disorder instigate attitudinal change? J Psychiat Int Care. 2015;11(1):43–51.CrossRef
50.
go back to reference Kvaale EP et al. The ‘side effects’ of medicalization: a meta-analytic review of how biogenetic explanations affect stigma. Clin Psychol Rev. 2013;33(6):782–94.CrossRefPubMed Kvaale EP et al. The ‘side effects’ of medicalization: a meta-analytic review of how biogenetic explanations affect stigma. Clin Psychol Rev. 2013;33(6):782–94.CrossRefPubMed
51.••
go back to reference Lebowitz MS, Ahn WK. Combining biomedical accounts of mental disorders with treatability information to reduce mental illness stigma. Psychiat Serv. 2012;63(5):496–9. Participants who read vignettes emphasizing both biological etiology of PD and treatability desired lower social distance from people with PD.CrossRef Lebowitz MS, Ahn WK. Combining biomedical accounts of mental disorders with treatability information to reduce mental illness stigma. Psychiat Serv. 2012;63(5):496–9. Participants who read vignettes emphasizing both biological etiology of PD and treatability desired lower social distance from people with PD.CrossRef
52.
go back to reference Zanarini MC et al. Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study. Am J Psychiatry. 2012;169(5):476–83.PubMedCentralCrossRefPubMed Zanarini MC et al. Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study. Am J Psychiatry. 2012;169(5):476–83.PubMedCentralCrossRefPubMed
Metadata
Title
The Stigma of Personality Disorders
Authors
Lindsay Sheehan
Katherine Nieweglowski
Patrick Corrigan
Publication date
01-01-2016
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 1/2016
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-015-0654-1

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