[Published 18 August 2015 on TheConversation, by Lorna Hogg and Paul Salkovskis]
"... we found that therapists’ judgements of the patient were negatively influenced by the label “borderline personality disorder”, but not by the description of the behaviour that corresponded to the diagnosis, or what was observed on video. For example, she was rated as less likely to respond to treatment, to require more time and to be more likely to self harm.The experiment teases apart the impact of a mental health label from other factors such as the behavioural description that may have led to that diagnosis. It seems that it is not the behaviour that influenced therapists, but the addition of the diagnosis, which made them inappropriately pessimistic."
[Published September 2016 on UoB, by multiple authors]
Objectives. Diagnosis is ubiquitous in Psychiatry, and whilst it can bring benefits; adverse effects of “labelling” may also be possible. The present study aimed to evaluate experimentally whether clinicians’ judgements about a patient with panic disorder were influenced by an inappropriately suggested diagnosis of co-morbid borderline personality disorder (BPD).
Design. An experimental design was used to evaluate clinician’s judgments when the nature of the information they were given was varied to imply BPD comorbidity.
Methods. Two hundred and sixty five clinicians watched a video recorded assessment of a woman describing her experience of uncomplicated “Panic Disorder”, and then rated her present problems and likely prognosis. Prior to watching the video recording, participants were randomly allocated to one of three conditions with written information including; (a) her personal details and general background; (b) the addition of a behavioural description consistent with BPD; (c) the further addition of a “label” (past BPD diagnosis).
Results. The BPD label was associated with more negative ratings of the woman’s problems and her prognosis than both information alone and a behavioural description of BPD “symptoms”. Conclusions. Regardless of potential actuarial value of such diagnoses, it is concluded that clinicians can be overly influenced by diagnostic labels in the context of a supposed comorbid problem, although such biases appear to be less likely if a description of the relevant behaviours is used instead. Thus the label, rather than the behaviour it denotes, may be stigmatising in mental health professionals.
Lam, D. C. K., Salkovskis, P. M., & Hogg, L. I. (2016). “Judging a book by its cover”: An experimental study of the negative impact of a diagnosis of borderline personality disorder on clinicians’ judgments of uncomplicated panic disorder. British Journal of Clinical Psychology, 55(3), 253-268. https://doi.org/10.1111/bjc.12093
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