Markham Dominic, Trower Peter
Psychology Department, South Warwickshire Primary Care Trust and University of Birmingham, UK.
Br J Clin Psychol. 2003 Sep;42(Pt 3):243-56. doi: 10.1348/01446650360703366.
The aim of the study was to investigate how the psychiatric label 'borderline personality disorder' (BPD) affected staff's perceptions and causal attributions about patients' behaviour.
The study utilized a within-participants questionnaire methodology and participants comprised qualified mental health nursing staff. The questionnaire contained descriptions of challenging behaviour in which the patient was described with a diagnosis of depression, schizophrenia or BPD. Participants were asked to identify a likely cause of the behaviour and then on a Likert-type scale rate attributions of internality, stability, globality and controllability. In addition they recorded their level of sympathy with the patient and their optimism for change.
Patients with a label of BPD attracted more negative responses from staff than those with a label of schizophrenia or depression. Causes of their negative behaviour were rated as more stable and they were thought to be more in control of the causes of the behaviour and the behaviour itself. Staff reported less sympathy and optimism towards patients with a diagnosis of BPD and rated their personal experiences as more negative than their experiences of working with patients with a diagnosis of depression or schizophrenia.
Staff regard patients with a BPD label to be more in control of negative behaviour than patients with a label of schizophrenia or depression. In accord with Weiner's (1985) model, attributions of control were inversely related to staff sympathy. Addressing attributions of control may provide a means to modify staff sympathy towards patients with a diagnosis of BPD and counteract their negative experiences.
本研究旨在调查“边缘型人格障碍”（BPD）这一精神科标签如何影响工作人员对患者行为的认知及因果归因。
本研究采用参与者内部问卷调查法，参与者为合格的精神科护理人员。问卷包含对具有挑战性的行为的描述，其中患者被诊断为患有抑郁症、精神分裂症或边缘型人格障碍。要求参与者找出该行为可能的原因，然后在李克特量表上对内在性、稳定性、整体性和可控性进行归因评分。此外，他们还记录了对患者的同情程度以及对改变的乐观态度。
被贴上边缘型人格障碍标签的患者比被贴上精神分裂症或抑郁症标签的患者从工作人员那里得到更多负面反应。他们负面行为的原因被认为更具稳定性，并且人们认为他们对行为的原因及行为本身更具掌控力。工作人员对被诊断为边缘型人格障碍的患者表现出较少的同情和乐观态度，并将与这些患者共事的个人经历评价为比与被诊断为抑郁症或精神分裂症的患者共事的经历更负面。
工作人员认为被贴上边缘型人格障碍标签的患者比被贴上精神分裂症或抑郁症标签的患者对负面行为更具掌控力。根据韦纳（1985年）的模型，可控性归因与工作人员的同情呈负相关。解决可控性归因问题可能提供一种方法来改变工作人员对被诊断为边缘型人格障碍患者的同情态度，并抵消他们的负面经历。
