Opening Minds Anti-Stigma Initiative, Mental Health Commission of Canada, 110 Quarry Park Blvd, Suite 320, T2C 3G3 Calgary, AB Canada.
Opening Minds Anti-Stigma Initiative, Mental Health Commission of Canada, 110 Quarry Park Blvd, Suite 320, T2C 3G3 Calgary, AB Canada ; Department of Psychology, University of Calgary, 2500 University Dr. NW, T2N 1 N4 Calgary, Alberta Canada.
Borderline Personal Disord Emot Dysregul. 2015 May 5;2:9. doi: 10.1186/s40479-015-0030-0. eCollection 2015.
Stigmatization among healthcare providers towards mental illnesses can present obstacles to effective caregiving. This may be especially the case for borderline personality disorder (BPD). Our study measured the impact of a three hour workshop on BPD and dialectical behavior therapy (DBT) on attitudes and behavioral intentions of healthcare providers towards persons with BPD as well as mental illness more generally. The intervention involved educational and social contact elements, all focused on BPD.
The study employed a pre-post design. We adopted the approach of measuring stigmatization towards persons with BPD in one half of the attendees and stigmatization towards persons with a mental illness in the other half. The stigma-assessment tool was the Opening Minds Scale for Healthcare Providers (OMS-HC). Two versions of the scale were employed - the original version and a 'BPD-specific' version. A 2x2 mixed model factorial analysis of variance (ANOVA) was conducted on the dependent variable, stigma score. The between-subject factor was survey type. The within-subject factor was time.
The mixed-model ANOVA produced a significant between-subject main effect for survey type, with stigma towards persons with BPD being greater than that towards persons with a mental illness more generally. A significant within-subject main effect for time was also observed, with participants showing significant improvement in stigma scores at Time 2. The main effects were subsumed by a significant interaction between time and survey type. Bonferroni post hoc tests indicated significant improvement in attitudes towards BPD and mental illness more generally, although there was a greater improvement in attitudes towards BPD.
Although effectiveness cannot be conclusively demonstrated with the current research design, results are encouraging that the intervention was successful at improving healthcare provider attitudes and behavioral intentions towards persons with BPD. The results further suggest that anti stigma interventions effective at combating stigma against a specific disorder may also have positive generalizable effects towards a broader set of mental illnesses, albeit to a lessened degree.
医疗保健提供者对精神疾病的污名化可能会对有效护理造成障碍。对于边缘型人格障碍（BPD）来说尤其如此。我们的研究测量了三个小时的 BPD 及辩证行为治疗（DBT）工作坊对医疗保健提供者对 BPD 患者以及更广泛的精神疾病的态度和行为意向的影响。该干预措施包括教育和社会接触元素，均专注于 BPD。
本研究采用了预-后设计。我们采用了在一半参与者中测量对 BPD 患者的污名化，而在另一半参与者中测量对精神疾病患者的污名化的方法。污名评估工具是医疗保健提供者开放性思维量表（OMS-HC）。采用原始版本和“BPD 特定”版本两种版本的量表。采用 2x2 混合模型方差分析（ANOVA）对因变量，即污名评分进行分析。被试间因素是量表类型，被试内因素是时间。
混合模型方差分析产生了量表类型的显著被试间主效应，对 BPD 患者的污名化程度大于对更广泛的精神疾病患者的污名化程度。还观察到时间的显著被试内主效应，参与者在时间 2 时的污名评分显著提高。主效应被时间和量表类型之间的显著交互作用所包含。Bonferroni 事后检验表明，对 BPD 和更广泛的精神疾病的态度有了显著改善，尽管对 BPD 的态度改善更大。
尽管目前的研究设计无法明确证明有效性，但结果令人鼓舞，即干预措施成功地改善了医疗保健提供者对 BPD 患者的态度和行为意向。结果进一步表明，针对特定障碍的抗污名干预措施可能对更广泛的一系列精神疾病也具有积极的可推广效应，尽管程度较小。
