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"You sure she's not making this up?": A qualitative investigation of stigma toward adults with borderline personality disorder in physical healthcare settings.“你确定她不是在编造吗?”:身体保健环境中对边缘型人格障碍成年患者的耻辱感的定性研究。
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“你确定她不是在编造吗?”:身体保健环境中对边缘型人格障碍成年患者的耻辱感的定性研究。

"You sure she's not making this up?": A qualitative investigation of stigma toward adults with borderline personality disorder in physical healthcare settings.

机构信息

Cleveland State University, Cleveland, OH, USA.

出版信息

Personal Ment Health. 2025 Feb;19(1):e1646. doi: 10.1002/pmh.1646.

DOI:10.1002/pmh.1646
PMID:39582091
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11586320/
Abstract

Borderline personality disorder (BPD) is associated with pervasive stigma that contributes to several consequences, such as inaccessible and inadequate healthcare. Existing literature concerning the experiences of BPD stigma within healthcare settings predominantly centers on mental healthcare contexts. However, individuals with BPD also present with elevated physical disabilities and health concerns, demonstrating a need for regular contact with medical professionals to manage and coordinate physical healthcare. The current qualitative study analyzes the dynamics of stigma and consequences in medical settings for physical healthcare among individuals diagnosed with BPD. Community adults (N = 16, M = 29.50, 44% cisgender women) provided qualitative responses describing their experiences with stigma in medical settings other than for mental health purposes. The inductive thematic analysis generated six key themes: (1) Dismissal and Misattribution of Physical Symptoms, (2) Delayed or Inappropriate Medical Diagnosis and Intervention, (3) Communication and Advocacy Challenges, (4) Invalidation of Emotional Well-Being and Distress, (5) Self-Harm Stigma, and (6) Presumed Drug-Seeking Behavior. This article demonstrates the persistent and complex role of stigma across physical healthcare settings for individuals with BPD, affecting their physical and mental healthcare outcomes. It also identifies areas for future research and improvement and offers insights to ameliorate these issues.

摘要

边缘型人格障碍(BPD)与普遍存在的污名有关,这种污名导致了多种后果,例如难以获得和不充分的医疗保健。现有的关于医疗环境中 BPD 污名的经验的文献主要集中在精神卫生保健背景下。然而,患有 BPD 的人也存在身体残疾和健康问题,这表明他们需要定期与医疗专业人员接触,以管理和协调身体保健。目前的定性研究分析了在医疗环境中,与精神健康目的无关的 BPD 患者的身体保健方面的污名和后果的动态。社区成年人(N=16,M=29.50,44%的顺性别女性)提供了定性回应,描述了他们在医疗环境中与精神健康目的无关的污名经历。归纳主题分析生成了六个关键主题:(1)身体症状的忽视和归因错误,(2)延迟或不适当的医疗诊断和干预,(3)沟通和倡导方面的挑战,(4)情感幸福感和痛苦的否定,(5)自伤污名,以及(6)被认为是寻药行为。本文展示了 BPD 患者在整个身体保健环境中持久且复杂的污名作用,影响了他们的身体和心理健康保健结果。它还确定了未来研究和改进的领域,并提供了改善这些问题的见解。