Academic journal article Ethical Human Psychology and Psychiatry

Comparing the Psychological Effects of Different Psychiatric Labels: Borderline, Paranoid, and Antisocial Personality Disorder; Major Depression; Anxiety Disorder; and Posttraumatic Stress Disorder

Academic journal article Ethical Human Psychology and Psychiatry

Comparing the Psychological Effects of Different Psychiatric Labels: Borderline, Paranoid, and Antisocial Personality Disorder; Major Depression; Anxiety Disorder; and Posttraumatic Stress Disorder

Article excerpt

The psychological effects of six Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) psychiatric labels on respondents were evaluated, three of them being variants of "personality disorder" (PD). Self-selecting students from a university in London, United Kingdom, were invited to take part in a repeated-measures questionnaire study delivered online. One hundred and seventy-three participants completed the questionnaire, responding to 16 items for each of the six mental health labels. Results showed that respondents reported the greatest dysphoric reactions to the "paranoid personality disorder" label, followed by the "borderline" and "antisocial" personality disorder labels, with "major depression," "anxiety disorder," and "posttraumatic stress disorder" thereafter. Borderline personality disorder was designated as being least understandable of the six labels. It is evident that the PD psychiatric labels have greater iatrogenic effects than the others included here. From this, we conclude that PD labels produce greater dysphoric consequences because they can be construed as implying a fault in an individual's core and immutable sense of self, which in turn may cause significant stigma and distress in those to whom they have been applied. We conclude that given these adverse effects of PD labels and conceptual problems associated with the notion of personality disorder, that such labels at the very least should be replaced by more compassionate and self-explanatory terms, which reflect the chronic difficulties forming and maintaining attachments that underpin this group of presenting complaints.

Keywords: psychiatric labels; effects; posttraumatic stress disorder (PTSD); depression; personality disorder (PD)

Labeling theory, originating in the work of Tannebaum (1938), and later in that of Goffman (1963), argued that having an attribute that is discrediting is stigmatizing, with stigmatized individuals being diminished in the minds of those perceiving the negative attribute and being blamed as the source of the discrediting characteristic, resulting in observers distancing themselves. Although there is extensive research on psychiatric stigma, less prevalent are studies examining the effects of psychiatric diagnostic labels on those to whom they are applied. Such labeling has been described by Brown (2002) as setting up expectations for deviant behavior. Although summary labels can be helpful in facilitating communication between professionals, they can be harmful when used by those who are unfamiliar with associated anchoring definitions. Scheff (1966) postulated that social attitudes are negatively influenced by the presence of psychiatric labels and that the mere presence of these negative terms causes patients to adopt problematic behavior, thereby exacerbating social rejection. Kirk (1974) has challenged these conclusions, arguing that it is the behavior of those with the mental illness, rather than the mental illness labeling per se that influences other peoples' responses. Nevertheless, Sirey et al. (2001), in a study of newly admitted adults for psychiatric treatments, found that medical adherence to pharmacological treatment for depression was significantly associated with self-perceived stigma. Where publically stigmatizing ideas are viewed as self-relevant, Corrigan, Kerr, and Knudsen (2005) call this "self-stigma." Such a tendency has been shown to be associated with significantly lower self-esteem among those with serious mental illnesses (Link, Struening, Neese-Todd, Asmussen, & Phelan, 2001) and as a barrier to recovery from affective disorder (Perlick et al., 2001). Furthermore, Corrigan and Watson (2006) note that as well as loss of self-esteem, some react with righteous anger in response to stigma, whereas others appear capable of ignoring the effects of public prejudice. However, the World Health Organization (2001) highlighted that the stigma associated with a psychiatric diagnosis can create "a vicious cycle of alienation and discrimination-leading to social isolation, inability to work, alcohol or drug abuse, homelessness, or excessive institutionalisation-which decreases the chance of recovery and normal life" (p. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.