Abstract
Purpose
The aim of this study was to explore the experience of having a personality disorder diagnosis within the context of forensic secure and community services.
Methods
We used an interpretative phenomenological analysis to analyse interviews with 10 service users purposively recruited from services in South London.
Results
Participants described two facets of their lived experience: (1) the way they see themselves now, in light of their offending and social background and (2) the pejorative nature of the personality disorder label, its relationship to mental illness and their need to distance themselves from it.
Conclusions
Having a forensic identity affects participants’ perceptions of their diagnosis and its treatment as well as their views about themselves.
Similar content being viewed by others
References
Singleton N, Meltzer H, Gatward R (1998) Psychiatric morbidity among prisoners in England and Wales. Stationary Office, London
Ullrich S, Deasy D, Smith J, Johnson B, Clarke M, Broughton N, Coid J (2008) Detecting personality disorders in the prison population of England and Wales: comparing case identification using the SCID-II screen and the SCID-II clinical interview. J Forens Psychiatry Psychol 19(3):301–322
National Institute for Mental Health in England (2003) Personality disorder: no longer diagnosis of exclusion. Department of Health, London
Fortune Z, Rose D, Crawford M, Slade M, Spence R, Mudd D, Barrett B, Coid J, Tyrer P, Moran P (2010) An evaluation of new services for personality-disordered offenders: staff and service user perspectives. Int J Soc Psychiatry 56(2):186–195
Tyrer P, Duggan C, Cooper S, Crawford M, Seivewright H, Rutter D, Maden T, Byford S, Barrett B (2010) The successes and failures of the DSPD experiment: the assessment and management of severe personality disorder. Med Sci Law 50(2):95
Bradley K (2009) The Bradley Report: Lord Bradley’s review of people with mental health problems or learning disabilities in the criminal justice system. Central Office of Information for the Department of Health, London. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_098694
Binks C, Fenton M, McCarthy L, Lee T, Adams C, Duggan C (2006) Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev (1). doi:10.1002/14651858.CD005652
Perseius K-I, Ojehagen A, Ekdahl S, Asberg M, Samuelsson M (2003) Treatment of suicidal and deliberate self-harming patients with borderline personality disorder using dialectical behavioral therapy: the patients’ and the therapists’ perceptions. Arch Psychiatr Nurs 17(5):218–227
Huband N, McMurran M, Evans C, Duggan C (2007) Social problem-solving plus psychoeducation for adults with personality disorder Pragmatic randomised controlled trial. Br J Psychiatry 190(4):307–313
Gibbon S, Duggan C, Stoffers JM, Huband N, Völlm BA, Ferriter M, Lieb K. (2009) Psychological interventions for antisocial personality disorder. Cochrane Database of Systematic Reviews: Protocols 2009 (1)
Sinclair J, Willmott L, Fitzpatrick R, Burns T, Yiend J (2012) Patients’ experience of dangerous and severe personality disorder services: qualitative interview study. Br J Psychiatry 200(3):252–253
Royal College of Psychiatrists (2008) Fair deal for mental health. Our manifesto for a 3 year campaign dedicated to tackling inequality in mental healthcare. Royal College of Psychiatrists
Arbuthnott M (2010) Fair deal: spelling it out for service users†. Psychiatrist 34(7):290–291
Shepherd G, Boardman J, Slade M (2008) Making recovery a reality. Sainsbury Centre for Mental Health, London
Turton P, Demetriou A, Boland W, Gillard S, Kavuma M, Mezey G, Mountford V, Turner K, White S, Zadeh E (2011) One size fits all: or horses for courses? Recovery-based care in specialist mental health services. Soc Psychiatry Psychiatr Epidemiol 46(2):127–136
Turner K, Lovell K, Brooker A (2011) ‘… and they all lived happily ever after’: ‘recovery’ or discovery of the self in personality disorder? Psychodynamic Practice 17(3):341–346
Roberts G (2011) ‘Forensic service user’: transitional identity or life sentence? Commentary on… Working with offenders. Adv Psychiatr Treat 17(3):188–190
Livingston JD, Rossiter KR, Verdun-Jones SN (2011) ‘Forensic’ labelling: an empirical assessment of its effects on self-stigma for people with severe mental illness. Psychiatry Res 88(1):115–122
Maltman L, Stacey J, Hamilton L (2008) Peaks and troughs: an exploration of patient perspectives of dangerous and severe personality disorder assessment (Peaks Unit, Rampton Hospital). Pers Ment Health 2(1):7–16
Smith JA (2011) Evaluating the contribution of interpretative phenomenological analysis. Health Psychol Rev 5(1):9–27
Smith J, Flowers P, Larkin M (2009) Interpretative phenomenological analysis: theory, method and research. Sage Publications, London
Mental Health Act (2007). Her Majesty’s Stationary Office, United Kingdom
Coid J, Kahtan N, Gault S, Jarman B (1999) Patients with personality disorder admitted to secure forensic psychiatry services. Br J Psychiatry 175(6):528–536. doi:10.1192/bjp.175.6.528
Horn N, Johnstone L, Brooke S (2007) Some service user perspectives on the diagnosis of Borderline personality disorder. J Ment Health 16(2):255–269
Nehls N (1999) Borderline personality disorder: the voice of patients. Res Nurs Health 22(4):285–293
Vaughn MS, Sapp AD (1989) Less than utopian: sex offender treatment in a milieu of power struggles, status positioning, and inmate manipulation in state correctional institutions. Prison J 69(2):73–89
Stalker K, Ferguson I, Barclay A (2005) ‘It is a horrible term for someone’: service user and provider perspectives on ‘personality disorder’. Disabil Soc 20(4):359–373
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders (Revised 4th edn). Washington, DC, pp 689–729
Gove W (2004) The career of the mentally ill: an integration of psychiatric, labeling/social construction, and lay perspectives. J Health Soc Behav 45(4):357–375
Westen D, Nakash O, Thomas C, Bradley R (2006) Clinical assessment of attachment patterns and personality disorder in adolescents and adults. J Consult Clin Psychol 74(6):1065–1085
Bender D, Farber B, Geller J (2001) Cluster B personality traits and attachment. J Am Acad Psychoanal 29(4):551–563
Downey G, Feldman SI (1996) Implications of rejection sensitivity for intimate relationships. J Pers Soc Psychol 70(6):1327–1343
Clarke A, Ndegwa D (2006) Forensic personality disorder in an MSU: lessons learnt after two years. Br J Forens Practice 8(4):29–33
Mays N, Pope C (2000) Qualitative research in health care: assessing quality in qualitative research. BMJ 320(7226):50–52. doi:10.1136/bmj.320.7226.50
Koekkoek B, van Meijel B, Tiemens B, Schene A, Hutschemaekers G (2011) What makes community psychiatric nurses label non-psychotic chronic patients as ‘difficult’: patient, professional, treatment and social variables. Soc Psychiatry Psychiatr Epidemiol 46(10):1045–1053
Department of Health (2005) Personality Disorder Capacity Plans 2005. Stationary Office, London
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Black, G., Thornicroft, G. & Murray, J. What do people in forensic secure and community settings think of their personality disorder diagnosis? A qualitative study. Soc Psychiatry Psychiatr Epidemiol 48, 1161–1168 (2013). https://doi.org/10.1007/s00127-012-0616-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-012-0616-4