A borderline personality disorder diagnosis may improve clinical psychology trainees' treatment beliefs

Background
Contentious debate persists over whether the stigma of borderline personality disorder (BPD) stems from the diagnostic label itself or the behaviours commonly associated with it. At the same time, it remains unclear whether old age identities exacerbate such stigma, raising concerns surrounding the quality of care experienced by the burgeoning population of older adults—both diagnosed and undiagnosed—presenting to mental health services with BPD symptoms.

Method
Using a 2 × 2 between-subjects experimental design, participants were randomized equally to one of four conditions varying by age (27 vs. 70 years) and diagnostic label (BPD vs. no diagnosis). The study used two-way independent-measures ANOVAs to examine 242 clinical psychology trainees' treatment beliefs, as well as their cognitive, emotional and behavioural reactions to a vignette character presenting with BPD symptoms.

Results
Contrary to expectations, participants reported more favourable treatment beliefs about patients with a BPD diagnosis relative to undiagnosed patients with identical BPD symptoms, as indicated by more positive beliefs about their therapeutic relationships, and more conviction in their treatability. Additionally, participants anticipated that they would exhibit more infantilising behaviours (i.e., child-like speech patterns) toward older adult patients than toward younger patients, independent of diagnostic label.

Conclusions
A BPD diagnostic label can improve clinical psychology trainees' expectations about the treatability of affected individuals and may have a positive influence on beliefs about the therapeutic relationship with younger adult patients in particular. Thus, the label may now be less stigmatising among current clinical psychology trainees compared to previous generations.