Oh G-d, A Borderline: Clinical Diagnostics As Fundamental Attribution Error Page: 13
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Borderline personality disorder. Personality disorders have a particular stigma about
them that is distinct from the stigma associated with other DSM disorders. A particular disorder
classified in the DSM, and the one that was used in the present study, is borderline personality
disorder (BPD). Like all Axis II (personality) disorders, BPD refers to an "enduring pattern" of
maladaptive behavior that is pervasive, causes significant distress, and is not due to a physical
illness (APA, 2000, p. 689). People diagnosed with BPD are thought to show a "pervasive
pattern of instability of interpersonal relationships, self-image, and affects, and marked
impulsivity that begins by early adulthood and is present in a variety of contexts" (APA, 2000, p.
706). Related to their "pervasive" and "enduring" natures and to a lifetime of personality
development they are thought to be particularly hard disorders to treat. As a result, mental health
workers tend to stigmatize these clients to some extent and treat them as though they are hard to
deal with (Netwon-Howes, Weaver, and Tyrer, 2008). In particular, BPD is known to receive a
heightened level of stigma from the public and mental health professionals and that stigma can
negatively impact the course of treatment (Aviram et al., 2006). Interestingly, Burns and Nolen-
Hoeksema (1992) found that participants diagnosed with BPD fared worse than other
participants with other diagnoses even though levels of one particular component of a strong
therapeutic relationship, empathy, were not different. The authors (Burns & Nolen-Hoeksema,
1992) note that clients exhibiting Axis II-type behaviors tend to idealize therapists, even when
therapeutic gains are not being made, or for fear of conflict rate therapist empathy higher than
their experience might otherwise suggest.
Theoretically, from an attribution theory model, disorders on Axis II inherently cannot be
considered to be of biological etiology and are therefore more likely to be seen as a reflection of
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Schmalz, Jonathan. Oh G-d, A Borderline: Clinical Diagnostics As Fundamental Attribution Error, thesis, December 2011; Denton, Texas. (digital.library.unt.edu/ark:/67531/metadc103389/m1/19/: accessed January 22, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .