An examination of how the label ‘antisocial personality disorder’ affects staff’s causal attributions of challenging behaviour and how stress interacts with this process : & clinical research portfolio

• Main Author: Keenan, Gwen
• Published: University of Glasgow 2010
• Subjects: 155; RT Nursing : BF Psychology
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.524030

The aim of this study was to investigate the effects of the diagnostic label ‘antisocial personality disorder’ on health care staff’s causal attributions of challenging behaviour, their emotional responses to that challenging behaviour, their optimism about treatment and behavioural change and their propensity to help. Of additional interest was how three aspects of burnout might impact on the above variables. This study employed a between subjects questionnaire methodology. There were 62 participants that comprised of healthcare staff working in low and medium secure mental health settings. Participants were given a case vignette describing a challenging behaviour. In one group, the character in the case vignette was described as having a diagnosis of ‘antisocial personality disorder’, in another group he was described as having a diagnosis of ‘schizophrenia’ and in the third group no diagnosis was provided. Participants then rated the causal attributions, emotional responses, optimism and helping behaviour. All ratings were taken on seven point bipolar scales. Finally they completed the Maslach Burnout Inventory (1996). Participants who were given the vignette with the ASPD diagnosis gave higher ratings for causal attributions of control. The no label group responded with the highest ratings of anger. On the sample as a whole, attributions of controllability and internality were correlated. Controllability was correlated with emotional responding and helping behaviour. Optimism was correlated with helping behaviour. Emotional exhaustion was associated with attributions of controllability and internality. Depersonalisation was also associated with attributions of controllability. Diminished personal accomplishment was associated with optimism. The label antisocial personality disorder may influence how staff make causal attributions of control. This may have implications for how staff respond to such patients. Attributions of control were associated with more anger, less sympathy and less helping behaviour. In addition staff that are experiencing high levels of stress may also have been more vulnerable to making attributions of control. This study found that qualified nursing staff were more likely to experience stress. These findings are discussed in relation to current literature and the clinical implications are described particularly in relation to the formulation of interventions for healthcare staff.