Staff feelings and patient diagnosis.
OBJECTIVE
To assess the associations between staff feelings toward patients and the patients' diagnoses, in view of the fact that clinical reports of such associations have not been corroborated by systematic research.


METHODS
At 24 psychiatric units, 143 patients were assessed according to their personality organization, and staff feelings toward these patients were followed for 5 years. The feelings were reported on a feeling checklist twice yearly, and outcome was assessed as the effect size at year 5, using ratings on Kernberg's structural model complemented with ratings on Strauss-Carpenter's function scale.


RESULTS
The study showed that it was possible, using discriminant analyses, to separate diagnostic groups by the different feelings that they evoked in the staff. Patients with borderline personality organization (BPO) evoked fewer relaxed and more aggressive feelings, in contrast to patients with psychotic personality organization (PPO). In contrast to patients with neurotic personality organization (NPO), who evoked feelings of sympathy and helpfulness, PPO patients evoked more feelings of insufficiency and disappointment. A stepwise discriminant analysis of reactions to patients with positive treatment outcome separated the 3 personality organizations with 2 functions using only 2 feelings, "relaxed" and "objective." The feeling relaxed separated the NPO patients from the BPO patients, and the feeling objective separated the PPO patients from the other groups. The patients' diagnoses accounted for larger proportions of variance in feelings for the patients with positive outcome.


CONCLUSIONS
The results implied that the patients' different personality organizations evoked different staff feelings in this treatment context and that positive treatment outcome was associated with more pronounced and clear-cut staff reactions.
Holmqvist
R
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Department of Education and Psychology, Linköping University, Sweden. rolfh@ipp.liu.se
D000293:Adolescent; D000328:Adult; D000339:Affect; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D009497:Neurotic Disorders / Q000175:diagnosis* / Q000523:psychology; D011369:Professional-Patient Relations; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology