title: Stigma towards borderline personality disorder: effectiveness and generalizability of an anti-stigma program for healthcare providers using a pre-post randomized design.
abstract: BACKGROUND
  Stigmatization among healthcare providers towards mental illnesses can present obstacles to effective caregiving. This may be especially the case for borderline personality disorder (BPD). Our study measured the impact of a three hour workshop on BPD and dialectical behavior therapy (DBT) on attitudes and behavioral intentions of healthcare providers towards persons with BPD as well as mental illness more generally. The intervention involved educational and social contact elements, all focused on BPD.
  
  
  METHODS
  The study employed a pre-post design. We adopted the approach of measuring stigmatization towards persons with BPD in one half of the attendees and stigmatization towards persons with a mental illness in the other half. The stigma-assessment tool was the Opening Minds Scale for Healthcare Providers (OMS-HC). Two versions of the scale were employed - the original version and a 'BPD-specific' version. A 2x2 mixed model factorial analysis of variance (ANOVA) was conducted on the dependent variable, stigma score. The between-subject factor was survey type. The within-subject factor was time.
  
  
  RESULTS
  The mixed-model ANOVA produced a significant between-subject main effect for survey type, with stigma towards persons with BPD being greater than that towards persons with a mental illness more generally. A significant within-subject main effect for time was also observed, with participants showing significant improvement in stigma scores at Time 2. The main effects were subsumed by a significant interaction between time and survey type. Bonferroni post hoc tests indicated significant improvement in attitudes towards BPD and mental illness more generally, although there was a greater improvement in attitudes towards BPD.
  
  
  CONCLUSIONS
  Although effectiveness cannot be conclusively demonstrated with the current research design, results are encouraging that the intervention was successful at improving healthcare provider attitudes and behavioral intentions towards persons with BPD. The results further suggest that anti stigma interventions effective at combating stigma against a specific disorder may also have positive generalizable effects towards a broader set of mental illnesses, albeit to a lessened degree.
authors.affiliation: Opening Minds Anti-Stigma Initiative, Mental Health Commission of Canada, 110 Quarry Park Blvd, Suite 320, T2C 3G3 Calgary, AB Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Knaak
authors.affiliation: Opening Minds Anti-Stigma Initiative, Mental Health Commission of Canada, 110 Quarry Park Blvd, Suite 320, T2C 3G3 Calgary, AB Canada ; Department of Psychology, University of Calgary, 2500 University Dr. NW, T2N 1 N4 Calgary, Alberta Canada.
authors.forename: Andrew Ch
authors.initials: ACh
authors.lastname: Szeto
authors.affiliation: Department of Psychiatry, University of Calgary, DBT Program & Central Mental Health Clinic and Foothills Medical Centre, Calgary Zone, Alberta Health Services, Calgary, Canada.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Fitch
authors.affiliation: Opening Minds Anti-Stigma Initiative, Mental Health Commission of Canada, 110 Quarry Park Blvd, Suite 320, T2C 3G3 Calgary, AB Canada.
authors.forename: Geeta
authors.initials: G
authors.lastname: Modgill
authors.affiliation: Opening Minds Anti-Stigma Initiative, Mental Health Commission of Canada, 110 Quarry Park Blvd, Suite 320, T2C 3G3 Calgary, AB Canada ; Department of Community Health Sciences, University of Calgary, 4th Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6 Calgary, Alberta Canada ; Department of Psychiatry & Mathison Centre for Mental Health Research & Education, University of Calgary, 4th Floor TRW Building, 3280 Hospital Drive NW, T2N 4Z6 Calgary, Alberta Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Patten
keywords: Anti-stigma program; Borderline personality disorder; Dialectical behavior therapy; Healthcare providers; Psycho-education intervention; Social contact; Stigma