Exploring the Pathways to Diagnosis for Men With Borderline Personality Disorder: A Qualitative Study.

J H Broadbear, M G Bhagwandas, S Crowley, L Cheney, S Rao
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Abstract

Borderline personality disorder (BPD) is often perceived as being more common in females, since women are more likely to seek help and be diagnosed. However, epidemiological studies have reported no sex differences in community prevalence. The purpose of this study was to learn from the narrative journeys of men who have received a diagnosis of BPD. Eight men participated, mean age 45.9 years (range 27-73 years). Recruitment was through clinician referrals at the study site and via social media and website advertising. Participants consented to a 60-90-min semi-structured interview via an audio-visual digital platform. Audio recordings were transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Three themes were identified: (i) The Emergence of Symptoms, (ii) Reaching Crisis Point and (iii) Receiving a Diagnosis. Participants reported many adverse experiences during childhood and adolescence. Early symptoms were often exacerbated by emotionally invalidating caregiving. Participants reported seeking mental health support only after reaching a crisis point, which often arose following an employment-related stressor. Participants typically initiated help-seeking by consulting a General Practitioner. Long delays were reported from initial help-seeking to being diagnosed with BPD; all expressed relief upon diagnosis. The findings highlight the deleterious consequences of emotional invalidation in participants' mental health and their capacity to access timely support. General Practitioners play a critical role in identifying probable symptoms of BPD in men and are the gateway to referral to psychiatrists and psychologists. It is vital that education is provided to assist their important work.

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探索边缘型人格障碍男性患者的诊断途径:定性研究。
边缘型人格障碍(BPD)通常被认为在女性中更为常见,因为女性更有可能寻求帮助和被诊断出来。然而,流行病学研究报告显示,社区发病率并无性别差异。本研究的目的是了解那些被诊断为 BPD 的男性的叙述历程。八名男性参与了这项研究,他们的平均年龄为 45.9 岁(27-73 岁不等)。研究人员是通过研究地点的临床医生转介以及社交媒体和网站广告招募的。参与者同意通过视听数字平台接受 60-90 分钟的半结构化访谈。采用解释性现象学分析法(IPA)对录音进行了转录和分析。确定了三个主题(i) 症状的出现;(ii) 达到危机点;(iii) 接受诊断。参与者报告了童年和青少年时期的许多不良经历。早期症状往往因情感上无效的照顾而加剧。参与者报告说,只有在达到危机点之后才会寻求心理健康支持,而危机点往往是在与就业相关的压力之后出现的。参与者通常是通过咨询全科医生开始寻求帮助的。据报告,从最初寻求帮助到被确诊为 BPD,中间经历了很长时间;所有参与者在确诊后都表示如释重负。研究结果凸显了情绪无效对参与者心理健康的有害影响,以及他们及时获得支持的能力。全科医生在识别男性 BPD 的可能症状方面起着至关重要的作用,也是将患者转介给精神科医生和心理学家的入口。提供教育以协助他们的重要工作至关重要。
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