BPS Attitude Scale

Abstract

The BPS-Einstellungsskala (Schäfer et al., 2023), also referred to as the BPS Setting Scale or the BPS Attitude Scale, is a specialized self-report questionnaire developed to quantitatively assess stigmatizing attitudes among psychiatric staff toward patients diagnosed with Borderline Personality Disorder (BPD). The development of this German-language instrument was based on the conceptual framework established by two existing English scales developed by Bodner, Cohen-Fridel, and Iancu (2011): the Borderline Patient Cognitive Attitudes and Treatment Inventory (BPD-CAT) and the Borderline Patient Emotional Attitudes Inventory (BPD-EA).

The initial translation process involved 64 items (44 from BPD-CAT and 20 from BPD-EA), strictly adhering to the European Social Survey Translation Guidelines. After excluding items due to translational ambiguity and relevance, a refined set of 43 items was analyzed. The final validated instrument comprises 22 items, which were subjected to a principal component analysis (PCA) to confirm its factor structure. The scale demonstrates robust psychometric properties, including strong internal consistency and significant criterion validity, making it a reliable tool for measuring professional stigma in clinical settings.

Keywords

Borderline Personality Disorder, BPD Assessment of Suicide Risk, BPD Assumption of Manipulative Tendencies, BPD Treatment Difficulties, BPD-Negative Emotions, Psychiatric Staff, Stigmatizing attitudes, Self-report questionnaire, BPS-Einstellungsskala.

Authors

Schäfer, Marvin; Luck-Sikorski, Claudia; Hochrein, Regine; Schomerus, Georg; Gollek, Sabine.

Purpose

The primary purpose of the BPS-Einstellungsskala is to provide a quantitative, psychometrically sound measure for assessing the level and nature of stigmatizing attitudes held by healthcare professionals, specifically psychiatric staff, toward patients diagnosed with Borderline Personality Disorder.

This assessment tool is crucial for identifying areas where professional training or institutional interventions are needed to mitigate prejudice, ultimately aiming to improve the quality of care and therapeutic alliance for individuals with BPD.

Construct

The scale measures the construct of stigmatizing attitudes toward BPD patients, conceptualized across four distinct dimensions identified through factor analysis. These dimensions reflect the various ways staff members perceive and react to BPD symptoms and behaviors.

The four specific psychological constructs assessed by the scale’s subcomponents are: BPD treatment difficulties, BPD assessment of suicide risk, BPD assumption of manipulative tendencies, and BPD-negative emotions. By separating these components, the BPS-Einstellungsskala provides a nuanced understanding of the sources of professional stigma.

Validity

The BPS-Einstellungsskala demonstrates significant criterion validity, established primarily through its relationship with measures of criterion validity, particularly social distance (Angermeyer & Matschinger, 1997).

Specific findings regarding correlations with social distance include:

• A substantial positive correlation between the overall BPS attitude scale and social distance (p < 0.001).

• A significant positive relationship between social distance and the BPD difficulties in treatment subscale (p < 0.001).

• A large significant positive association between social distance and the BPS allegation of manipulative intentions (p < 0.001).

• A small but significant positive association between social distance and BPS-negative emotions (p < 0.001).

• The association between social distance and the BPD assessment of suicide risk subscale was not statistically significant (p = 0.067).

It is important to note that due to the absence of a normal distribution in the data, a Spearman correlation was conducted for social distance and BPS-negative emotions, which yielded a non-significant result (Spearman’s ρ = − .20, p = .056), highlighting potential complexity in the relationship between these specific variables.

Reliability

The BPS-Einstellungsskala demonstrates strong internal consistency, a key indicator of reliability, as measured by Cronbach’s alpha coefficients across the overall scale and its subscales.

The internal consistency values are reported as follows:

• Overall BPS-Einstellungsskala: Cronbach’s alpha = .90.

• BPD difficulties in treatment subscale: Cronbach’s alpha = .90.

• BPD assessment of suicide risk subscale: Cronbach’s alpha = .82.

• BPD assumption of manipulative intentions subscale: Cronbach’s alpha = .72.

• BPD-negative emotions subscale: Cronbach’s alpha = .84.

These values indicate that the items within the scale and its subscales measure their intended constructs consistently and reliably.

Factor Analysis

A Principal Component Analysis (PCA) was conducted on the final 22-item version of the BPS-Einstellungsskala to determine its underlying factor structure. The analysis successfully identified a robust four-principal component structure.

The identified components align precisely with the theoretical domains of stigma examined: BPD treatment difficulties, BPD assessment of suicide risk, BPD assumption of manipulative tendencies, and BPD-negative emotions. This four-factor model collectively accounts for 63.60% of the total explained variance, confirming the multidimensional nature of professional stigma towards BPD patients. Observed correlations between these principal components and the external criterion of social distance ranged from small to large.

Instrument

Test Type: Original Inventory/Questionnaire.

Format: The 22 items on the BPS-Einstellungsskala are rated using a five-point Likert scale, where responses range numerically from “1 = decline” to “5 = agree.”

Language Available: German.

Population Group: Human (Male and Female).

Age Group: Adulthood (18 years and older), including Young Adulthood (18-29 years), Thirties (30-39 years), and Middle Age (40-64 years).

Population Details: The validation study sample consisted of psychiatrists, psychologists, and nursing staff (i.e., psychiatric staff) located in Germany, with participant ages ranging from 21 to 62 years.

Test Methodology: The methodology employed in the development and validation of the BPS-Einstellungsskala includes rigorous psychometric procedures such as Test Validity, Criterion Validity, Test Reliability, Internal Consistency, Factor Analysis, Exploratory Factor Analysis, and Principal Component Analysis.

Keywords

Borderline Personality Disorder, BPD Assessment of Suicide Risk, BPD Assumption of Manipulative Tendencies, BPD Treatment Difficulties, BPD-Negative Emotions, Psychiatric Staff, Stigmas, Psychometrics.

Authors

Author ORCID Identifier: No data is Available.

Affiliation:

• Schäfer, Marvin: Forschungsgruppe COPE, SRH Hochschule für Gesundheit

• Luck-Sikorski, Claudia: Forschungsgruppe COPE, SRH Hochschule für Gesundheit

• Hochrein, Regine: Forschungsgruppe COPE, SRH Hochschule für Gesundheit

• Schomerus, Georg: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig

• Gollek, Sabine: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig

Affiliation Email addresses:

• Schäfer, Marvin: [email protected]

• Luck-Sikorski, Claudia: No data is Available

• Hochrein, Regine: No data is Available

• Schomerus, Georg: No data is Available

• Gollek, Sabine: No data is Available

Correspondence Address:

Schäfer, Marvin: SRH Hochschule für Gesundheit GmbH, Forschungsgruppe COPE, Neue Straße 28–30, Gera, Germany, 07548, [email protected]

Permissions & Fee and Test Year

Permissions: Contact Corresponding Author

Commercial: No

Fee: No

Test Year: 2023

Reference’s

Primary Reference:

Schäfer, M., Luck-Sikorski, C., Hochrein, R., Schomerus, G., & Gollek, S. (2023). Entwicklung eines Selbstauskunftsfragebogens zur Erfassung stigmatisierender Einstellungen des psychiatrischen Personals gegenüber Patienten mit Borderline-Persönlichkeitsstörung [Development of a self-report questionnaire for the measurement of stigmatizing attitudes of the psychiatric staff towards patients with borderline personality disorder]. Psychiatrische Praxis, 50(8), 424–430. doi:10.1055/a-2088-3629

Other References:

• Angermeyer, M. C., & Matschinger, H. (1997). Social distance towards people with mental illness.

• Bodner, E., Cohen-Fridel, E., & Iancu, I. (2011). Borderline Patient Cognitive Attitudes and Treatment Inventory (BPD-CAT).

• Bodner, E., Cohen-Fridel, E., & Iancu, I. (2011). Borderline Patient Emotional Attitudes Inventory (BPD-EA).

• European Social Survey. (2018). European Social Survey Translation Guidelines.

Items of the BPS Attitude Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

This measure consists of 22 items. The specific items are not provided in the given text.