Sara Cohen-Fridel

Staff attitudes toward patients with borderline personality disorder

OBJECTIVE Our aims were (1) to develop 2 inventories for the measurement of cognitive and emotional attitudes toward borderline personality disorder (BPD) patients and their treatment and (2) to use these tools to understand and compare attitudes of psychiatrists, psychologists, and nurses toward BPD patients. METHOD Two lists of items referring to cognitive (47 items) and emotional attitudes (20 items) toward BPD patients were formulated. Fifty-seven clinicians (25 nurses, 13 psychologists, and 19 psychiatrists), who had been working in public psychiatric institutions for more than 1 year, rated their level of agreement with each item. The list of cognitive attitudes yielded 3 factors (required treatment, suicidal tendencies, and antagonistic judgment). The list of emotional attitudes yielded 3 other factors (negative emotions, experienced difficulties in treatment, and empathy). RESULTS Psychologists scored lower than psychiatrists and nurses on antagonistic judgments, whereas nurses scored lower than psychiatrists and psychologists on empathy. Regression stepwise analyses conducted on the 3 emotional attitudes separately showed that suicidal tendencies of BPD patients mainly explained the negative emotions and the difficulties in treating these patients. All groups were interested in learning more about the treatment of these patients. CONCLUSIONS Suicidal tendencies of BPD patients provoke antagonistic judgments among the 3 professions. Nevertheless, psychiatrists, psychologists, and nurses hold distinctive cognitive and emotional attitudes toward these patients. Mapping these differences can improve the education and training in the management of BPD patients.

Different dimensions of ageist attitudes among men and women: a multigenerational perspective

BACKGROUND Ageism, a form of prejudice in which one relates negatively to people due to their age, exists throughout life. However, no attempt has been made to compare ageist attitudes across the life cycle, from young adulthood to old age. Consequently, the current study examined age and gender differences in ageism throughout adulthood. METHODS 955 Israeli participants (age range: 18-98 years) were divided into three age-groups: young (18-39), middle-aged (40-67), and old (68-98), and were administered the Fraboni Scale of Ageism. Age and gender differences were examined both for the three groups and for subgroups within the older adult cohort. RESULTS Multivariate analysis of variance revealed that middle-aged participants were significantly more ageist than younger and older groups. Across all age groups, men exhibited more avoidance and stereotypical attitudes toward older adults than women. Among the old age group, participants aged 81-98 held more ageist stereotypes and reported more avoidance of older adults than those aged 68-73. Within the older adult cohort, gender was a significant predictor for ageist attitudes among those aged 68-73 and 81-98, but not for people aged 74-80. CONCLUSIONS Ageism demonstrates a changing pattern across the life span. While gender differences remain stable, ageist attitudes toward growing old as we age ourselves are constantly changing. In order to gain a better understanding of ageism as a general and global phenomenon, we need to consider the role of such attitudes in different stages of life.

Relations between attachment styles, ageism and quality of life in late life

BACKGROUND This study is the first to explore the relations between attachment styles, ageism, and quality of life (QoL) among elderly people. The attachment theory describes how human beings relate to each other, according to their attachment style. Previous studies have examined the connection between attachment styles and prejudice toward distinctive social groups and minorities. Ageism as a form of prejudice is a way of relating negatively to people because they are old. QoL among the elderly was found to be associated with negative age-perceptions. It was therefore hypothesized that QoL, attachments styles, and demographic characteristics can explain ageism among the elderly. METHODS Four questionnaires were administered: Fraboni Scale of Ageism (FSA), which comprises four scales (separation, affective, stereotype, and intergeneration); Experiences in Close Relationships Scale, which measures four attachment styles (secure, dismissive, fearful, and preoccupied); SF-36 health status inventory (eight scales); and sociodemographic questions. Ninety-four elderly men and women aged 64-85 years living in the community completed the questionnaires. RESULTS MANCOVAS indicated that securely attached individuals score lower [corrected] than fearfully attached individuals, and that securely and dismissively attached individuals score higher than fearful and preoccupied individuals on seven QoL scales. Multiple regression analyses showed that attachment styles, age, gender, and some QoL scales contribute to the explained variance of ageism. CONCLUSIONS Secure attachment in late life seems to be related to less ageism and a better QoL. The enhancement of a secure attachment base in elderly people may assist in moderating ageism and improving older peoples QoL.

Cross-cultural ageism: ageism and attitudes toward aging among Jews and Arabs in Israel.

BACKGROUND While it is generally agreed that traditional societies are more favorable toward their elders, research findings have been inconsistent. Accordingly, this study presents a cultural comparison between Jews and Arabs in Israel in attitudes toward older adults and personal views regarding ones own aging. It was assumed that Arabs would rate their culture as more tolerant toward older adults, would report spending more time with them, and express lower ageism and aging anxieties. METHOD We examined 154 native Israeli citizens, 86 Jewish and 68 Muslim Arabs, who completed measures of ageism, aging anxieties, and cultural views of older adults. RESULTS Arabs rated their culture as more tolerant toward their elders, perceived older adults as significantly more contributing to society, and reported engaging in less avoiding behaviors toward them. Arabs also exhibited less general fears of growing old and concerns over ones physical appearance in old age. But it was interesting to note that Arab women reported higher scores of aging anxieties and ageist attitudes in comparison to Arab men, whereas no such differences were found among Jews. CONCLUSIONS Our findings point that the cultural importance of elders for the Arab cohort transcends beyond Westernization processes which affect the Arab society in Israel, and reflect the demanding role of Arab women as primary caregivers for the elders in the family. Limitations and implications of the study are discussed.

The Paths Leading From Attachment to Ageism: A Structural Equation Model Approach

The study introduces a model in which attachment patterns serve as predictors, empathy and fear of death as mediators, and ageism as the predicted variable. Data were collected from young adults (N = 440). Anxious attachment was directly and positively correlated with ageism, and also indirectly and positively by the mediator “fear of death.” Avoidant attachment was indirectly and negatively correlated with ageism by the mediator “empathy”. It is suggested that interventions for reducing ageist attitudes among younger adults would focus on existential fears, as well as on empathic ability, according to the attachment tendencies of these individuals.

The effect of exposure to missile attacks on posttraumatic stress disorder symptoms as a function of perceived media control and locus of control.

Exposure is one of the most robust predictors of post-traumatic stress disorder (PTSD) symptoms in warfare situations. Yet, while many are sensitive to exposure, others do not develop PTSD. In the current study, we address how perceived media control along with external locus of control moderate effects of exposure on PTSD symptoms among 1268 individuals exposed to missile attacks (mean age=36.97). We expected that the coupling of low perceived media control, whereby one feels poor control over media consumption (an inability to stop), especially when irrelevant and non-informative (e.g., involuntarily viewing the same terror incident shown repeatedly in a looped fashion) along with a self-perception of external locus of control, will render participants highly vulnerable to exposure. As expected, results suggest that effects of exposure on PTSD are not automatic, rather, the coupling of both low media control along with believing that life event are controlled by external factors exacerbates effects of exposure. These findings bear practical implications, as both media control and locus of control can be modified by therapeutic interventions, rendering one less vulnerable to the detrimental effects of traumatic exposure.

P03-03 - Perceived quality of life and ageism among elderly people living in sheltered housing and in the community

Introduction Although there are studies on ageist attitudes and perceptions of quality of life (QoL) among elderly people, no publications exist that compare ageist attitudes and QoL perceptions among elderly people who live in private sector sheltered housing (PRSSH) and in the community. Objectives To map the differences and understand the relations between QoL and negative social perceptions of one’s own age group among older adults, living in PRSSH and in the community. Aims (1) To examine if there are differences in ageist attitudes and perceptions of quality of life (QoL), and (2) to understand the role of QoL in explaining ageist attitudes among these two groups of elderly people. Methods The sample included 126 participants, aged 64–94, who live in PRSSH or in the community. The participants completed Fraboni et al. scale of ageism, a QoL inventory (SF-36 inventory), which provides scores on measures such as physical functioning, mental health and social functioning, and answered demographic questions. Results Multivariate analyses of covariance (MANCOVA) partially supported our hypotheses that elderly people who live in PRSSH will demonstrate more ageist attitudes towards people of their own age, and report a lower QoL than elderly people who live in the community. Gender also had a distinctive effect on ageism and QoL among individuals in PRSSH. These findings were supported by regression analyses. Conclusions Although PRSSH may offer luxurious living conditions, the current study shows that living in an age segregated environment, may trigger negative self-perceptions of old age and decrease QoL.

EPA-1169 – The attitudes of psychiatric hospital directors and workers toward hospitalization and treatment of patients with borderline personality disoroder (BPD)

Introduction Negative attitudes towards treatment hospitalization of patients with borderline personality disorder (BPD) exist among mental health clinicians. These attitudes could affect the treatment administered to these patients, the length of hospitalization and its cost. Objectives To establish recommendations for health officials regarding the hospitalization and treatment of BPD patients in order to shorten the length of hospitalization of patients with BPD and improve the quality of their treatment. Aims A thorough examination of the attitudes towards BPD patients among four professions (psychiatrists, psychologists, social workers and nurses) in four hospitals, and of the directors of the hospitals and of several wards, so as to evaluate their policy regarding the admission and the treatment of BPD patients. Methods We administered questionnaires on explicit and implicit attitudes towards these patients to 710 clinicians in 4 hospitals in Israel, and interviewed the hospitals’ directors and several ward directors. We collected data on the hospitalizations of patients with BPD during the period 2009-2011 and analyzed differences on these measures between professions and hospitals. Results Nurses and psychiatrists had the most negative attitudes towards these patients, and differences were noted between hospitals. While hospital D was characterized by more negative attitudes, less negative attitudes were found in hospital A, and accordingly the longer were admissions and hospitalizations’ costs in this hospital. Conclusions Nurses and psychiatrists are likely to express negative attitudes towards these patients. Possibly, the directors’ attitudes and policy influenced lengths of the hospitalizations and costs of treatment of BPD patients.