Attitude to personality disorder among prison officers working in a dangerous and severe personality disorder unit Len Bowers a, ⁎ , Paola Carr-Walker a , Teresa Allan a , Patrick Callaghan a , Henk Nijman a,c , Jo Paton b a St Bartholomew School of Nursing and Midwifery, City University, Philpot St., London E1 2EA, UK b Safer Custody Group, HM Prison Service, UK c Radboud University, Nijmegen, The Netherlands Received 17 October 2004; received in revised form 9 September 2005; accepted 20 October 2005 Abstract Background: It is well established that staff attitudes to personality disordered patients are commonly negative, characterised by pessimism and rejection. A recent study in forensic psychiatric hospitals has described the psychological and social factors underlying positive attitudes, and suggested that staff with more positive attitudes perform better and are less stressed. Aim: To assess whether it is possible to predict which staff will adjust positively to working with personality disordered people. More specifically to confirm links between attitude to personality disorder and: job performance; perception of managers; personal well-being; burnout; and interaction rates with inmates. Methods: The opening of a new Dangerous and Severe Personality Disorder unit within a UK prison allowed a longitudinal study of prison officers to be performed, in which a number of measures, including the Attitude to Personality Disorder Questionnaire (APDQ), were collected at three fixed points (at baseline, eight and sixteen months after the opening of the unit). Results: Attitude to Personality Disorder varied over the course of the study, and changes in attitude were linked to events experienced by individual officers. More positive attitude to personality disorder was associated with improved general health and job performance, decreased burnout, and favourable perception of managers. Conclusions: Attitude to Personality Disorder has important outcomes, and is responsive to the psychosocial environment. Its measurement is not useful for staff selection, because of low stability over lengthy time periods. The APDQ has been demonstrated to be valid measure of attitude to PD, and potentially useful for outcome studies, or benchmarking between units. © 2006 Elsevier Inc. All rights reserved. 1. Background Personality disordered patients are generally not popular or well liked by psychiatric professionals. Numerous studies have demonstrated that the treatment of such patients is surrounded by pessimism, rejection and hostility (e.g. Gallop, Lancee, & Garfinkle, 1989; Lewis & Appleby, 1988). Hostile attitudes develop in response to the difficult behaviours of personality disordered patients, such as hostility, manipulation, uncooperativeness, acting in a way that is disconfirming of the professional role, and self-harming behaviours (Ganong, Bzdek, & Manderino, 1987; May & International Journal of Law and Psychiatry 29 (2006) 333 – 342 ⁎ Corresponding author. Tel.: +44 20 7040 5824; fax: +44 20 7040 5811. E-mail address: L.Bowers@city.ac.uk (L. Bowers). 0160-2527/$ - see front matter © 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.ijlp.2005.10.005