Abstract
A proportion of individuals who are seen at accident and emergency following deliberate
self-harm (DSH) are admitted to the medical wards where they are psychiatrically assessed.
This exploratory study investigated the interaction between the psychiatrist who conducts
this interview and the patient. A sample of 60 DSH patients were seen immediately
following their interview with the psychiatrist. They completed questionnaires which
assessed personality disturbance and were asked questions regarding their experience of the
interview. At the same time the psychiatrist completed parallel measures which assessed
their experience of the interview. The comparison group consisted of 30 new Psychology
out-patients. They were recruited and assessed in the same way as the experimental group.
It was predicted that personality disorder / disintegration would be associated with poorer
therapeutic alliance and a repetition of particular patterns of interactions (including
avoidance, hostility or rescue). If demonstrated this would support the hypothesis that the
experience of the psychiatric interview may inadvertently perpetuate the individual's view
of the interpersonal world, which could then increase their likelihood of further
dysfunctional coping and decrease the likelihood of them gaining constructive mental
health.
The study also investigated the attitudes of staff working with this client group. Based on
previous research it was predicted that staff would hold quite negative attitudes about
deliberate self-harm. Within its theoretical framework, the study considered how such
attitudes may be present and how they may contribute to the interaction patterns described
above.
