ABSTRACT

A personality disorder (PD) diagnosis can be considered by a patient to be stigmatizing. This presents interactional challenges for the clinician who makes the diagnosis and communicates it to the patient.Through an analysis of video-recorded clinical interviews of PD patients, we explore the anticipation and delivery of the diagnosis in psychiatry. The method of the study is conversation analysis (CA). The diagnostic evaluation process of each patient extends over a number of clinical interviews. At the beginning of the process, the clinicians speak about the personality disorder diagnosis in an anticipatory manner. At the end of the process, they eventually communicate it to the patients. This analysis focuses on the interactional practices used by psychiatrists to help a patient “save face” when mentioning the (prospective) diagnosis. We demonstrate that both the avoidance and corrective practices of face work occur in the data. Even with these prartices, the delivery of the diagnosis to the patent can lead to conflict. We conclude that, in extended diagnostic evaluation processes, the preparatory work by the clinician is important to secure patient participation.The data for this analysis are in Finnish.

摘要

人格障碍 (PD) 诊断可能被患者视为污名化。这给做出诊断并将其传达给患者的临床医生提出了互动挑战。通过对 PD 患者的临床访谈录像的分析，我们探讨了精神病学诊断的预期和交付。研究方法是对话分析（CA）。每位患者的诊断评估过程都涉及多次临床访谈。在这个过程的开始，临床医生以一种预期的方式谈论人格障碍的诊断。在过程结束时，他们最终将其传达给患者。该分析侧重于精神科医生在提及（预期）诊断时帮助患者“挽回面子”的互动实践。我们证明了面部工作的避免和纠正做法都出现在数据中。即使采用这些做法，向专利提供诊断也可能导致冲突。我们得出结论，在扩展的诊断评估过程中，临床医生的准​​备工作对于确保患者参与非常重要。该分析的数据为芬兰语。