Exploring Attitudes Towards The Power Threat Meaning Framework and Its Utility

Systematic literature review

A systematic literature review was conducted to explore the impact of a ‘bipolar disorder’ (BD) diagnosis on identity. Twenty papers representing 299 participants were identified and synthesised via thematic synthesis. The results indicated that participants’ identities were often negatively impacted following BD diagnosis, largely stemming from impositions of biomedical conceptualisations of distress and the associated stigma from societal discourses around BD. The impacts of BD on identity were both profound and varied. The results further question the appropriateness of medicalised conceptualisations of distress and highlight the need for clinicians to hold a range of conceptualisations in mind, and meaningfully explore these to co-construct preferred narratives.

Empirical research project

Given the polarised and heated debates about the Power Threat Meaning Framework (PTMF) and its utility, a Q-methodological study was undertaken with the aim of systematically exploring the nuanced perspectives on the Framework. Forty people with an interest in mental health sorted 58 statements to communicate their viewpoints regarding the utility of the PTMF. Four attitudes were identified: ‘An important development’ reflected the view of the Framework as a viable alternative to psychiatric diagnoses. ‘A possible adjunct to diagnoses’ positioned the Framework as having some uses, as well as significant limitations, meaning it could be used alongside diagnoses. The attitude represented by ‘Adds little to practice’ considered the Framework to offer little beyond existing models. ‘Flawed attack on psychiatry’ depicted the viewpoint that the Framework is an unnecessary and flawed attack on psychiatry. The factors convey a range of viewpoints towards the PTMF and its utility, highlighting key areas of difference and some commonality. All viewpoints expressed a desire for better communication between those with different perspectives on the Framework to support its development.