Experiences of loneliness among people with a diagnosis of 'personality disorder': A qualitative interview study in the UK.

Loneliness is common among people diagnosed with a 'personality disorder' and addressing this is a recovery goal. Little qualitative research has explored the experience of loneliness among people with a diagnosis of 'personality disorder'. This study aimed to provide an in-depth understanding of loneliness among people with a 'personality disorder' diagnosis, and approaches used to alleviate it, informing future psychosocial intervention co-production. We conducted semi-structured interviews with 16 people in the United Kingdom from a range of sociodemographic backgrounds via charities and research networks. Data were analysed using reflexive thematic analysis. We identified five overarching themes: 1) the experience of loneliness, 2) the mutually reinforcing relationship between loneliness and mental health difficulties, 3) the perceived origins of loneliness, 4) a unique form of stigma, and 5) recovery rooted in managing to find a sense of belonging. Our findings suggest that loneliness is a painful and enduring experience that participants perceived to originate from invalidating early childhood experiences. These early experiences contributed to ongoing feelings of loneliness, persisting into adulthood. Loneliness was perceived to compound features of 'personality disorder' and vice versa. Experiences of stigma and discrimination related to the diagnosis of 'personality disorder' and any protected characteristics presented another barrier to achieving connections with others, further playing into an apparent mutually reinforcing relationship between loneliness and features of 'personality disorder'. Our findings indicate a clear need to address loneliness in this group. The findings help identify potential targets for psychosocial interventions aimed at reducing loneliness and promoting social connectedness in people with a diagnosis of 'personality disorder'. Psychosocial interventions, combining valued group-based activities and/or safe social relationships alongside developing psychological skills for self-understanding and acceptance, have the potential to reduce feelings of loneliness.