Screening for Borderline Personality Disorder

The McLean Screening Instrument, SCID-5-PD and Others

Teenager taking test
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There are no specific tests that can diagnose borderline personality disorder (BPD); however, mental health professionals often use screening instruments to help them identify a particular diagnosis. Here are several common types of screening tools that may be used to diagnose BPD. 

1. The McLean Screening Instrument

The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) is a commonly used 10-item measure to screen for BPD.

 This measure was developed as a very brief paper-and-pencil test to detect possible BPD in people who are seeking treatment or who have a history of treatment.

The MSI-BPD was developed by Dr. Mary Zanarini and her colleagues at McLean Hospital. The test consists of 10 items that are based on the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria for borderline personality disorder. The first eight items of the MSI-BPD represent the first eight DSM-IV/5 diagnostic criteria for BPD, while the last two items assess the final DSM-IV/5 criterion, i.e., the paranoia/dissociation criterion.

Scoring of the MSI-BPD

Each item is rated as a "1" if it is present and a "0" if it is absent, and items are totaled for possible scores ranging from 0 to 10. A score of 7 has been determined to be a good diagnostic cut-off, meaning that a score of 7 or higher indicates that you are likely to meet criteria for borderline personality disorder.

Uses for the MSI-BPD

The MSI-BPD is a useful tool for detecting individuals who may have borderline personality features. It has not been tested in community samples, so it is not known whether it is good at detecting BPD in the general population. However, it has shown to be very effective in detecting possible BPD in people who are seeking treatment or who have a history of treatment for mental health problems.

Psychometric Properties of the MSI-BPD

The MSI-BPD has demonstrated good psychometric properties. It has adequate internal consistency and good test and retest reliability. It has also demonstrated good sensitivity and specificity for detecting borderline personality disorder when a score of 7 is used as a diagnostic cut-off.

2. Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD)

This official clinical interview of the American Psychiatric Association (APA) is an update of the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), but is very similar. Your mental health professional may use this screening tool to help find your diagnosis by asking you questions directly related to the criteria for BPD that are listed in the DSM-5.

This screening instrument also has an optional self-reporting questionnaire with 108 questions that you, the patient, can answer, but not all clinicians who choose the SCID-5-PD will use this. 

3. Personality Diagnostic Questionnaire, 4th Edition (PDQ-4)

This screening test consists of 99 true or false questions that can help screen for different personality disorders, including borderline personality disorder.

4. Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD)

This tool, also developed by Dr. Mary Zanarini, is used for patients who have already been diagnosed with BPD to see if there have been any changes over time.

Which Tool is Best?

A recent study using the first three of these screening methods with adolescents and young adults showed that the screening instrument were all equally effective in predicting a diagnosis of BPD.

Sources:

Zanarini MC, Vujanovic AA, Parachini EA, Boulanger JL, Frankenburg FR, Hennen J. "A Screening Measure for BPD: The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD)." Journal of Personality Disorders 17(6):568-573, 2003.

"Structured Clinical Interview for DSM-5® Personality Disorders (SCID-5-PD) ." American Psychiatric Association Publishing (2015).

"Personality Diagnostic Questionnaire for the DSM IV and DSM 5 ." The Official PDQ-4 Website. 

"Laboratory for the Study of Adult Development ." McLean Hospital (2016).

Van Alebeek, A., van der Heijden, P.T., Hessels, C., et. al. "Comparison of Three Questionnaires to Screen for Borderline Personality Disorder in Adolescents and Young Adults." European Journal of Psychological Assessment, Aug 28, 2015.

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