Screening for Borderline Personality Disorder With the McLean Screening Instrument: A Review and Critique of the Literature

2019 ◽  
pp. 1-11 ◽  
Author(s):  
Mark Zimmerman ◽  
Caroline Balling
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
High Sensitivity ◽  
Screening Instrument ◽  
Borderline Personality ◽  
Self Report ◽  
Cutoff Score ◽  
Cutoff Scores ◽  
Diagnostic Detection

Borderline personality disorder (BPD) is underdiagnosed in clinical practice. One approach towards improving diagnostic detection is the use of screening questionnaires. It is important for a screening test to have high sensitivity because the more time-intensive/expensive follow-up diagnostic inquiry will presumably only occur in patients who are positive on the initial screen. The most commonly studied self-report scale specific for BPD is the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). We summarize the performance of the scale across studies, examine the performance of the scale using different cutoff scores, and highlight the approach used by investigators in recommending a cutoff score. Most studies of the scale have taken a case-finding approach in deriving the cutoff score on the scale instead of a screening approach. For the purposes of screening, it may be more appropriate for the cutoff score on the MSI-BPD to be less than the currently recommended cutoff of 7.

scholarly journals Validation of the French version of the McLean Screening Instrument for Adolescent Borderline Personality Disorder (MSI-BPD)

2020 ◽  
Author(s):  
Bojan Mirkovic ◽  
Mario Speranza ◽  
Lionel Cailhol ◽  
Julien-Daniel Guelfi ◽  
Fernando Perez-Diaz ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychometric Properties ◽  
High Sensitivity ◽  
High Specificity ◽  
Structured Interview ◽  
Screening Instrument ◽  
Borderline Personality ◽  
French Version ◽  
Low Sensitivity

Abstract Background: The study examines the psychometric properties of the French version of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) created by M. Zanarini to screen borderline personality disorder in clinical and non-clinical populations.Method: In this multicentric longitudinal study from the European Network on Borderline Personality Disorder, a sample of 84 adolescent patients from five psychiatric centres and 85 matched controls without psychiatric comorbidity completed the MSI-BPD, French version, and were interviewed with the Structured Interview for DSM-IV Personality (SIDP-IV), in order to assess the presence or absence of borderline personality disorder.Results: The MSI-BPD showed excellent internal consistency (α = 0.87 [0.84;0.90]). Compared to the semi-structured reference interview (SIDP-IV), the MSI-BPD showed substantial congruent validity (AUC = 0.93, CI 95%: 0.90 - 0.97). The optimal cut-off point in the present study was 5 or more, as it had relatively high sensitivity (0.87) and specificity (0.85). In our sample, the cut-off point (7 or more) proposed by the original developers of the MSI-BPD showed high specificity (0.95) but low sensitivity (0.63).Conclusions: The French version of the MSI-BPD is now available, and its psychometric properties are satisfactory. The French version of the MSI-PBD can be used as a screening tool for borderline personality disorder, for clinical purposes or in research studies.

scholarly journals Validation of the French version of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD)

2020 ◽  
Author(s):  
Alexandra Pham-Scottez ◽  
Bojan Mirkovic ◽  
Lionel Cailhol ◽  
Julien-Daniel Guelfi ◽  
Fernando Perez-Diaz ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychometric Properties ◽  
High Sensitivity ◽  
High Specificity ◽  
Structured Interview ◽  
Screening Instrument ◽  
Borderline Personality ◽  
French Version ◽  
Low Sensitivity

Abstract Background The study examines the psychometric properties of the French version of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) created by M. Zanarini to screen borderline personality disorder in clinical and non-clinical populations. Method In this multicentric longitudinal study from the European Network on Borderline Personality Disorder, a sample of 85 adolescent patients from five psychiatric centres and 85 matched controls without psychiatric comorbidity completed the MSI-BPD, French version, and were interviewed with the Structured Interview for DSM-IV Personality (SIDP-IV), in order to assess the presence or absence of borderline personality disorder. Results The MSI-BPD showed excellent internal consistency (α = 0.87 [0.84;0.90]). Compared to the semi-structured reference interview (SIDP-IV), the MSI-BPD showed substantial congruent validity (AUC = 0.93, CI 95%: 0.90 - 0.97). The optimal cut-off point in the present study was 5 or more as it had relatively high sensitivity (0.87) and specificity (0.85). In our sample, the cut-off point (7 or more) proposed by the original developers of the MSI-BPD showed high specificity (0.95) but low sensitivity (0.63). Conclusions The French version of the MSI-BPD is now available, and its psychometric properties are satisfactory. The French version of the MSI-PBD can be used as a screening tool for borderline personality disorder, for clinical purposes or in research studies.

Predictors of 18-month outcome for patients with borderline personality disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1026-1026 ◽  
Author(s):  
D. Karaklic ◽  
J. Thuile ◽  
B. Granger ◽  
I. Secret ◽  
C. Bungener
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Life Events ◽  
Borderline Personality ◽  
Self Report ◽  
Global Functioning ◽  
Borderline Patients

IntroductionFor quite a long time, borderline personality disorder (BPD) has been viewed as a chronic disorder and borderline patients as extremely difficult to treat. However, those views are changing and there is an increasing recognition that the BPD has a far more benign course than previously thought, but predictors of its outcome remain poorly explored.Objective and aimsThe purpose of this study was to determine the most clinically relevant predictors of the outcome of BPD at the 18-month follow-up.MethodsBorderline patients (n = 75) were compared to patients with other personality disorders (OPD) (n = 40). All subjects were assessed at baseline and 6, 12, and 18 months with a series of semi structured interviews (personality disorders, global functioning, mental disorders, life events, …) and self-report measures (alexithymia and impulsivity). Logistic regression was used to estimate hazard ratios.ResultsAt the 18-month follow up, 57 BPD patients and 22 with OPD have been evaluated, 45% of borderline subjects and 50% of the OPD subjects achieved remission. Low impulsivity, low alexithymia, good global functioning, and older age at onset of symptoms were found to be significant predictors of good outcome of BPD. Our clinical data suggest that life events and the quality of current relationships are determinant in the outcome of BPD.Conclusions45% of patients with BPD are likely to improve in 18-months. Specific factors, such as impulsivity, alexithymia, life events and quality of current relationships, determine the short-term outcome of this disorder.

scholarly journals Predictors of suicide attempts in patients with borderline personality disorder over 16 years of prospective follow-up

2012 ◽  
Vol 42 (11) ◽  
pp. 2395-2404 ◽  
Author(s):  
M. M. Wedig ◽  
M. H. Silverman ◽  
F. R. Frankenburg ◽  
D. Bradford Reich ◽  
G. Fitzmaurice ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Self Report ◽  
Time Varying ◽  
Post Traumatic Stress ◽  
Completed Suicide ◽  
Self Harm

BackgroundIt is clinically important to understand the factors that increase the likelihood of the frequent and recurrent suicide attempts seen in those with borderline personality disorder (BPD). Although several studies have examined this subject in a cross-sectional manner, the aim of this study was to determine the most clinically relevant baseline and time-varying predictors of suicide attempts over 16 years of prospective follow-up among patients with BPD.MethodTwo-hundred and ninety in-patients meeting Revised Diagnostic Interview for Borderlines (DIB-R) and DSM-III-R criteria for BPD were assessed during their index admission using a series of semistructured interviews and self-report measures. These subjects were then reassessed using the same instruments every 2 years. The generalized estimating equations (GEE) approach was used to model the odds of suicide attempts in longitudinal analyses, controlling for assessment period, yielding an odds ratio (OR) and 95% confidence interval (CI) for each predictor.ResultsNineteen variables were found to be significant bivariate predictors of suicide attempts. Eight of these, seven of which were time-varying, remained significant in multivariate analyses: diagnosis of major depressive disorder (MDD), substance use disorder (SUD), post-traumatic stress disorder (PTSD), presence of self-harm, adult sexual assault, having a caretaker who has completed suicide, affective instability, and more severe dissociation.ConclusionsThe results of this study suggest that prediction of suicide attempts among borderline patients is complex, involving co-occurring disorders, co-occurring symptoms of BPD (self-harm, affective reactivity and dissociation), adult adversity, and a family history of completed suicide.

Prediction of Treatment Outcome of Adolescents With Borderline Personality Disorder: A 2-Year Follow-Up Study

2021 ◽  
pp. 1-20
Author(s):  
Erik Simonsen ◽  
Martin Vestergaard ◽  
Ole Jakob Storeb⊘ ◽  
Sune Bo ◽  
Mie Sedoc J⊘rgensen
Keyword(s):  
Treatment Outcome ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Self Report ◽  
Oppositional Defiant ◽  
Positive Treatment ◽  
Personality Features ◽  
Borderline Personality Features

This study examined prediction of various clinical outcomes in adolescents with borderline personality disorder (BPD) features. Of the 112 adolescents who participated at baseline, 97 were seen at 2-year follow-up, of which 49 (50.5%) had clinically improved, defined as a decrease in BPD pathology of minimum 12 points on the Borderline Personality Features Scale for Children (BPFS-C). Eighty-one adolescents fulfilled the diagnostic criteria for BPD and scored above clinical cutoff on the BPFS-C at baseline, of which 26 (32%) had remitted at follow-up by self-report on the BPFS-C. Results showed that adolescents with comorbid oppositional defiant disorder at baseline were less likely to have clinically improved or remitted at follow-up. Participants with increased self-reported depression and less exposure to physical abuse at baseline had increased odds of remission. Our findings suggest that more internalizing and less externalizing symptoms increase the odds of positive treatment outcome in adolescents with BPD.

Emotion-Oriented Coping Style Predicts Self-Harm in Response to Acute Psychiatric Hospitalization

Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Jacqueline M. Frei ◽  
Vladimir Sazhin ◽  
Melissa Fick ◽  
Keong Yap
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychiatric Hospitalization ◽  
Coping Styles ◽  
Psychiatric Inpatients ◽  
Borderline Personality ◽  
Self Report ◽  
Therapeutic Interventions ◽  
Coping Behaviors ◽  
Self Harm

Abstract. Psychiatric hospitalization can cause significant distress for patients. Research has shown that to cope with the stress, patients sometimes resort to self-harm. Given the paucity of research on self-harm among psychiatric inpatients, a better understanding of transdiagnostic processes as predictors of self-harm during psychiatric hospitalization is needed. The current study examined whether coping styles predicted self-harm after controlling for commonly associated factors, such as age, gender, and borderline personality disorder. Participants were 72 patients (mean age = 39.32 years, SD = 12.29, 64% male) admitted for inpatient treatment at a public psychiatric hospital in Sydney, Australia. Participants completed self-report measures of coping styles and ward-specific coping behaviors, including self-harm, in relation to coping with the stress of acute hospitalization. Results showed that younger age, diagnosis of borderline personality disorder, and higher emotion-oriented coping were associated with self-harm. After controlling for age and borderline personality disorder, higher levels of emotion-oriented coping were found to be a significant predictor of self-harm. Findings were partially consistent with hypotheses; emotion-oriented but not avoidance-oriented coping significantly predicted self-harm. This finding may help to identify and provide psychiatric inpatients who are at risk of self-harm with appropriate therapeutic interventions.

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