Self Discovery

Self-Discovery: Understanding Yourself and Borderline Personality Disorder

We are here to assist you or your loved ones in exploring and understanding whether Borderline Personality Disorder (BPD) could be contributing to negative outcomes and symptoms. By combining insights from both symptom-based and object relations perspectives, we provide a comprehensive approach to self-assessment. This educational tool aims to illuminate the key aspects of BPD, guiding individuals in recognizing potential signs and understanding the underlying relational dynamics that may influence their experiences. Whether you are seeking clarity for yourself or considering our services, this page offers valuable questions and insights to aid in your self-discovery journey.

0 %

of individuals with BPD report severe functional impairment in their daily lives, impacting their relationships, work, and overall quality of life.

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years, on average, before receiving an accurate diagnosis, which can delay treatment and increase suffering.

0 %

of individuals with BPD experience self-harming behaviors at some point in their lives.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) — Overview of Borderline Personality Disorder

The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision)

The DSM-5-TR provides comprehensive criteria for diagnosing Borderline Personality Disorder (BPD). This section outlines the diagnostic criteria, features, and considerations for BPD according to the DSM-5-TR.

Scoring and interpretation

While the DSM-5-TR provides essential criteria for identifying Borderline Personality Disorder (BPD), it is important to note that this information is not a substitute for a professional diagnosis. According to the DSM-5-TR, a diagnosis of BPD is considered when an individual exhibits five or more of the specified criteria. These criteria include a pattern of instability in relationships, self-image, and emotions, among other symptoms.

Importance of Meeting Criteria

To be diagnosed with BPD, an individual must meet at least five of these criteria. This threshold ensures that the symptoms are not only present but also pervasive and significantly impact the person’s functioning and well-being. Meeting this criterion is essential for distinguishing BPD from other mental health conditions and for guiding appropriate treatment strategies.

Diagnostic Criteria

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)

2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

3. Identity disturbance: markedly and persistently unstable self-image or sense of self.

4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)

5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.5.

6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

7. Chronic feelings of emptiness.

8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD)

About the MSI-BPD

The MSI-BPD is used to help identify individuals who may have BPD by assessing specific symptoms associated with the disorder. It consists of a series of self-report questions or statements related to BPD symptoms. Respondents indicate the extent to which they experience each symptom.

The MSI-BPD is a well-validated and widely-used screener for BPD (Zimmerman & Balling, 2021). The ten items of the MSI-BPD are written such that a positive response indicates the presence of BPD symptoms.

Scoring and Interpretation

Each item is rated on a scale with “1“ corresponding to “present” and “0“ corresponding to “absent” and all items are written such that a positive responses indicate the presence of BPD symptoms. The total score ranges from 0 to 10.

A score greater than or equal to 7 is the cutoff for Borderline Personality Disorder (Zanarini et al., 2003).

If the score is 5 or 6, then further evaluation for BPD is recommended (Zimmerman & Balling, 2021).

Scores of 4 or less indicates the level of symptoms are not consistent with BPD.

Validity

The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) has shown good reliability and validity, with a Cronbach alpha of 0.78 (Zanarini et al., 2003). It correlates well with other BPD tools and effectively measures BPD as a global construct (Gardner & Qualter, 2009).

A cutoff score of 7 has been suggested for clinical use, with sensitivity of 81% and specificity of 89% (Zanarini et al., 2003). However, achieving 90% sensitivity might require a lower cutoff of 5 or 6 (Zimmerman & Balling, 2021), and a score of 5.5 or higher could be useful for adolescents (Noblin et al., 2013).

Developer

Zanarini, M. C., Vujanovic, A. A., Parachini, E. A., Boulanger, J. L., Frankenburg, F. R., & Hennen, J. (2003). A screening measure for BPD: the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). Journal of Personality Disorders, 17(6), 568–573. https://doi.org/10.1521/pedi.17.6.568.25355

Score 1 for "Present" and
Score 0 for "Absent"

1. Have any of your closest relationships been trouble by a lot of arguments or repeated breakups?

2. Have you deliberately hurt yourself physically (e.g. punched yourself, cut yourself, burned yourself)? How about made a suicide attempt?

3. Have you had at least two other problems with impulsivity (e.g. eating binges and spending sprees, drinking too much and verbal outbursts)?

4. Have you been extremely moody?

5. Have you felt very angry a lot of the time? How about often acted in an angry or sarcastic manner?

6. Have you often been distrustful of other people?

7. Have you frequently felt unreal or as if things around you were unreal?

8. Have you chronically felt empty?

9. Have you often felt that you had no idea of who you are or that you have no identity?

10. Have you made desperate efforts to avoid feeling abandoned or being abandoned (e.g., repeatedly called someone to reassure yourself that he or she still cared, begged them not to leave you, clung to them physically)?

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