Psychometric Properties of the Chinese Version of the Brief Borderline Symptom List in Undergraduate Students and Clinical Patients

Abstract

The brief version of the Borderline Symptom List (BSL-23) is a self-rated scale developed from the initial 95-item version of Borderline Symptom List (BSL-95). The current study aimed to evaluate the psychometric properties of the Chinese version of the BSL-23. A total of 570 undergraduate students and 323 clinical patients completed the BSL-23, the borderline subscale of the Personality Diagnostic Questionnaire (PDQ-4+), the Center for Epidemiologic Studies Depression Scale (CES-D), the Barratt Impulsiveness Scale, 11th version (BIS-11), the Childhood Trauma Questionnaire (CTQ) and the Attachment Style Questionnaire (ASQ). A Confirmatory Factor Analysis (CFA) was conducted to test the one-factor structure of the BSL-23. Cronbach’s alpha, Omega coefficient, Split-Half coefficient, Mean Inter-Item Correlation (MIC) and test-retest reliability were also measured. The correlations between the BSL-23 and other psychological variables were used to assess criterion-related validity and convergent validity. Participants who scored ≥ 5 on the borderline subscale of the PDQ-4+ were placed into the borderline personality disorder (BPD) screening-positive group, while the others were placed into the screening-negative group. Independent sample t-tests were performed to examine the differences in BSL-23 scores between the BPD screening-positive group and the BPD screening-negative group. The CFA results supported the one-factor structure of the BSL-23 in both samples. The internal consistency was high both in the undergraduate sample (Cronbach’s α = 0.93, Omega = 0.95, Split-Half coefficient = 0.89, MIC = 0.38) and the clinical sample (Cronbach’s α = 0.97, Omega = 0.97, Split-Half coefficient = 0.96, MIC = 0.56). The test-retest reliability within 2 weeks was 0.62. The BSL-23 displayed moderate to high correlations with the PDQ-4+-Borderline subscale, the CES-D, the BIS-11, the CTQ and the ASQ (r = 0.35 – 0.70). In addition, the BSL-23 discriminated between the BPD screening-positive and the BPD screening-negative participants, and also between the patient sample and undergraduate sample. In conclusion, the Chinese version of the BSL-23 has satisfactory psychometric properties to assess BPD symptoms.

A proposed severity classification of borderline symptoms using the borderline symptom list (BSL-23)

“…The BSL-23 has one highly dominant eigenvalue that reflects its single factor structure and has good to excellent psychometric properties [21]. These properties have been replicated in several studies that validated the translations of the BSL-23 [24][25][26] into 18 foreign languages [23]. Both the BEST and BSL-23 were not constructed as diagnostic or screenings instruments; accordingly, they provide no cut-off scores.…”

Insecure attachment and maladaptive emotion regulation mediating the relationship between childhood trauma and borderline personality features

“…The BSL‐23 consists of 23 items regarding the subjective severity of BPD symptomatology in the past week (Bohus et al, 2009; H. Yang et al, 2018). Participants are required to indicate the extent of their suffering from 0 to 4, with a total score ranging from 0 to 92.…”

“…Another important psychosocial factor in the development of BPD is attachment style (Buchheim et al, 2017; Choi‐Kain, Fitzmaurice, Zanarini, Laverdière, & Gunderson, 2009; Levy, Johnson, Clouthier, Scala, & Temes, 2015). Secure parental attachment is crucial for the healthy development of children and can prevent adverse mental outcomes (Cotter, Kaess, & Yung, 2015; Mikulincer & Shaver, 2007), whereas, both interview‐based (Buchheim et al, 2017; Pace, Guiducci, & Cavanna, 2017) and self‐report research (Frias, Palma, Farriols, Gonzalez, & Horta, 2016; H. Yang et al, 2018) have found that BPD features were highly correlated with insecure attachment styles. Specifically, BPD patients usually demonstrate unresolved, fearful, and preoccupied attachment styles, accompanied by interpersonal dysfunction (Buchheim et al, 2017; Fischer‐Kern et al, 2015; Levy et al, 2006).…”

Structural and Functional Connectivity of the Anterior Cingulate Cortex in Patients With Borderline Personality Disorder

“…Patients with BPD have been shown consistently to be hypersensitive to negative emotional stimuli, with emotional dysregulation and negative regulatory strategies that are often accompanied by anxiety and depression (Yen et al, 2002; Niedtfeld et al, 2010; Schulze et al, 2016; Yang et al, 2018). The present findings of significantly higher SAIS-negative affectivity, CERQ-negative subscale, CES-D, and STAI scores in BPD patients than HCs are consistent with heightened negative intensity, depression, and anxiety levels as well as reliance on negative emotion cognition regulation strategies in BPD.…”