Reliability and Validity of the Borderline Personality Disorder Severity Index

Abstract

The psychometric properties and validity of the Borderline Personality Disorder Severity Index (BPDSI), a semistructured interview assessing the frequency and severity of manifestations of Borderline Personality Disorder (BPD) during a circumscribed period, were investigated in two studies. In study 1, patients with BPD (n = 15), with other personality disorders (PD; n = 18), and without Axis II disorders (but with Axis I disorders; n = 10) assessed with the SCID were interviewed with the BPDSI (1-yr. version). Patients also filled out a number of questionnaires. A second rater judged taped BPDSI interviews. The BPDSI appeared to yield highly reliable (ICC = .93) and internally consistent (Cronbach's alpha = .85) scores. The BPDSI strongly discriminated BPD patients from other patients, and was not related to other Axis II pathology. Concurrent and construct validity was excellent. In study 2, a version of the BPDSI suitable for use in treatment outcome research was investigated (3-month version) in a sample of 64 BPD patients, 23 Cluster C PD patients, and 20 nonpsychiatric controls. Again, reliability coefficients were excellent (ICC = 0.97; Cronbach's alpha = 0.93), and validity indices were good. Clinical norms were also derived. In a sample of 28 BPD patients, the instrument detected improvement during 6 months of psychotherapy.

Intensive prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts

“…Potential predictors of treatment outcome were measured at baseline or early treatment and all variables were treated as continuous variables, unless otherwise indicated. Potential predictors were assigned to one of three domains: (1) the demographic domain: age, educational level (primary, secondary, vocational, higher vocational education, or university), and living condition (as a categorical variable: living alone vs. together with partner or other people like children or parents); (2) the clinical domain: PTSD symptom severity as assessed using the PSS-SR (Foa et al, 1993), depressive symptom severity as measured with the Beck Depression Inventory (BDI-II; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), dissociative symptom severity as assessed using the Dissociative Experiences Scale (DES; Bernstein & Putnam, 1986), current severity of borderline personality disorder manifestations as measured with the Borderline Personality Disorder symptom checklist (BPD-47 symptom checklist; Arntz et al, 2003), and psychoactive medication use (as a categorical variable: yes, no); and (3) the fear habituation domain: fear activation during the first exposure session, calculated as the highest given Subjective Units of Distress (SUD) rating (SUD peak) on a 0–10 point scale (no anxiety to maximum anxiety), within-session fear habituation during the first session, calculated as SUD peak minus the latest SUD rating at the end of the first exposure session, and between-session fear habituation, calculated as the difference between SUD peak scores from the first and second imaginal exposure session (Rauch, Foa, Furr, & Filip, 2004; van Minnen & Hagenaars, 2002). …”

Affect dysregulation, psychoform dissociation, and adult relational fears mediate the relationship between childhood trauma and complex posttraumatic stress disorder independent of the symptoms of borderline personality disorder

“…BPD symptoms were confirmed using the Personality Disorder Severity Index (BPDSI; Weaver & Clum, 1993; Dutch version IV, Arntz et al, 2003). The BPDSI is a semi-structured interview that contains nine sections (abandonment, relationships, self-image, impulsivity, parasuicide, affect, emptiness, anger, dissociation and paranoia) corresponding to the symptom clusters of BPD.…”

“…The BPDSI is a semi-structured interview that contains nine sections (abandonment, relationships, self-image, impulsivity, parasuicide, affect, emptiness, anger, dissociation and paranoia) corresponding to the symptom clusters of BPD. The BPDSI has good validity and reliability (Arntz et al, 2003). Cronbach’s alphas were adequate (for the subscales ranging from .70 to .93; and for the total score .96).…”

Fluvoxamine Reduces Responsiveness of HPA Axis in Adult Female BPD Patients with a History of Sustained Childhood Abuse

“…Subjects were recruited from outpatient mental health-care centers and by advertising. In order to be included in the fluvoxamine trial, all of the patients had to obtain a score of 110 or more on the borderline trait and distress scale of a self-report screener 'Assessment of DSM-IV Personality Disorder' (ADP-IV) (Schotte et al, 1998), meet more than 5 of the BPD criteria on the 'Structured Interview for DSM-IV Personality Disorders' (SIDP-IV) (De Jong et al, 1996;Pfohl et al, 1995), and receive a score of 20 or more on the fully structured 'Borderline Personality Disorder Severity Index' (BPDSI) (Arntz et al, 2002;Weaver and Clum, 1993).…”