Mclean screening instrument for borderline personality disorder scoring

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Highlights

McLean Screening Instrument data were collected in a clinical cohort

Scores were related to retrospectively-reported trauma, and time attitudes

Scores were also related to variables gathered up to 20 years previously

Individuals explained why they endorsed items in interviews

Abstract

Borderline Personality Disorder is a severe psychiatric disorder with debilitating consequences. Screening for the disorder is problematic as symptoms overlap with other psychiatric disorders. The McLean Screening Instrument (MSI) assesses endorsement (yes/no) of 10 symptoms, with a cut-off of seven indicating potential caseness. Participants were (N = 68) from an established clinical cohort who completed a structured clinical interview, the MSI, the Childhood Trauma Questionnaire, and the Adolescent and Adult Time Attitudes Scale. A proportion (N = 20) also completed a follow-up interview examining their rationale for endorsing MSI items. Total number of MSI items endorsed was meaningfully related to scores on emotional neglect and negative time attitudes. There was substantive overlap between MSI threshold (≥7 items) and lifetime diagnosis of a mental disorder. The stated rationale for endorsing MSI items, was less indicative of personality trait, and was related more to particular developmental periods, one-off episodes, and life-contexts. Additionally, participants conflated constructs such as emptiness with loneliness, and moodiness with general emotionality. Those meeting MSI threshold recalled more childhood emotional neglect, and were more negative about all time periods. It is apparent that scoring of the MSI is driven by prevailing life circumstances as much as enduring personality traits.

Keywords

Borderline Personality

McLean Screening Instrument

Childhood Trauma

Time Attitudes

SCID-5-RV

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© 2022 Published by Elsevier B.V.

Mclean screening instrument for borderline personality disorder scoring

Open Access

Proszynski, Jacqueline Area of Honors: Psychology Degree: Bachelor of Science Document Type: Thesis Thesis Supervisors: Kenneth N. Levy, Thesis Supervisor
Kenneth N. Levy, Honors Advisor
Dr. Jeffrey M Love, Faculty Reader
Keywords: MSI-BPD
Clinical Assessment
BPD
Predictive Validity
Abstract: Purpose: Borderline personality disorder (BPD) is a highly prevalent, debilitating, and deadly disorder that is difficult to diagnose. As many as 1 in 10 individuals with BPD successfully commit suicide, thus identifying those with BPD is critically important. In the present study, we assess the predictive validity of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD, Zanarini et al., 2003) for detecting BPD. Four indices were examined: positive predictive power (PPP), negative predictive power (NPP), specificity (SPE), and sensitivity (SEN). Methods: Two-hundred and thirty-nine individuals ages 18 to 60 (M= 27.5; S.D. = 10.07)) completed the MSI-BPD and the International Personality Disorder Examination (IPDE; Loranger, 1994). Results: Sixty-three participants (26.4%) met criteria for BPD on the IPDE. The kappa value for an MSI-BPD threshold of 5, 6, or 7 indicated moderate levels of agreement (Fleiss, 1981). The MSI-BPD showed excellent sensitivity with cut-off scores of 5 or 6 and weaker sensitivity with cut-off scores of 7 or 8. In contrast, its specificity increased as the cut-off increased. The positive predictive value ranged from 0.48 (cutoff of 5) to 0.56 (cut-off of 7). However, the negative predictive power was high for all cut-offs. Conclusion: The MSI-BPD can be an effective screening tool for detecting BPD. Our findings are generally consistent with the initial validation study for which a cutoff of 7 was recommended. However, we recommend a cut-off score of 6 as useful in a two-stage process to identify those likely to have BPD. When caseness is particularly important, a cut-off of seven may be preferred.

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What is McLean screening instrument for borderline personality MSI?

What Is the McLean Screening Instrument? The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) is a commonly used 10-item measure to screen for borderline personality disorder (BPD).

How do you score borderline symptoms 23?

Results. Six grades of symptom severity were defined for the BSL-23 mean score: none or low: 0–0.28; mild: 0.28–1.07; moderate: 1.07–1.87; high: 1.87–2.67; very high: 2.67–3.47; and extremely high: 3.47–4. These grades received consistent empirical support from the independent instruments and samples.

Is there a screening tool for borderline personality disorder?

The screening instrument for borderline personality disorder (SI-Bord) consists of a 5-item self-reported questionnaire on the key features of BPD from the DSM-5 using a 5-point Likert scale.

How do they evaluate you for BPD?

Personality disorders, including borderline personality disorder, are diagnosed based on a: Detailed interview with your doctor or mental health provider. Psychological evaluation that may include completing questionnaires. Medical history and exam.