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Young people with borderline personality disorder (BPD) commonly seek help but often go unrecognized. Screening offers a means of identifying individuals for more detailed assessment for early intervention and for research. Aims: This study compared the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Borderline Personality Questionnaire (BPQ), the BPD items from the International Personality Disorder Examination Screening Questionnaire and the BPD items from the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II) Personality Questionnaire. Method: 101 outpatient youth (aged 15-25 years) completed the screening measures and were interviewed, blind to screening status, with the SCID-II BPD module. The screening measures were readministered two weeks later to assess test-retest reliability. Results: All four instruments performed similarly but the BPQ had the best mix of characteristics, with moderate sensitivity (0.68), the highest specificity (0.90), high negative predictive value (0.91) and moderate positive predictive value (0.65). Compared to the other three instruments, the BPQ had the highest overall diagnostic accuracy (0.85), a substantially higher kappa (0.57) with the criterion diagnosis, the highest test-retest reliability (ICC = 0.92) and the highest internal consistency (α = 0.92). The only clear difference to emerge in the Receiver Operator Curve (ROC) analysis was that the BPQ significantly outperformed the MSI (p = 0.05). Conclusion: Screening for BPD in outpatient youth is feasible but is not a replacement for clinical diagnosis.
Borderline personality disorder (BPD) usually emerges during adolescence and is associated with serious morbidity, such as mood, anxiety, and sub- stance use disorders, along with severe impairment of psychosocial func- tioning (Chanen, Jovev, & Jackson, 2007). A substantial body of evidence indicates that BPD diagnostic criteria are no less reliable, valid, and stable prior to age eighteen years than they are in adulthood (Chanen et al., 2004; Chanen, Jovev, & Jackson, 2007; Westen, Shedler, Durrett, Glass, & Martens, 2003). BPD affects 0.9% (Lewinsohn, Rohde, Seeley, & Klein, 1997) to 3% (Bernstein et al., 1993) of community-dwelling teenagers (similar to the prevalence in adults; Lenzenweger, Lane, Loranger, & Kessler, 2007) but this rises to 10.8% (Bernstein et al., 1993) to 14% (Chabrol, Montovany, Chouicha, Callahan, & Mullet, 2001) if lower symptom thresholds are used. In clinical samples, the limited data suggest a prevalence of 11% in adolescent outpatients (Chanen et...