Borderline Symptom List (BSL-23) 边缘型人格障碍量表

synopsis（简介）

The Borderline Symptom List – Short Version (BSL-23) is a 23-item self-rating instrument for specific assessment of borderline personality disorder (BPD) symptomatology in adults (18+). The scale assesses DSM BPD diagnostic criteria (e.g., affective instability, recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour, and transient dissociative symptoms) in addition to items that are based on borderline-typical empirical findings regarding self-criticism, problems with trust, emotional vulnerability, and proneness to shame, self-disgust, loneliness, and helplessness (Kleindienst et al., 2020).

Individuals with high scores on the BSL-23 are more likely to have BPD and associated challenges with managing emotions, self-image, relationship issues, and general functioning in everyday life.

边缘型症状表--简易版（Borderline Symptom List - Short Version，BSL-23）是一个包含 23 个项目的自我评分工具，用于对成年人（18 岁以上）的边缘型人格障碍（BPD）症状进行具体评估。该量表除了评估 DSM BPD 诊断标准（如情感不稳定，反复出现自杀行为、手势或威胁，或自残行为，以及短暂的分离症状）外，还评估基于边缘型典型经验发现的有关自我批评、信任问题、情感脆弱以及易羞愧、自我厌恶、孤独和无助的项目（Kleindienst 等人，2020 年）。
BSL-23得分较高的人更有可能患有BPD，并在管理情绪、自我形象、人际关系问题和日常生活的一般功能方面面临相关挑战。

Validity and Reliability（效度和信度）

The BSL-23 items are based on criteria of the DSM-5, on the revised version of the Diagnostic Interview for Borderline Personality Disorder, and on the experiences of both clinical experts and input from BPD (Kleindienst et al., 2020). The BSL-23 has a single factor structure and has excellent psychometric properties, with high internal consistency with a Cronbach’s of 0.97 and test-retest reliability of 0.82 within 1 week (Bohus, 2009). These properties have been replicated in several studies that validated the translations of the BSL-23 into 18 foreign languages (Kleindienst et al., 2020). The BSL-23 also has strong convergent validity with correlations between the BSL-23 and depression as measured by the BDI (r = 0.87), as well as general severity of psychopathology as measured by the SCL-90-R GSI (r = 0.89; Bohus, 2009).
Kleindienst et al. (2020) tested the BSL-23 on over 1,000 adults and developed cut-off scores and severity levels (none or low, mild, moderate, high, very high, and extremely high) for clients with BPD. They found that individuals with a severity grade of “none or low” were virtually free from diagnostic BPD-criteria and had a high level of global functioning corresponding to few or no symptoms. Severity grades indicating “high” to “extremely high” levels of BPD symptoms were observed at a much higher rate in treatment-seeking patients (70.0%) than in a healthy control group with no prior psychopathology history (0.0%)

BSL-23 的项目是根据 DSM-5 的标准、边缘型人格障碍诊断访谈的修订版以及临床专家的经验和边缘型人格障碍患者的意见（Kleindienst et al.） BSL-23 具有单因素结构，心理测量特性极佳，内部一致性高，Cronbach's 为 0.97，一周内测试-再测可靠性为 0.82（Bohus，2009 年）。这些特性在将 BSL-23 翻译成 18 种外语的多项研究中得到了验证（Kleindienst 等人，2020 年）。BSL-23 还具有很强的收敛效度，BSL-23 与 BDI 测量的抑郁之间存在相关性（r = 0.87），与 SCL-90-R GSI 测量的一般精神病理学严重程度之间也存在相关性（r = 0.89；Bohus，2009 年）。
Kleindienst 等人（2020 年）对 1,000 多名成年人进行了 BSL-23 测试，并为 BPD 患者制定了临界分数和严重程度等级（无或低、轻度、中度、高度、极高和极高）。他们发现，严重程度等级为 "无或低 "的人几乎不符合 BPD 诊断标准，其整体功能水平较高，很少或没有症状。在寻求治疗的患者（70.0%）中观察到的 BPD 症状严重程度等级为 "高 "至 "极高 "的比例（0.0%）远远高于无精神病史的健康对照组（0.0%）。

Scoring and Interpretation（得分解释）

The average score of items (range 0 to 4, sum of scores divided by 23) is calculated, with a higher score indicating more impairment. Six grades of symptom severity were defined by Kleindienst et al. (2020) based upon the average score:
None/Low: 0 – 0.3
Mild: 0.3 – 1.1
Moderate: 1.1 – 1.9
High: 1.9 – 2.7
Very High: 2.7 – 3.5
Extremely High: 3.5 – 4
Scores of 1.50 or higher indicates the responses are consistent with BPD, with empirical data showing this cutoff score is able to discriminate between BPD patients and clients with other clinical psychopathology (e.g. anxiety disorders, major depressive disorders, schizophrenia, etc.; Kleindienst et al., 2020).
Percentiles are also presented comparing the respondents scores to a healthy group (n = 356; with no history of psychopathology) and a BPD group (n = 317; met DSM-V diagnostic criteria for BPD; Kleindienst et al. 2020). A percentile of 50 means that the client has scored at the typical level compared with the comparative group. An average score of 1.5 corresponds to a percentile of 17 compared to the BPD group, and a percentile of 99.9 compared to the healthy control group. These metrics indicate that a score of 1.5 is typical for someone with BPD but highly extreme compared to someone without a psychiatric diagnosis.
There is an additional question (24) that provides an indication of the client’s perspective on their overall well-being, but it is not included in the overall score. The rating on this last question (from 0 to 100) is strongly correlated with specific indicators of wellbeing for BPD patients, including self-perception, affect regulation, self-destruction, dysphoria, loneliness, intrusions, and hostility (Bohus, et al., 2007).

计算项目的平均得分（范围为 0 至 4 分，得分总和除以 23），得分越高表示受损程度越严重。Kleindienst 等人（2020 年）根据平均得分将症状严重程度分为六个等级：
无/低：0 - 0.3
轻度： 0.3 - 1.1
中度： 1.1 - 1.9
高： 1.9 - 2.7
极高： 2.7 - 3.5
极高：3.5 - 4
1.50 分或更高的分数表明受试者的反应与 BPD 一致，经验数据显示，这一临界分数能够区分 BPD 患者和其他临床精神病理学受试者（如焦虑症、重度抑郁症、精神分裂症等；Kleindienst 等人，2020 年）。
百分位数还将受访者的得分与健康组（n = 356；无精神病史）和 BPD 组（n = 317；符合 DSM-V BPD 诊断标准；Kleindienst 等人，2020 年）进行比较。百分位数为 50 意味着客户的得分与比较组相比处于典型水平。与 BPD 组相比，平均得分 1.5 相当于百分位数 17，与健康对照组相比，百分位数为 99.9。这些指标表明，1.5 分对于患有 BPD 的人来说很典型，但与没有精神病诊断的人相比则非常极端。
还有一个附加问题（24 分）可以显示客户对其整体幸福感的看法，但不包括在总分中。最后一个问题的评分（从 0 到 100）与 BPD 患者的特定幸福感指标密切相关，包括自我认知、情感调节、自我毁灭、焦虑症、孤独感、入侵感和敌意（Bohus 等人，2007 年）。