Scoring the MSI-BPD
Each item in the MSI is rated as a “1” if it is present and a “0” if it is absent, and items are totaled for possible scores from 0 to 10. A score of 7 is generally considered a valid clinical cutoff, meaning that a score of 7 or higher indicates that a person likely meets the criteria for a BPD diagnosis. However, some researchers have proposed a lower cutoff.
Reliability and Validity
The MSI-BPD has demonstrated valid, reliable psychometric properties. It has adequate internal consistency and test-retest reliability. It has also demonstrated sensitivity and specificity for detecting borderline personality disorder when a score of 7 is used as the cutoff.
Uses for the MSI-BPD
Clinicians use the MSI-BPD to assess a person for BPD, sometimes in conjunction with other screening tools. Research suggests the MSI-BPD is helpful in detecting BPD in the general population, but more studies are needed.
Other BPD Screening Tools
The MSI-BPD is only one of several tools that clinicians use to screen for BPD. Others include the following.
Structured Clinical Interview
The Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD) is an official diagnostic interview from the American Psychiatric Association (APA) that clinicians use to assess for personality disorders such as BPD. It is an update of the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). A mental health professional may use this screening tool to help determine a person’s diagnosis by asking questions directly related to the criteria for BPD that are listed in the DSM-5. This screening instrument also has an optional self-reporting questionnaire with 108 questions, but not all clinicians who choose the SCID-5-PD use this.
Personality Diagnostic Questionnaire (PDQ-4)
The Personality Diagnostic Questionnaire, 4th Edition (PDQ-4) screening test consists of 99 true-or-false questions that can help screen for various personality disorders, including BPD.
Zanarini Rating Scale
The Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), also developed by Dr. Zanarini, is used for patients who have already been diagnosed with BPD to test for changes over time.
Impact of BPD Screening
BPD is challenging to diagnose and treat, in part because it’s often misdiagnosed and confused with other mental health conditions such as bipolar disorder. Further complicating the issue is that BPD often exists with comorbidities, including bipolar disorder, and poses a significant risk of suicide, which makes accurate screening tools such as the MSI-BPD particularly important. Once BPD is diagnosed, however, the clinician can develop a treatment plan to address it. This might include such targeted approaches as dialectical behavioral therapy (DBT), which has been shown to be effective for people with BPD.
Potential Pitfalls of the MSI-BPD
It’s important to note that the MSI-BPD is not a diagnostic tool; rather, it’s a screening tool that helps determine the likelihood that a person has BPD. An actual diagnosis requires structured and semi-structured interviews and therapy, ideally with a clinician who offers a strong background in BPD diagnosis and treatment. As such, the MSI-BPD is just one of several tools used in the diagnostic process and should not be used alone for diagnosis. Another potential problem is related to the MSI-BPD’s ease of use and availability online, which could allow someone to attempt to self-screen without fully understanding its intent or the implications of the result. The test is best administered by a professional who can interpret the results and then recommend an appropriate course of action. Lastly, assessments such as the MSI-BPD provide a picture of a person’s mental status only at a particular point in time. Astute clinicians also must take into account the person’s patterns of behavior over time.
A Word From Verywell
BPD is a particularly difficult disorder to diagnose and treat. Research indicates that the MSI-BPD is one of several valuable tools in this effort, however, and takes very little time to complete. If your screening indicates the possibility of BPD, your clinician can then recommend further testing and treatment options.
