McLean Screening Instrument for Borderline Personality Disorder

The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) is a validated, 10-item self-report questionnaire designed to rapidly detect…

Questions: 10
Duration: 5 min
Original title: MSI-BPD — McLean Screening Instrument for Borderline Personality Disorder
Adaptation: McLean Screening Instrument for Borderline Personality Disorder
Authors: Zanarini, M. C., Vujanovic, A. A., Parachini, E. A., Boulanger, J. L., Frankenburg, F. R., & Hennen, J.
Created: 2003

The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) is a validated, 10-item self-report questionnaire designed to rapidly detect the presence of borderline personality disorder traits in adult and adolescent populations. By mapping directly onto the core diagnostic criteria, such as emotional dysregulation, identity disturbance, and interpersonal instability, it offers clinicians a practical tool to orient their diagnostic assessment.

Because borderline personality features are frequently masked by comorbid mood or anxiety presentations, the MSI-BPD serves as a valuable baseline screener during intake. It enables clinicians to flag complex personality dynamics early in care, facilitating a structured clinical interview to assess the full presentation. The measure's brevity and symptom-specific focus also make it useful for establishing an initial clinical baseline before opening psychoeducation or introducing targeted interventions, such as mapping DSM-5 personality disorder criteria with the patient.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

5/ 10

The MSI-BPD is a brief self-report screening questionnaire for borderline personality disorder (BPD), consisting of 10 dichotomous (yes/no) items based on the 9 DSM-IV/DSM-5 diagnostic criteria—Criterion 9 (stress-related paranoid ideation / dissociative symptoms) being assessed by two distinct items. Validated in adolescents (≥ 15 years) and adults, it aims to identify individuals likely to present with BPD who require comprehensive clinical evaluation. It is not a diagnostic tool: a positive screen warrants referral for a structured clinical interview (e.g., SCID-5-PD, DIPD-IV/5).

0–4

Symptom levels not consistent with BPD

5–6

BPD cannot be ruled out

7–10

Traditional cutoff for BPD screening among adults

Individuals in this range require further evaluation as 19% of individuals with BPD score below 7

For information

Cut-off≥ 5High sensitivity screening cutoff

Cutoff required to reach 90% sensitivity

Zimmerman et al. (2021)

Cut-off≥ 6Cutoff for adolescent populations

Lower cutoff may be beneficial for younger demographics

Noblin et al. (2014)

Scoring

Sum, total score from 0 to 10, each item is scored 0 or 1.

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What the test measures

The MSI-BPD measures the self-reported presence of core borderline personality features over the respondent's lifetime. The items correspond directly to the diagnostic criteria, capturing multiple clinical facets:

Interpersonal instability: Chaotic relationships characterized by intense arguments or repeated breakups.
Impulsivity: Engagement in potentially self-damaging behaviors across multiple domains, often pointing to an insufficient self-control schema.
Emotional lability: Severe mood swings, chronic feelings of emptiness, and intense, poorly controlled anger.
Identity disturbance: A persistent lack of a coherent sense of self or identity.
Self-harm: Deliberate physical self-injury or suicide attempts.
Cognitive symptoms: Stress-related paranoia, distrustfulness, or severe dissociative episodes.

The instrument is designed for adolescents (typically 15 and older) and adults presenting in clinical settings who require screening for personality pathology.

When and why to use it

Clinicians typically integrate the MSI-BPD during the initial assessment phase to systematically screen for borderline personality traits.

Intake screening: To efficiently flag potential borderline pathology when a patient presents with complex emotional crises or treatment-resistant anxiety.
Differential support: To distinguish core personality dynamics from overlapping affective disorders, helping clinicians parse characterological traits from bipolar disorder warning signs.
Psychoeducation preparation: To gather baseline symptom data before introducing complex clinical frameworks, such as exploring schema maintenance vicious cycles or teaching active acceptance.
Treatment planning: To highlight specific domains of dysregulation that require immediate safety interventions or adaptive coping strategies.

A validated screening score provides a clear, criterion-based indicator that anchors the clinician’s initial impression, signaling when a comprehensive structured diagnostic interview is warranted.

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The questions

For each statement, indicate whether it applies to you by answering "Yes" or "No". Each "Yes" response counts for 1 point, each "No" response for 0 points.
1. Have some of your closest relationships been troubled by many arguments or repeated breakups?
Examines the presence of intense, unstable interpersonal dynamics characterized by conflict.
- No
- Yes
2. Have you deliberately hurt yourself physically (e.g., hitting, cutting, or burning yourself)? Have you made a suicide attempt?
Probes for a history of deliberate physical self-injury or suicidal behavior.
- No
- Yes
3. Have you had at least two other problems with impulsivity (e.g., binge eating and excessive spending, excessive drinking and verbal outbursts)?
Screens for damaging impulsive behaviors across multiple areas of functioning.
- No
- Yes
4. Have you been extremely moody?
Assesses affective instability and severe emotional reactivity.
- No
- Yes
5. Have you felt very angry most of the time? Have you often acted in an angry or sarcastic way?
Evaluates difficulties with anger regulation and the expression of intense frustration.
- No
- Yes
6. Have you often been suspicious of other people?
Explores stress-related paranoid ideation and interpersonal distrust.
- No
- Yes
7. Have you frequently felt unreal or as if things around you were unreal?
Checks for the occurrence of severe dissociative symptoms or feelings of unreality.
- No
- Yes
8. Have you chronically felt empty?
Inquires about chronic internal experiences of emptiness.
- No
- Yes
9. Have you often felt like you don't know who you are or that you have no identity?
Assesses the presence of severe identity disturbance or an unstable self-image.
- No
- Yes
10. Have you made frantic efforts to avoid feeling abandoned or being abandoned (e.g., repeatedly calling someone to make sure they still care, begging them not to leave you, physically clinging to them)?
Screens for frantic efforts to avoid real or perceived abandonment.
- No
- Yes