Dear Elizabeth,

Maybe you could use the Personality Diagnostic Questionnaire-4+  (Hyler, 1994) and only select the 9 items for screening borderline personality disorder.

Sincerely

Dear Elizabeth,

There is quite a lot of debate regarding the notion of an "objective" test.  That said, there are several structured and semi-structured assessments for Borderline Personality Disorder that are used in clinical research.  Two that come to mind are

the Diagnostic Interview for Borderlines (DIB): Mary C. Zanarini, John G. Gunderson, Frances R. Frankenburg, and Deborah L. Chauncey (1989). The Revised Diagnostic Interview for Borderlines: Discriminating BPD from other Axis II Disorders. Journal of Personality Disorders: Vol. 3, No. 1, pp. 10-18.

the Structured Clinical Interview for DSM-III (or DSM-IV): Michael B. First, Robert L. Spitzer, Miriam Gibbon, and Janet B. W. Williams (1995). The Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Part I: Description. Journal of Personality Disorders: Vol. 9, No. 2, pp. 83-91.

If you would like more information, send me an email and perhaps we can discuss assessment and your particular project in more detail.

Sincerely, Lance Rappaport

Perhaps you can use the International Personality Disorder Examination IPDE  form World Health Organization.

(The International Personality Disorder Examination

The World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration International Pilot Study of Personality Disorders

Armand W. Loranger, PhD; Norman Sartorius, MD, PhD; Antonio Andreoli, MD; Peter Berger, MD; Peter Buchheim, MD; S. M. Channabasavanna, MD; Bina Coid, PhD; Alv Dahl, MD; Rene F. W. Diekstra, PhD; Brian Ferguson, MD; Lawrence B. Jacobsberg, MD, PhD; W. Mombour, MD; Charles Pull, MD; Yutaka Ono, MD; Darrel A. Regier, MD

Arch Gen Psychiatry. 1994;51(3):215-224. doi:10.1001/archpsyc.1994.03950030051005.)

Dear Elizabeth

The main problem is to make sure that pathologic personalities really exist.

As many psychiatric concepts, the present one is purely hypothetic, without any scientific basis.

It would be a pity to exclude so-called personnalities which are, frequently if not allways, reversible,  liked to illness, mainly deprssion, and not fixed states of health.

Dear Elizabeth,

Interesting study. Personality disorder (PD) is highly prevalent amongst people with treatment-resistant depression, and PD is known to worsen depression outcome [1]. This applies to non-borderline PD as well, so you may want to think hard about just targeting borderline PD.

An alternative to exclusion may be to identify and include those with PD, for subgroup investigation/analysis.

If you want a screening tool that screens for all PDs, rather than borderline PD alone, Germans et al's paper may be of use [2].

References:

1. Newton-Howes, G., et al. (2006). "Personality disorder and the outcome of depression: meta-analysis of published studies." British Journal of Psychiatry 188: 13-20.

2. Germans, S., et al. (2012). "Results of the search for personality disorder screening tools: clinical implications." Journal of Clinical Psychiatry 73(2): 165-173.

Hope this helps and best of luck!

Dear Elizabeth,

SCID-II the borderline personality disorder module, is used in many trials (also in our) and consist of questions for each of the nine criteria.

First, MB., Gibbon M, Spitzer RL, Williams, JBW, Benjamin LS.: Structured Clinical Interview for DSM-IV Axis II Personality Disorders, (SCID-II). Washington, D.C.: American Psychiatric Press, Inc., 1997.

All the best,

Kate

See an option below:

Scoring the DSM-IV personality disorders using the Five-Factor Model: Development and validation of normative scores for North American, French, and Dutch-Flemish samples.

Miller et al. 

Miller, Joshua D., University of Georgia, Athens, GA, US, [email protected]

Journal of Personality Disorders, Vol 22(5), Oct, 2008. pp. 433-450.

See also:

Five-Factor Measure of Borderline Personality Traits : Measures to Assess Maladaptive Variants of the Five-Factor Model. Mullins-Sweatt et al. (2012).

Journal of personality assessment [J. pers. assess.], 2012, Vol. 94, Issue 5 p475-487.

DiagnosticInterviewforDSM-ⅣPersonalityDisorders theInternationalPersonalityDisorderExamination，theStructuredInterviewforDSM-ⅣPersonality，thePersonalityDisorderInterview–Ⅳ，StructuredClinicalInterviewforDSM-ⅣAxisⅡPersonalityDisorders

Hello,

At our DBT clinic we use the SCID-II interview for diagnosis (First, MB., Gibbon M, Spitzer RL, Williams, JBW, Benjamin LS.: Structured Clinical Interview for DSM-IV Axis II Personality Disorders, (SCID-II). Washington, D.C.: American Psychiatric Press, Inc., 1997), as well as some questionnaire measures to gain a more complete picture of the individuals BPD symptom severity. We use the Borderline Symptom Inventory, and the Difficulties in Emotion Regulation questionnaire, among others. 

Thanks for the response, David! My lab isn't too fond of using the SCID II due to it taking quite a while to administer. We are currently leaning towards using the Borderline Symptom Inventory, but I'm hesitant that those symptoms overlap too much with treatment-resistant depression symptoms. The Difficulties in Emotion Regulation seems like a great tool, especially to filter out participants that aren't too aware of how they are feeling (we rely on some self-report questionnaires in our studies).

Yes, I think you're right Elizabeth, there is a lot of overlap in symptomology between BPD and treatment-resistent depression, so relying solely on self-report measures can be problematic. Of course the two problems are also highly comorbid.

I agree, the SCID-II is time consuming, and of course requires a lot of training to administer well, but I believe it's necessary to use some sort of clinical interview to accurately diagnose BPD. Although questionnaires like the SCID-II Screener have shown good reliability, I've observed that relying solely on such measures would end up giving a lot of false-positives.

I also think that because BPD has such a complex polythetic diagnostic criteria (i.e., there are hundreds of diagnostic constellations for BPD), one needs to engage the patient/participant in a dialog about their experience to really make a good assessment of individuals' BPD symptom severity and character. I also think the clinical interview helps parse out what may be other personality disorders presenting like, or crossing over with BPD (e.g., the other cluster-B personality disorders).

Unfortunately, borderline personality disorder is often underdiagnosed or misdiagnosed. Borderline personality disorder can be detected by  a thorough interview and a discussion about symptoms. A careful and thorough medical exam can help rule out other possible causes of symptoms. No single test can diagnose borderline personality disorder.

Hello, I am doing research on Toxic Personalities which is known under the category of BPD. According to some studies, Borderline personality disorder can be treated with psychotherapy, or “talk” therapy. In some cases, a mental health professional may also recommend medications to treat specific symptoms. In other research the method was as follows: transference-focused psychotherapy, dialectical behavior therapy, or supportive treatment and received medication when indicated.

Hello Dr. Proffitt, with all due respect, I think you may be misled by the relatively innocuous mantle 'personality disorder'. While certainly some personality disorders have questionable veracity (e.g., depressive personality disorder), BPD and the attendant cluster-B disorders in their truest forms do not represent quirks of personality; these are quite real disorders that can make sufferers lives' a living hell. People with BPD, for instance, commonly engage in non-suicidal self-injury (e.g., cutting, burning, over-dosing) in an effort to manage overwhelming affect, experience an extremely high rate of alcohol and other drug addiction, and frequently attempt suicide and complete suicide. 

The most effective treatment for BPD is not pharmacotherapy, in fact medication tends to have a limited effect on this disorder. Intensive talk therapies like dialectical behavior therapy that teach sufferers coping skills, and strategies that help cultivate a life worth living are currently the most effective treatments we have.

I agree we over-pathologize many disorders, and I agree that we rush to medication when things go wrong in our lives, but BPD has nothing to do with unusual personalities, or 'toxic personalities'. They are people dealing with overwhelming affect that would push any of us to the brink.

Dr.Eddie, thank you for your explanations.

Dear David.

I agree with you but for treatment because, as other compulsive diseases, BPD is a consequence of depression (as a neuro-biochemical dysfunction) an efficiently treated by antidepressants, if algorythm is efficient.

You could have a look to the English version of the abstract of my book in french.

http://bmaroy.free.fr