Clinical Summary
Clinical Summary: Psychometric Properties of the Borderline Symptom List 23 for Brazilian Portuguese in a Nonclinical Sample
Clinicians in Brazil need brief tools that capture borderline symptom severity, not just categorical borderline personality disorder diagnoses. This study provides validation data for a Brazilian Portuguese version of the Borderline Symptom List 23, supporting its use when a rapid appraisal of current borderline symptom burden or repeated symptom monitoring is needed.
Design
The present study aimed to address this gap by conducting a cross-cultural adaptation of the BSL-23 into Brazilian Portuguese and by evaluating its psychometric properties in a large nonclinical sample.
N
2,682 participants
Population
The sample consisted of 2,682 participants who completed an online survey.
Setting
The finalized instrument was administered alongside a sociodemographic questionnaire and additional measures through an online survey platform.
Key Findings
- Across the 3 subsamples, Factor 1 explained 56.6% of the variance in sample 1, 56.8% in sample 2, and 55.5% in sample 3, supporting a stable unidimensional structure of the BSL-23 in Brazilian participants.
- Internal consistency was excellent across subsamples, with Cronbach α and McDonald ω identical and high (α= ω=0.95; 95% CI, 0.95–0.96), and no item-rest correlation fell below 0.40.
- The confirmatory factor analysis improved after allowing correlated residuals between items 02 and 08 (r = 0.62, P < .001) and items 01 and 03 (r = 0.53, P < .001), yielding χ2228 = 1,715.96, χ2/df = 7.52, CFI = 0.95, TLI = 0.95, and RMSEA = 0.088 [90% CI, 0.084–0.091].
- The BSL-23 strongly separated lower- and higher-severity groups: Welch t1336.8 = 74.94, P < .001, Cohen d = 6.54; 95% CI, 6.17–6.91, with mean scores of 32.31 (SD = 4.28) versus 88.54 (SD = 11.33).
- Concurrent validity was strongest for emotional dysregulation and depressive distress, with correlations of r=0.79, P<.001 for DASS-21 depression, r=0.70, P<.001 for DASS-21 stress, r=0.69, P<.001 for the DERS total score, and r=0.41, P <.001 for CTQ emotional abuse.
Clinical Bottom Line
The Brazilian Portuguese BSL-23 provides a brief, reliable total score for borderline symptom severity and appears suitable for symptom tracking in Brazilian research and clinical contexts. Use it to quantify current burden and follow change over time, not as a stand-alone basis for categorical diagnosis.
Practice Implications
- Interpret the Brazilian Portuguese BSL-23 primarily as a single total-score measure of borderline symptom severity, since the scale showed a stable 1-factor structure across 3 subsamples.
- Use the BSL-23 alongside a broader clinical assessment for case identification rather than as a stand-alone diagnostic tool, because this validation was conducted in a nonclinical sample and did not establish cutoff scores.
- Consider the BSL-23 for repeated administration during treatment or follow-up, given its brevity and the strong reliability estimates of α= ω=0.95; 95% CI, 0.95–0.96.
- When comparing scores across gender, small item-level differences should not preclude use: the latent gender effect was λ = −0.07, P < .001, and the mean-group effect size was small (Cohen d = −0.18).
