How to Use the Brazilian BSL-23 in Borderline Assessment
How should clinicians use the Brazilian Portuguese BSL-23 to assess current borderline symptom severity?
Adults with possible borderline personality disorder often need a brief measure that captures current symptom burden rather than only categorical diagnosis. This guide applies to Brazilian clinical contexts where clinicians want a rapid appraisal of borderline-typical symptoms over the previous week while keeping the instrument embedded in a broader clinical evaluation.
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Administer the 23-item self-report scale
Use the Brazilian Portuguese Borderline Symptom List 23 as a self-report measure for adults. Ask the patient to rate each of the 23 symptom items based on experiences during the previous week on the 0 to 4 scale, where 0 means not at all and 4 means very strong.
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Interpret the result as a total severity score
Interpret the instrument primarily as a single overall measure of borderline symptom severity rather than as separate subscales. In this study, the Brazilian version showed a stable unidimensional structure across 3 subsamples, with the first factor explaining 56.6%, 56.8%, and 55.5% of the variance.
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Use the score to quantify current burden
Use the total score to appraise how much borderline-typical symptomatology is present in the past week. The study found excellent internal consistency for the total score, with Cronbach alpha and McDonald omega both 0.95 and no item-rest correlation below 0.40, supporting use of the summed symptom burden as a dependable index.
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Embed the result in a broader clinical assessment
Use the BSL-23 to support case identification only as part of a comprehensive assessment rather than as a stand-alone diagnostic test for borderline personality disorder. The authors state that the instrument was not originally conceived as a stand-alone screening tool and that its best-supported clinical role is as a brief measure of symptom burden within expert clinical judgment.
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Interpret associated symptom domains appropriately
When reviewing elevated scores, understand that higher BSL-23 scores in this study were most strongly associated with depression, stress, and emotion regulation difficulties. Correlations were strongest with DASS-21 depression at r=0.79, DASS-21 stress at r=0.70, DERS total score at r=0.69, and DERS strategies at r=0.66, whereas associations with impulsivity were statistically significant but small.
Clinical Considerations
- This validation was conducted in a nonclinical sample, so the study does not establish diagnostic accuracy or clinically meaningful cutoff scores.
- The BSL-23 should not be used as the sole basis for categorical borderline personality disorder diagnosis.
- The study did not evaluate the visual analog scale or supplementary behavior items from the original instrument.
- Applicability to Portuguese-speaking populations outside Brazil should not be presumed because idiomatic and sociocultural differences may alter meaning.
Bottom Line
Use the Brazilian Portuguese BSL-23 as a brief, reliable total-score measure of current borderline symptom severity, but pair it with a full clinical assessment rather than treating it as a diagnostic test.
