How-To Guides

The Brazilian Portuguese Borderline Symptom List 23 (BSL-23) is a 23-item self-report measure designed to assess borderline-typical symptom severity during the previous week in adults. Each item is rated from 0 (“not at all”) to 4 (“very strong”), and the study supports interpreting the instrument primarily as a single total-score measure rather than as separate subscales.

Yes. Across 3 random subsamples, the analyses supported a stable unidimensional structure for the Brazilian Portuguese BSL-23. Factor 1 explained 56.6% of the variance in sample 1, 56.8% in sample 2, and 55.5% in sample 3, and the acceleration factor consistently indicated a single dominant factor.

Reliability was excellent. Across all 3 subsamples, Cronbach α and McDonald ω were both 0.95 (95% CI, 0.95–0.96), and no item-rest correlation was below 0.40, indicating that all items contributed adequately to the total score.

The 1-factor confirmatory model showed acceptable but imperfect initial fit, and fit improved after allowing correlated residuals between items 02 and 08 and between items 01 and 03. After those adjustments, the model yielded χ²228 = 1,715.96, χ²/df = 7.52, CFI = 0.95, TLI = 0.95, and RMSEA = 0.088 (90% CI, 0.084–0.091).

Yes, the findings suggest the BSL-23 can be used for gender comparisons in Brazilian samples with minimal practical bias. Although several items showed statistically significant differential functioning, the overall effects were small: the MIMIC model found a small latent gender effect (λ = −0.07, P < .001), indicating slightly lower expected scores among men, and the mean-group difference was also small (Cohen d = −0.18).

The scale showed very strong discriminative capacity. Participants at or below the 25th percentile and at or above the 75th percentile differed by 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) in the lower group and 88.54 (SD = 11.33) in the higher group.

In the high-symptom network, items related to self-harm and self-directed negativity were the most influential. Item 12, “I wanted to punish myself,” emerged as the central node, connecting closely with items reflecting self-hate and intrusive, fear-related cognitions; by contrast, in the low-symptom group, item 08, “I was lonely,” was the most central.

The strongest correlations were with measures of depressive distress, stress, and emotion regulation difficulties. The BSL-23 total score correlated r = 0.79 with DASS-21 depression (P < .001), r = 0.70 with DASS-21 stress (P < .001), r = 0.69 with the DERS total score (P < .001), and r = 0.66 with the DERS strategies dimension (P < .001); for childhood trauma, emotional abuse showed the strongest CTQ association at r = 0.41 (P < .001).

Yes. The study found strong associations between BSL-23 scores and depression, stress, and emotion regulation difficulties, while correlations with impulsivity on the Barratt Impulsiveness Scale were statistically significant but small. The authors interpreted this pattern as supporting that the BSL-23 primarily captures emotional dysregulation rather than executive impulsivity.

No. The authors state that the Brazilian Portuguese BSL-23 appears clinically useful as a brief measure of borderline-specific symptomatology and may contribute to case finding when embedded within a broader assessment framework, but it was not validated here as a stand-alone diagnostic instrument. Because this study used a nonclinical sample, it did not establish diagnostic accuracy or clinically meaningful cutoff scores.

The most clinically supported use is as a brief tool to quantify current borderline symptom burden and to monitor symptom change over time. The discussion emphasizes that the BSL-23 may be especially valuable for tracing symptom trajectories, appraising treatment response, and informing routine outcome monitoring, rather than serving as the sole basis for categorical diagnosis.

The main limitation is that the validation was conducted in a nonclinical sample, which limits inferences about diagnostic accuracy and prevents derivation of clinically meaningful cutoff scores. The study also did not examine test-retest reliability, and the authors caution that the findings should not automatically be generalized to other Portuguese-speaking countries because idiomatic usage, sociocultural context, and clinical meaning may differ.