Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 17;20(1):479.
doi: 10.1186/s12888-020-02807-6.

Development and validation of a screening instrument for borderline personality disorder (SI-Bord) for use among university students

Trustsavin Lohanan  1 , Thanakorn Leesawat  1 , Tinakon Wongpakaran  2 , Nahathai Wongpakaran  3 , Nuntaporn Karawekpanyawong  3 , Awirut Oon-Arom  3 , Pimolpun Kuntawong  3
Affiliations

Development and validation of a screening instrument for borderline personality disorder (SI-Bord) for use among university students

Trustsavin Lohanan et al. BMC Psychiatry. .

Abstract

Background: The screening instrument for borderline personality disorder (SI-Bord) consists of a 5-item self-reported questionnaire on the key features of BPD from the DSM-5 using a 5-point Likert scale. This study investigated its validity and reliability in screening for BPD in university students.

Methods: A cross-sectional study was conducted on a sample of university students in Thailand between November and December 2019. An online assessment gathered demographic data and results from the SI-Bord, the Perceived Stress Scale-10 (PSS-10) and the Patient Health Questionnaire-9 (PHQ-9). Participants whose SI-Bord scores were ≥ 1 were randomly selected to be interviewed and assessed for a BPD diagnosis by four psychiatrists using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) as a reference point. An intraclass correlation coefficient (ICC) of 0.925 (95% CI, 0.805-0.979) ensured inter-rater reliability between the four psychiatrists. The diagnostic sensitivity and specificity of the SI-Bord, as compared to that of the SCID-II, were determined to indicate the cut-off score. The Receiver Operating Characteristics (ROC) was analyzed to evaluate its diagnostic accuracy.

Results: The study included 342 students aged 18-25 years (the mean age was 20.25 ± 1.4 years), 80.4% of whom were female. Among the 68 participants selected for an online interview, 16 were diagnosed with BPD. The cut-off score of the SI-Bord was > 9, as suggested by the Youden index, yielding a sensitivity of 56.3% and a specificity of 92.3%. It had a positive predictive value of 69.2% and negative predictive value of 87.3%. The SI-Bord had adequate discriminative power between cases and non-cases of BPD, with the area under the ROC curve being 0.83. Cronbach's alpha for the SI-Bord was 0.76, indicating acceptable internal consistency. The SI-Bord score was positively correlated to PHQ-9 and PSS-10 scores (r = 0.67 and r = 0.69, p < 0.001, respectively) and negatively correlated to MSPSS (r = - 0.50, p < 0.001). The prevalence of BPD in the sample was 6.4%, according to the cut-off score > 9.

Conclusion: The SI-Bord demonstrated good reliability and validity for screening BPD in university students. However, a study in non-Thai and other population groups should be warranted.

Keywords: Borderline personality disorder; Instrument; Screening; Undergraduate; Validation.

PubMed Disclaimer

Conflict of interest statement

Tinakon Wongpakaran is an Associate Editor of BMC Psychiatry. All the authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study. SI-Bord = Screening instrument for borderline personality disorder, r-MSPSS = Revised Thai Multi-Dimensional Scales of Perceived Social Support, TPSS = Thai version of perceived stress scale, PHQ-9 = Patient health questionnaire-9
Fig. 2
Fig. 2
ROC curve with 95% Confidence Inerval for the SI-Bord. dotted lines = upper and lower confidence limit of the SI-Bord, bold line = SI-Bord score, AUC = area under the curve
See this image and copyright information in PMC

References

    1. Maser B, Danilewitz M, Guérin E, Findlay L, Frank E. Medical student psychological distress and mental illness relative to the general population: a Canadian cross-sectional survey. Acad Med. 2019;94(11):1781–1791. doi: 10.1097/ACM.0000000000002958. - DOI - PubMed
    1. Peterson AL, Chen JI, Karver MS, Labouliere CD. Frustration with feeling: latent classes of non-suicidal self-injury and emotion regulation difficulties. Psychiatry Res. 2019;275:61–70. doi: 10.1016/j.psychres.2019.03.014. - DOI - PMC - PubMed
    1. Sathirapanya C, Hhempan W. Stress among students in UniversityStress among students in UniversityStress among students in university. J Lib Arts Maejo U. 2013;1(1):42–58.
    1. Heinen I, Bullinger M, Kocalevent RD. Perceived stress in first year medical students - associations with personal resources and emotional distress. BMC Med Educ. 2017;17(1):4. doi: 10.1186/s12909-016-0841-8. - DOI - PMC - PubMed
    1. Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400. doi: 10.1016/j.jpsychires.2012.11.015. - DOI - PubMed

Publication types

LinkOut - more resources