Table. Scales to assess severity and change in persons with borderline personality disorder.

Instrument	Citations	Mode of administration	Content	Format	Comments
BPD Severity Index	Arntz A, et al. Reliability and validity of the Borderline Personality Disorder Severity Index. J Pers Disord. 2003;17:45-59.	Rater	Semistructured inquiry about the frequency and severity of specific symptoms of BPD in a specified time (3 mo).	Criteria are scored on an 11-point scale reflecting frequency of occurrence, and a total score is derived to represent overall severity of BPD for a given period.	Good inter-rater and test-retest reliability as well as sensitivity to change. Also good discriminant and convergent validity.
Zanarini Rating Scale for BPD (ZAN-BPD)	Zanarini MC, et al. Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. J Pers Disord. 2003;17:233-242.	Rater	Questions from the DIPD-IV were adapted to reflect a 1/2-wk time period.	Each BPD criterion is rated on a 0 to 4 anchored scale reflecting severity of symptoms.	Good convergent and discriminant validity. Also good inter-rater and test-retest reliability as well as sensitivity to change.
Borderline Evaluation of Severity over Time (BEST)	Pfohl B, et al. Reliability and validity of the Borderline Evaluation of Severity over Time (BEST): a new scale to measure change and severity in borderline personality disorder. In press.	Self-report	15 items: 12 “negative” items modeled on the BPD criteria and 3 “positive” coping behaviors. Items are rated for the past 7 or 30 days (or other time period).	The negative items are scored on a 1 to 5 ordinal scale from “none/slight” to “extreme.” The positive behaviors are scored on a 1 to 5 ordinal scale from “almost never” to “almost always.”	Adequate test-retest reliability, high internal consistency, and high discriminant validity. Sensitive to clinical change as early as week 4.
Borderline Symptom List (BSL)	Bohus M, et al. Psychometric properties of the Borderline Symptom List (BSL). Psychopathology. 2007;40:126-132.	Self-report	95 items reflecting subjective distress and “intrapsychic strain” are rated for the last week. A briefer version that includes 21 of the original items and 10 behavioral markers of BPD has been developed more recently.	Items reflecting subjective distress are rated on a 0 to 4 ordinal scale, from “not at all” to “very strong.” Behavioral markers are rated on a 0 to 4 ordinal scale from “not at all” to “daily or more often.”	High internal and test-retest reliability; sensitive to change.

BPD: borderline personality disorder; DIPD-IV, Diagnostic Interview for DSM-IV Personality Disorders.