The Predictive Validity of the Mclean Screening Instrument for Borderline Personality Disorder

Download or read book The Predictive Validity of the Mclean Screening Instrument for Borderline Personality Disorder written by Jacqueline Proszynski and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Purpose: Borderline personality disorder (BPD) is a highly prevalent, debilitating, and deadly disorder that is difficult to diagnose. As many as 1 in 10 individuals with BPD successfully commit suicide, thus identifying those with BPD is critically important. In the present study, we assess the predictive validity of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD, Zanarini et al., 2003) for detecting BPD. Four indices were examined: positive predictive power (PPP), negative predictive power (NPP), specificity (SPE), and sensitivity (SEN). Methods: Two-hundred and thirty-nine individuals ages 18 to 60 (M= 27.5; S.D. = 10.07)) completed the MSI-BPD and the International Personality Disorder Examination (IPDE; Loranger, 1994). Results: Sixty-three participants (26.4%) met criteria for BPD on the IPDE. The kappa value for an MSI-BPD threshold of 5, 6, or 7 indicated moderate levels of agreement (Fleiss, 1981). The MSI-BPD showed excellent sensitivity with cut-off scores of 5 or 6 and weaker sensitivity with cut-off scores of 7 or 8. In contrast, its specificity increased as the cut-off increased. The positive predictive value ranged from 0.48 (cutoff of 5) to 0.56 (cut-off of 7). However, the negative predictive power was high for all cut-offs. Conclusion: The MSI-BPD can be an effective screening tool for detecting BPD. Our findings are generally consistent with the initial validation study for which a cutoff of 7 was recommended. However, we recommend a cut-off score of 6 as useful in a two-stage process to identify those likely to have BPD. When caseness is particularly important, a cut-off of seven may be preferred.