We have probably all had this moment in our work: does this individual experience borderline personality disorder? This is a crucial question because it informs directions for treatment and potential referral (e.g., to specialized treatment, like DBT). Luckily, there are borderline personality disorder assessment tools that can help support therapist clinical judgement.
A borderline personality disorder diagnosis is not cut and try. There are multiple experiences and diagnoses that share features with borderline. This often requires a thorough “rule out” or deliberation of other difficult experiences.
Borderline is frequently misdiagnosed as bipolar disorder, and vice versa. The reason for this misdiagnosis is somewhat unclear according to research, but many attribute it to the mood lability component that both experiences share. However, each condition requires very different therapy approaches to help.
Additionally, experiences in PTSD can sometimes look like borderline (e.g., negative alterations in cognition and mood, hyperarousal). But many who experience borderline also have a trauma history. So that also raises the possibility of someone describing early trauma experiences actually (or not actually) experiencing borderline symptoms.
But is there a good and easy way to assess borderline personality symptoms we suspect? In step the McLean. The McLean Screening for Borderline Personality Disorder is a measure of symptoms consistent with DSM diagnosis criteria as well as other features of borderline.
Pros: The McLean is quick and easy borderline personality disorder assessment tools to administer (only 10 items!). The measure is widely available for use and can be used in many settings. It is also well-validated by research. And it’s very easy to score!
Limits: Like any assessment tool, results do not guarantee 100% accuracy (like life, no assessment tool is perfect).
Clinical judgement is powerful, but we can also be wrong. The McLean is a good and free addition to therapist resources that help improve accuracy. This is important for a condition that requires specific treatment, but that gets easily confused with other conditions.
