A systematic review on the applications of Borderline-Symptom List (BSL-23) a self-report measure for adults with Borderline Personality Disorder

Objective The Borderline Symptom List (BSL-23) was developed to provide a relatively brief and objective measure of BPD symptomatology. This review aims to provide a synthesis of how the measure has been used in practice, with what populations, research questions and methodologies, and to review its known reliability across these populations.Methods A systematic review was conducted by searching relevant databases for studies which had used the BSL-23 with an adult BPD sample. Results were analysed narratively, and a meta-analysis of reported reliability coefficients was conducted.Results 29 studies comprising 3492 participants were included. Most studies were conducted in Germany or Spain. Results indicated an overrepresentation of younger women. Notably, there is no evidence of a published validation of an English language version. Meta-analysis of Cronbach’s alpha suggests very high reliability, possibly hinting at a narrow conceptualisation of assessed symptoms.Discussion The BSL-23 remains a versatile tool. It has been applied in diverse settings for various purposes in a range of study designs. Clinicians and researchers need to be aware of the settings in which the BSL-23 has been used less frequently, with the current review making a number of recommendations for future research to fill the most important gaps.