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Brazilian adaptation of the McLean Screening Instrument for Borderline Personality Disorder.

INTRODUCTION
Borderline personality disorder (BPD) is a serious and extremely prevalent mental disorder. Early diagnosis is vital for treatment. However, there are no specific validated screening instruments for Brazilian Portuguese. This study aimed to adapt the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) to the Brazilian context. The MSI-BPD is a self-report instrument based on the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) that allows a fast and reliable assessment of BPD, with measures of sensitivity and specificity similar to the diagnostic interview for the DSM-5 (SCID-II), taken as the gold standard.


METHOD
Simultaneous translation, synthesis version, back-translation, and analysis by experts were performed to create the final version of the instrument in Brazilian Portuguese. The translated instrument was responded by 1,702 adults aged 18-59 years to verify validity evidence on content, internal structure, relationship with other variables, and reliability.


RESULTS
The exploratory and confirmatory factor analyses show the unifactorial structure's adequacy. The scale showed satisfactory internal consistency (KR-20 of the Cronbach's alpha = 0.691) and good test-retest reliability (ICC = 0.802). Logistic regression analysis using PID-5-BF (DSM-5) as reference established an ideal cut-off point of 8 symptoms, with adequate sensitivity (0.79) and specificity (0.75), similar to the original instrument. The area under the curve (AUC) was 0.830 (95% confidence interval, 0.802-0.858), with a positive predictive value of 89.2%.


CONCLUSION
The Brazilian version of MSI-BPD has adequate psychometric properties to be used as a screening tool for BPD by the clinician.