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 3,492 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.