Identification of Borderline Personality Disorder in Adolescents: Psychometric Properties and Diagnostic Efficiency of a Juvenile Version of the Impulsivity and Emotion Dysregulation Scale (IES-27-J).

Abstract

Objective: The diagnostic efficiency of screening instruments for adolescents with Borderline Personality Disorder (BPD)-that are applicable to its new classification in DSM-5 and ICD-11-has not yet been sufficiently studied.

Methods: We examined the reliability and diagnostic efficiency of the juvenile version of the Impulsivity and Emotion Dysregulation Scale (IES-27-J) in a German-speaking sample of inpatient 12-19-year-old adolescents (N = 220, including n = 88 with BPD and n = 132 with other mental disorders). Using a receiver operating characteristic (ROC) analysis, optimal cutoff values were determined for this self-report instrument. Analyses were conducted for two different diagnostic thresholds with at least four and five BPD diagnostic criteria, respectively, in accordance with the semi-structured clinical interview International Personality Disorder Examination (IPDE).

Results: Results indicate that the IES-27-J is a reliable and valid instrument with moderate to high discriminative ability (areas under the curve [AUC] = 0.77 and 0.80, respectively). Using the preferred cutoff values, sensitivity (71% and 83%) and specificity (76% and 67%) turned out to be moderate.

Conclusion: The application of the IES-27-J can be considered favorable in a two-stage approach, using a lower cutoff value in a first step to miss fewer patients with BPD, and conducting a clinical interview in a second step to confirm the diagnosis. More studies in different settings, including direct comparisons with other screening instruments, are necessary to further assess the clinical utility of the IES-27-J.