Brief Description
The Borderline Evaluation of Severity Over Time (BEST) measures severity and change in symptoms in persons with borderline personality disorder (BPD). The (BEST) was developed to rate the thoughts, emotions, and behaviors typical of BPD. The first 8 items comprise subscale A (Thoughts and Feelings) and involve assessments of mood reactivity, identity disturbance, unstable relationships, paranoia, emptiness, and suicidal thinking; items 9-12, comprise subscale B (Behaviors-Negative), which rates negative actions such as injuring oneself; and items 13-15, comprise subscale C (Behaviors-Positive), which rates actions such as following through on therapy plans. For the first 12 items, respondents rate how much distress the BPD symptoms listed cause them (e.g., “Worrying that someone important in your life is tired of you or is planning to leave you”) on a scale from “None/Slight” to “Extreme.” For items 13-15, respondents rate how often they use the behaviors listed on a scale from “Almost Always” to “Almost Never.”
Assessment Administration Type
Self-report
Number of questions
15
Age Range for Administration
18+
Recommended Frequency of Administration
No standardized frequency; recommend administering every other week or as clinically indicated.
Summary of Scoring and Interpretations
The BEST contains 15 questions and 3 subscales: A (Thoughts and Feelings); B (Behaviors-Negative), and C (Behaviors-Positive). All items are rated on a 5-point Likert-like scale. Subscales A and B are on a 5-point Likert scale from 1 (“None/slight”) to 5 (“Extreme) and subscale C is rated from 5 (“Almost Always”) to 1 (“Almost Never”). A total BEST score is calculated by first summing the item responses for each subscale. Then scores of subscales A and B are added together, and the total from subscale C is subtracted. A correction factor of 15 is added to yield the final score (i.e., Total Score = A + B - C + 15). Item responses range from 12 (best) to 72 (worst); higher scores are associated with higher levels of BPD symptoms. See the table below for subscales and their associated items.
Subscale | Item |
A (Thoughts and Feelings) | 1-8 |
B (Behaviors-Negative) | 9-12 |
C (Behaviors-Positive) | 13-15 |
Blueprint Adjustments
N/A
Clinical Considerations
Estimated completion time: 3-4 minutes
The BEST was designed to measure severity in an ill population and was not designed as a diagnostic instrument.
The BEST Subscales A and B are taken from the DSM-IV criteria; the two subscales recognize that Thoughts and Feelings (A) are different from the Negative Behaviors (B) typical of BPD. Section C was added to acknowledge the acquisition of positive behaviors through treatment, as well as to reinforce the use of new skills before seeing improvement in A and B, because scores in subscale C were expected to improve first.
Citation
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