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Zanarini Rating Scale for Borderline Personality Disorder
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About Zanarini Rating Scale for Borderline Personality Disorder
Scale Name
Zanarini Rating Scale for Borderline Personality Disorder
Author Details
Mary C Zanarini
Translation Availability
Not Sure
Background/Description
Borderline personality disorder (BPD) is a complex mental health condition characterized by emotional instability, impulsive behaviors, and difficulties in interpersonal relationships. Diagnosing and tracking BPD symptoms over time can be challenging. To address this need, the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) was developed.
The ZAN-BPD is a standardized, clinician-administered rating scale designed to assess the severity and track changes in BPD symptomatology. Published in 2003 by O.F. Kernberg, R.E. Paris, and A.E. Zanarini, the ZAN-BPD reflects the nine diagnostic criteria for BPD outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
The ZAN-BPD utilizes a structured interview format, focusing on a one-week timeframe for symptom evaluation. Each of the nine BPD criteria is rated on a five-point Likert scale, ranging from 0 (absent) to 4 (severe). This approach allows clinicians to capture both the frequency and intensity of BPD symptoms experienced by the patient. In addition to the total score, the ZAN-BPD also provides sub-scores for four core areas of BPD psychopathology: affective, cognitive, impulsive, and interpersonal.
The ZAN-BPD demonstrates strong psychometric properties, including good internal consistency, inter-rater reliability, and convergent validity with other BPD diagnostic instruments. This makes it a valuable tool for clinicians evaluating BPD in adult patients. Furthermore, the ZAN-BPD’s ability to track symptom changes over time proves useful in monitoring treatment progress and informing treatment decisions.
It is important to note that the ZAN-BPD is a clinician-administered tool and not a self-report measure. Additionally, the DSM-5, the current diagnostic manual, has revised the criteria for BPD. While the ZAN-BPD can still be a valuable tool, clinicians should be aware of these considerations when using the scale.
Administration, Scoring and Interpretation
- The clinician should be familiar with the ZAN-BPD instrument, including the nine BPD criteria and corresponding scoring guidelines.
- It’s recommended to have a copy of the ZAN-BPD for reference during the interview.
- Gather relevant background information about the patient, such as past diagnoses and treatment history.
- The clinician conducts a semi-structured interview with the patient, focusing on the past week.
- Each of the nine BPD criteria is addressed using specific questions tailored to assess the frequency and intensity of symptoms.
- The clinician should maintain a neutral and objective approach while creating a safe space for open communication.
Reliability and Validity
This study investigated the psychometric properties of the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD). Convergent validity was assessed by correlating the ZAN-BPD with relevant scales of the Symptom Checklist-90 (SCL-90) and the Diagnostic Interview Schedule for Borderline Disorders-Revised (DIB-R). These correlations were found to be statistically significant, indicating convergence with established measures of psychopathology.
Discriminant validity was also evaluated by comparing ZAN-BPD scores between two groups: 139 patients diagnosed with BPD according to DSM-IV criteria and a control group of 61 participants without BPD. The ZAN-BPD successfully differentiated between the groups, demonstrating its ability to distinguish individuals with and without BPD.
Internal consistency of the ZAN-BPD was assessed using Cronbach’s alpha, yielding a high value (0.85). Interrater reliability was evaluated through 32 conjoint interviews with blinded raters, and same-day test-retest reliability was assessed in a separate sample (n=40) with all raters blind to prior information. All intraclass correlations fell within the good to excellent range, indicating strong reliability of the ZAN-BPD.
Finally, the ZAN-BPD’s sensitivity to change was examined. A third sample (n=41) was re-interviewed by a blind rater 7-10 days after initial ZAN-BPD administration. The SCL-90 was also re-administered. Significant correlations were found between the change scores of the ZAN-BPD and the SCL-90, suggesting that the ZAN-BPD captures clinically meaningful changes in symptomatology over time.
Available Versions
10-Items
Reference
Zanarini, M. C., Vujanovic, A. A., Parachini, E. A., Boulanger, J. L., Frankenburg, F. R., & Hennen, J. (2003). Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. Journal of personality disorders, 17(3), 233–242. https://doi.org/10.1521/pedi.17.3.233.22147
Important Link
Scale File:
Frequently Asked Questions
What is the ZAN-BPD?
A clinician-administered tool to assess severity and track changes in borderline personality disorder (BPD) symptoms.
What does it measure?
The ZAN-BPD rates nine core BPD criteria based on the DSM-IV (may differ slightly from DSM-5). Scores reflect the frequency and intensity of symptoms over the past week.
How is it scored?
Each symptom is rated on a 0-4 scale (0 = absent, 4 = severe). Total score ranges from 0-36, with higher scores indicating greater BPD symptom severity.
Who uses the ZAN-BPD?
Clinicians like psychiatrists or psychologists diagnose and track BPD.
Is there a self-report version?
Yes, a self-report version exists, but clinician-administered ZAN-BPD is considered more reliable for diagnosis.
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