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Borderline Symptom List 23 (BSL-23)

  • Borderline Symptom List 23 (BSL-23)

  • Date Format: MM slash DD slash YYYY
  • Please follow these instructions when answering the questionnaire: In the following table you will find a set of difficulties and problems which possibly describe you. Please work through the questionnaire and decide how much you suffered from each problem in the course of the last week. In case you have no feelings at all at the present moment, please answer according to how you think you might have felt. Please answer honestly. All questions refer to the last week. If you felt different ways at different times in the week, give a rating for how things were for you on average. Please be sure to answer each question.
  • In the course of last week...

    0 = not at all 1 = a little 2 = rather 3 = much 4 = very strong
  • Total each column
    0 =
    1 =
    2 =
    3 =
    4 =
    Add totals from each column -> TOTAL SCORE: ________
  • Overall personal state

    Now we would like to know in addition the quality of your overall personal state in the course of the last week. 0% means absolutely down, 100% means excellent. Please check the percentage which comes closest.

  • BSL - Supplement: Items for Assessing Behavior

  • During the last week.....

    0 = not at all 1 = once 2 = 2-3 times 3 = 4-6 times 4 = daily or more often
  • Total each column
    0 =
    1 =
    2 =
    3 =
    4 =
    Add totals from each column -> TOTAL BEHAVIOR SCORE: ________
  • This field is for validation purposes and should be left unchanged.