986157

research-article20212021
SGOXXX10.1177/2158244020986157SAGE OpenBibi and Kazmi

Original Research

SAGE Open

Urdu Translation and Validation of

January-March 2021: 1­–10
© The Author(s) 2021
DOI: 10.1177/2158244020986157
https://doi.org/10.1177/2158244020986157

11-Item Measure to Assess Borderline journals.sagepub.com/home/sgo

Personality Features in Pakistani

Adolescents

Humaira Bibi1 and Syeda Farhana Kazmi1

Abstract
The current study includes Urdu translation and validation of Borderline Personality Features Scale–11 (BPFS-11) in two
phases. Phase 1 included forward and back translation of BPFS-11, and Phase 2 included establishment of psychometric
properties for BPFS-11. For this purpose, 930 adolescents were selected from different hospitals, schools, and colleges. The
reliability value of the scale was .72. Exploratory factor analysis revealed factor structure with four principal dimensions;
besides confirmatory factor analysis, goodness-of-fit indices indicated good fit of model to data, and two dimensions of scale
and factors showed good values of internal consistency. The obtained value for goodness-of-fit index was .995, for adjusted
goodness-of-fit index was .989, for comparative fit index was .998, for incremental fit index was .998, and for root mean
square error of approximation (RMSEA) value was .019. Good values of composite reliability and convergent validity were
measured for both dimensions of the scale. The analysis of criterion-related validity showed significant positive correlation of
BPFS-11 with Affective Lability Scale, Deliberate Self-Harm Inventory, and neuroticism scale of Big Five Inventory. Significant
differences were found between scores of individuals having borderline personality disorder and scores of normal individuals.
The results of the current study indicated that BPFS-11 is short and easily administered diagnostic tool that has good
psychometric properties and can be helpful for diagnosis of borderline personality features in adolescents. It can enhance the
understanding of the participants regarding the statements of the scale for Urdu natives.

Keywords
borderline personality, Affective Lability Scale, Deliberate Self-Harm Inventory, neuroticism, Urdu, Pakistan

Borderline personality disorder (BPD) is a psychiatric state Pakistan concluded that the prevalence rate is 18% for BPD.
that is associated with dysregulation of emotions, bad tem- The study also concluded that the adolescents between 13
per, fear of rejection, feelings of worthlessness, self-harm, and 19 years of age and young adults between 20 and 29
and unstable relationships with others. It is common in both years of age had significantly higher tendencies toward men-
psychiatric population and in the general community (Brune, tal disorders (Hussain, 2018).
2016). BPD is an emotionally unstable personality disorder, Pakistan is a developing country and faces a lot of prob-
and patients with this disorder mostly have difficulty in the lems related to health, education, employment, poverty,
management of problems (Winston, 2018). availability of resources, and political instability. All these
The prevalence of BPD is increasing day by day. Some problems lead to negative mental states, which in turn may
non-clinical surveys of general population of the United lead to psychological disturbances. In a study, Hasan et al.
States estimated that the prevalence of BPD is 1.6% and life- (2011) selected all registered cases of 2003–2009; there are
time prevalence is 5.9%. The ratio of females to males with 2.22% cases that were diagnosed on Axis II (personality dis-
the disorder is greater in clinical populations than it is in gen- orders). Out of these, 18.18% were diagnosed as BPD.
eral population. The ratio is 3:1 in clinical settings; however, Availability of reliable and valid tools to measure personality
lifetime prevalence of BPD does not differ significantly
between men and women (Skodol, 2019). A study conducted 1
Hazara University Mansehra, Pakistan
in Iran concluded that the prevalence rate of BPD in adoles-
Corresponding Author:
cents is 0.9% (Mohammadi et al., 2014). Humaira Bibi, Lecturer, Department of Psychology, Hazara University
In Pakistan, prevalence rate of BPD is also increasing. A Mansehra, Mansehra 21300, Pakistan.
study conducted on 3,500 individuals from different cities of Email: humairasaqib1981@gmail.com

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2 SAGE Open

disorders is very less. Urdu is a national language of Pakistan, variations or fluctuations of severe affect, having difficulty
as well as largely spoken language in many Indian states. It in regulation of these variations and their behavioral conse-
is a widely spoken language in South Asia; besides South quences (Marwaha et al., 2014). Affective instability in BPD
Asia, Urdu is a spoken language of many emigrants and their is due to a marked reactivity to environmental events.
children who are working in Middle East region, Australia, Affective instability is a crucial part of impulsive personality
the United Kingdom, and other European countries. So, it is functioning (Herpertz et al., 1997). Self-harm is to perform
very difficult for less educated or uneducated individuals to behaviors that provide injury to own self. These behaviors
understand questions in English. may or may not include suicidal attempts. It is any type of
Unfortunately, none of the diagnostic tool is available in self-injury (Muehlenkamp et al., 2012). Self-harming behav-
Urdu. So, there is a need to translate a scale in Urdu that iors are common in adolescents and young adults, and ado-
can be easily administered on educated, uneducated, and lescents involved in self-harming behaviors are at a greater
less educated persons, belonging to rural or urban areas of risk of suicide (Sanchez-Teruel et al., 2020). BPD often
Pakistan. The current study translated the Borderline involves in a number of disruptive behaviors, such as self-
Personality Features Scale–11 (BPFS-11) in Urdu to make it destructive actions, impulsivity, and suicidal ideations. So,
applicable for Pakistani population and population of other they are at a considerable risk of providing harm to their
countries who can understand Urdu but cannot understand selves and others if they are left unmanaged (Shaikh et al.,
English. 2017). Self-harm behaviors are part of impulsivity; impulsiv-
The BPFS-11 is a short version of original Borderline ity can cause harm to yourself and those around you (Salters-
Personality Features Scale for Children (BPFS-C; Crick Pedneault, 2020). So, in a broad sense, both of these factors
et al., 2005). BPFS-C is a 24-item scale that is widely used (affective instability and self-harm) are closely related to or
measure to diagnose borderline personality characteristics in part of impulsivity/reactivity factor of BPD.
children above 9 years as well as in adolescents. It has four Identity is related to sense of self and individuality, which
subscales: Negative Relationships, Affective Instability, depends on social recognition. There are a number of identity
Self-Harm, and Identity Problems. BPFS-C was translated problems such as identity crisis and identity diffusion. All
and validated in different languages; Lui and Wang (2019) these problems depend on self-evaluation and evaluation of
translated and validated this scale in Chinese language, and others (Sollberger, 2013). Several symptoms in interpersonal
concluded that BPFS-C was a reliable and valid measure to domain of BPD are actually manifestations of intrapersonal
assess borderline personality features in Chinese children difficulties (e.g., difficulty being alone and misperception of
and adolescents. The BPFS-11 includes 11 items that were the intentions of others as wicked), and identity problems are
selected from BPFS-C by using item response theory meth- part of intra-/interpersonal preoccupation (Ramarajan, 2014;
ods. It includes items related to all four factors of BPFS-C, Stanley & Siever, 2010).
but there was not enough support for these factors in BPFS- Negative relationships are hostile relationships with oth-
11. So, it is a unidimensional scale, with scoring criteria of ers and based on disagreement or rivalry behaviors with oth-
5-point Likert-type scale, ranging from not at all true to ers (Easley & Kleinberg, 2010). Disturbance in interpersonal
always true (Sharp et al., 2014). Other researchers translated relationship is the main characteristic of BPD. Gunderson
and validated both BPFS-C and BPFS-11 original English et al. (1996) found that two interpersonal criteria, avoidance
scales in Portuguese language, and concluded that both of abandonment and unstable relationships, differentiated
scales are reliable and valid measures to diagnose borderline borderline from other personality disorders; disturbances in
personality features in adolescents (Carreiras et al., 2020). interpersonal relationship are part of intra- and interpersonal
The Italian version of the Borderline Personality Features preoccupation; and this domain is unique part of BPD (Siever
Scale for Children–11 (BPFSC-11) was tested on a commu- & Weinstein, 2009). So, in general, both of these factors,
nity sample and presented adequate internal consistency, and identity problems and negative relationships, are part of
confirmatory factor analysis (CFA) supported a bifactor intra-/interpersonal factor of BPD.
model with all items significantly loading on a general factor Somma et al. (2016) used BPFS-11 on Italian adolescents
with two specific factors (Fossati et al., 2019). Another study and concluded that it is an excellent screening instrument to
conducted by Haltigan and Vaillancourt (2016) on Canadian measure borderline personality features in adolescents, and it
adolescents between 13 and 16 years had made efforts to showed positive correlation with Deliberate Self-Harm
confirm the four-factor model of BPFS-C, but was not Inventory (DSHI) and Difficulties in Emotion Regulation
successful, but EFA (exploratory factor analysis) and CFA Scale.
of the study provided support to two-factor models of The current study has made an attempt to translate and
BPFS-C, intra-/interpersonal preoccupation and impulsivity/ validate the BPFS-11 into Urdu language and to establish the
reactivity. psychometric properties of BPFS-11 in Pakistani culture.
The items of BPFS-11 are related to four subscales: Research instruments in Urdu have a great value in Pakistan
Affective Instability, Self-Harm, Identity Problems, and as well as in neighboring countries, and for conducting
Negative Relationships. Affective instability is quick research on South Asian population who are working in
Bibi and Kazmi 3

European countries or in any area where majority Urdu on three subscales: Depression/Elation, Anger, and Anxiety/
speakers live in. So, the current study aimed to translate and Depression. The higher scores indicate high affective
validate the BPFS-11 in Urdu, according to Pakistani culture lability.
for Urdu speakers, especially for those who are unable to
understand the scale in English. As it is a national language DSHI. It was developed by Gratz (2001). It is a self-report
of Pakistan, for Pakistani population (especially for children measure that has 17 items; it measures presence and fre-
and adolescents), it is easy to understand the scale in Urdu. quency of a range of self-harming actions. In the present
The current study has three main aims: first is to translate study, the DSHI was used to evaluate the construct validity
and adapt the BPFS-11 in Urdu, second is factor analysis of of Urdu translation of BPFSC-11. High scores on this scale
the translated and adapted BPFS-11 on indigenous population, show greater frequency of self-harming behaviors, whereas
and third is to validate BPFS-11 to establish psychometric low scores show low frequency of self-harming behaviors.
properties of scale and to measure concurrent and construct
validity of scale. Big Five Inventory (BFI). It was developed by John et al. (1991).
It has 44 items, and eight to 10 items are related to each trait.
It has five subscales. In the current study, NEU subscale was
Method
used. NEU has eight items (4, 9, 14, 19, 24, 29, 34, and 39).
The current study was conducted in two phases. Phase 1 Items 9, 24, and 34 are reverse-scoring items. Scoring crite-
includes translation of BPFS-11 in Urdu and Phase 2 includes ria is a 5-point Likert-type scale, ranging from 1 = strongly
establishment of psychometric properties of scale. To exam- disagree to 5 = strongly agree.
ine the factors of BPFS-11, CFA was used. The scores of
BPFS-11 were correlated with scores of Affective Lability
Scale (ALS), DSHI and neuroticism (NEU) scale by using
Phase 1: Translation of BPFS-11 in the Urdu
correlation. As disturbances in affective components and Language
emotional regulation are basic characteristics of BPD, ALS Translation of BPFS-11 was done, from the source (English)
was selected to check criterion-related validity of BPFS-11. to target language (Urdu) with the assistance of six bilingual
Similarly, individuals with BPD also attempt self-harming experts (three assistant professors, one professor, and two
behaviors, and because self-harm is a characteristic of BPD, lecturers). They were requested to translate the scale word-
deliberate self-ham inventory was selected to check crite- by-word, so that meanings of words cannot change. The next
rion-related validity of BPFS-11. Both of these scales were step is a careful evaluation of all items by a committee of six
also used to check criterion-related validity of BPFS-11 orig- experts in clinical psychology field (one associate professor,
inal English scale (Sharp et al., 2014). As borderline person- one assistant professor, and four lecturers). These experts
ality has positive association with NEU personality trait deeply examined every item with respect to style, grammar,
(Furnham & Crump, 2014), NEU scale was used for measur- and word selection that seems closer to the original test. The
ing related validity of BPFS-11. Independent t test was used next step was back translation of the scale by using the
to compare the scores of borderline patients with scores of Brislin (1976) method. Two lecturers of Urdu, two lecturers
normal adolescents. of English, and one lecturer of psychology were requested to
translate the Urdu items back into English. These lecturers
Measures did not have any idea or familiarity with the original English
version scale of BPFS-11. Then these selected items were
In the present study, the following measures were used. administered on a small sample of 20 adolescents with age
ranging from 12 to 19 years. Results revealed that there is no
BPFS-11. BPFS-11 was developed by Sharp et al. (2014). It ambiguity in scale items. All items are clear and logical, and
is a short version of BPFS-C (Crick et al., 2005). It includes they can be used for further analyses.
11 items, with scoring criteria of 5-point Likert-type scale,
ranging from 1 = not at all true to 5 = always true. Higher
Phase 2: Psychometric Properties of BPFS-11
scores indicate high level of borderline personality features.
Cutoff point is 34; adolescents having scores higher than 34 To determine the psychometric properties of Urdu transla-
are considered as having features of BPD and adolescents tion of BPFS-11, Cronbach’s alpha was used for reliability
having scores less than 34 are considered as normal. analysis of scale. Analysis of Moment Structure (AMOS 20;
CFAs) was used for evaluating construct validity of factors
ALS. It was developed by Oliver and Simons (2004). ALS of BPFS-11. Correlation with ALS and DSHI was used to
has 18 items. Scoring criteria is a 4-point Likert-type scale, determine the convergent validity of BPFS-11. The scores
ranging from 0 = very uncharacteristic of me, to 3 = very of healthy adolescents were also compared with the scores of
characteristic of me. ALS yields total scores as well as scores adolescents having borderline personality.
4 SAGE Open

Sample were administered in English language because all of the

subjects can understand both Urdu and English language
A sample of 1,600 adolescents was approached from differ- easily.
ent hospitals (diagnosed borderline patients), schools, and After completion of the data, all participants were thanked
colleges and universities of Pakistan by using convenient to take part in research. Some of the data were discarded
sampling technique. Initially, participants who were seeking because of incomplete questionnaires.
treatment for psychiatric illness were approached in different
private- and public-sector hospitals of Pakistan. Written per-
mission was obtained from relevant hospital authorities for Data Analyses
data collection. Participants who gave written informed con-
After collection of data, appropriate statistical analyses were
sent were included in the study. Similarly, in educational set-
applied for data analyses. EFA in SPSS-20 was used for fac-
tings, participants were approached by obtaining written
tor structure and principal dimensions of the scale. CFA in
permission from relevant authorities and by taking written
AMOS-22 was used to evaluate the factors of BPFS-11. The
informed consent from participants. BPFS-11 was adminis-
Pearson product–moment correlation coefficient was used
tered on all those participants. Based on the initial screening
for measuring correlation among all scales; t test was used
on BPFS-11, those 930 participants, who showed BPD
for measuring differences between the scores of adolescents
symptoms, by obtaining greater scores than cutoff point on
with borderline personality features and adolescents without
the scale, were short-listed for further assessment. Out of
borderline personality features.
these 930 adolescents, 414 (44.5%) were boys and 516
(55.5%) were girls. The data of remaining 670 adolescents,
who have low scores on the scale, were used as a comparison Results
group to compare the scores of borderline patients with non-
borderline adolescents. The results of the present study are as follows.

Procedure Reliability of BPFS-11

The prior approval for data collection was taken from rele- The reliability analysis of BPFS-11 was conducted. BPFS-11
vant authorities (hospital in-charge and administration, showed satisfactory levels of reliability. The alpha value for
school and college principals). Approval from the ethical total scale was .72. For Factor 1, alpha value was .79, and for
committee has also obtained. Participants were residents of Factor 2, alpha value was .82.
Pakistan. Subjects were approached, and written informed Correlation analysis indicated that BPFS-11 Urdu transla-
consent was obtained from them. Necessary instructions tion has a significant positive correlation with BPFS-11 orig-
were given to the subjects to complete the questionnaires as inal English scale at .01 level of significance, so both Urdu
honestly and completely as possible. In hospital settings, translation and English version are significantly correlated
subjects were approached in out-patient departments (OPDs) with each other.
and psychiatry wards, and BPFS-11 was administered on
diagnosed borderline patients within the age range of 12 to
Validation of BPFS-11
19 years. In educational settings, BPFS-11 was administered
on students within age range of 12 to 19 years, both girls and EFA was used for factor structure and principal dimensions
boys. All the participants who have obtained scores greater of the scale. CFA was used to evaluate the factors of BPFS-
than cutoff point of BPFS-11 were selected for final analy- 11. CFA is a widely used method of factor analysis. Based on
ses. Participants who have obtained scores less than cutoff the primary criteria, all the observed factors had acceptable
point of BPFS-11 were used as comparison group, to com- standardized regression values, that is, greater than .35
pare their results with the results of those adolescents who (Field, 2009). Thus, in the present study, the factor loadings
have borderline personality features. of CFA for the two dimensions of BPFS-11 were above .35.
Out of the selected adolescents who have greater than cut- For comprehensive analysis, the graphic representation of
off scores on BPFS-11, 200 adolescents (100 boys [50%] and factors is given below:
100 girls [50%]) were requested to fill the BPFS-11 in both Figure 1 showed the factor models of two dimensions of
languages, Urdu translated scale and original English scale, BPFS-11. All the values are greater than .35, which is an
to find out correlation between both scales. Other 200 ado- acceptable criterion for standardized regression value.
lescents (100 boys [50%] and 100 girls [50%]) were requested Table 1 indicated demographic characteristics of sample
to fill the ALS along with BPFS-11, next 200 (100 boys with respect to age, gender, education and monthly family
[50%] and 100 girls [50%]) were requested to fill the NEU income alongwith their frequency and percentage.
subscale of BFI along with BPFS-11, and other 200 (100 Table 2 showed extraction value of all items of BPFS-11
boys [50%] and 100 girls [50%]) adolescents were requested and showed that all of the 11 items have satisfactory value
to fill the DSHI along with BPFS-11. All the additional scales and can be used to measure borderline personality features.
Bibi and Kazmi 5

Figure 1. Graphical presentation of two dimensions of BPFS-11.

Note. BPFS-11 = Borderline Personality Features Scale–11.

Table 1. Demographic Characteristics of Sample With Table 2. Communalities Values of Extraction Method by using
Borderline Personality Features (N = 930). Principal Components Analysis of BPFS-11 (N = 930).

Demographics Frequency % Item No. Value

Age 1 .74
12–15 100 10.8 2 .71
16–19 830 89.2 3 .75
Gender 4 .79
Boys 414 44.5 5 .75
Girls 616 55.5 6 .64
Education 7 .77
Metric 120 12.9 8 .83
Intermediate 810 87.1 9 .64
Monthly family income 10 .83
Less than 50,000 217 23.3 11 .61
50,000 to 100,000 330 35.5 Note. BPFS-11 = Borderline Personality Features Scale–11.
100,000 above 383 41.2

Table 6 shows that BPFS-11 has significant positive cor-

Table 3 showed factor loading value of two factors of relation with DSHI, ALS, and NEU scale.
BPFS-11 Urdu translation. Table 7 shows that all subscales of BPFS-11 have signifi-
Table 4 showed CFA for goodness-of-fit index (GFI) for cant positive correlation with DSHI, ALS, and NEU scale.
two subscales of BPFS-11. The acceptable values for GFI Table 8 indicated comparison between healthy and non-
(goodness-of-fit index), AGFI (adjusted goodness-of-fit healthy individuals on BPFS-11 and its subscales. The com-
index), CFI (comparative fit index), and IFI (incremental fit parison was made between the two groups, 300 healthy
index) are .90 or greater and the current study obtained val- adults and 300 diagnosed with BPD. The analysis of inde-
ues between .995 and .998. So, the current study has signifi- pendent t test indicated significant differences between the
cant findings. scores of healthy individuals and borderline patients on
Table 5 indicated satisfactory values of Cronbach’s alpha, BPFS-11 and both of its subscales. The value of Cohen’s d
composite reliability, and convergent validity of two factors indicated differences between the mean scores of two groups
of BPFS-11. on BPFS-11 and its subscales.
6 SAGE Open

Table 3. Factor Loading for Exploratory Factor Analysis by Using Varimax Rotation Analysis of BPFS-11 (N = 930).

Item No. Factor 1 Factor 2

2 .84
6 .79
11 .77
9 .71
4 .87
5 .85
1 .82
% variance 14.17
Cumulative variance 72.38
Kaiser–Meyer–Olkin measure .721
Bartlett’s test of sphericity 3.389 < 0.0001

Note. BPFS-11 = Borderline Personality Features Scale–11.

Table 4. Model Fit Indices for BPFS-11 (N = 930).

Goodness-of-fit indices

Models χ2(df) χ2/df GFI AGFI CFI IFI RMSEA

BPFS-11 16.03(12) 1.336 .995 .989 .998 .998 .019
(two factors)

Note. BPFS-11 = Borderline Personality Features Scale–11; GFI = goodness-of-fit index; AGFI = adjusted goodness-of-fit index; CFI = comparative fit
index; IFI = incremental fit index; RMSEA = root mean square error of approximation.

Table 5. The CFA Reliability and Validity Results for Final Model of BPFS-11 (N = 930).

Cronbach’s alpha CR AVE

Construct Items Factor loading (>.7) (>0.6) (>0.5)
Factor 1 (intra-/ BPD.2 .84 .79 0.87 0.61
interpersonal BPD.6 .79
preoccupation) BPD.9 .71
BPD.11 .77
Factor 2 (impulsivity/ BPD.1 .82 .84 0.89 0.72
reactivity) BPD.4 .87
BPD.5 .85

Note. CFA = confirmatory factor analysis; BPFS-11 = Borderline Personality Features Scale–11; CR = composite reliability; AVE = average variance
extracted; BPD = borderline personality disorder.

Table 6. Correlation Among BPFS-11, DSHI, AFL, and NEU Scale (N = 600).

Scales BPFS-11 DSHI ALS NEU

BPFS-11 — .24** .15* .35**
DSHI — — .26** .33**
ALS — — — .28**
NEU — — — —

Note. BPFS-11 = Borderline Personality Features Scale–11; DSHI = Deliberate Self-Harm Inventory; ALS = Affective Lability Scale; NEU = neuroticism.
*p < .05. **p < .01.
Bibi and Kazmi 7

Table 7. Correlation Among Subscales of BPFS-11, DSHI, AFL, and NEU Scale (N = 600).

Scales IIPF IRF DSHI ALS NEU

IIPF — .29** .34** .30** .27**
IRF — — .24** .23** .33**
DSHI — — — .26** .34**
ALS — — — — .28**
NEU — — — — —

Note. BPFS-11 = Borderline Personality Features Scale–11; DSHI= Deliberate Self-Harm Inventory; ALS= Affective Lability Scale; NEU = neuroticism;
IIPF = intra-/interpersonal preoccupation factor; IRF = impulsivity/reactivity factor.
**p < .01.

Table 8. Comparison Between the Scores of Adolescents With Borderline Personality Features and Adolescents Without Borderline
Personality Features on BPFS-11 and Its Subscales.

Healthy individuals Borderline patients

(n = 300) (n = 300) 95% CI
Cohen’s
Scales M SD M SD t(598) p LL UL d
BPFS-11 19.72 3.42 42.02 4.96 64.05 .001 21.61 22.98 5.23
IIPF 7.28 1.85 14.52 3.22 33.75 .001 6.82 7.66 2.78
IRF 4.19 1.33 11.12 2.52 42.10 .001 6.61 7.25 3.44

Note. BPFS-11 = Borderline Personality Features Scale–11; CI = confidence interval; LL = lower limit; UL = upper limit; IIPF = intra-/interpersonal
preoccupation factor; IRF = impulsivity/reactivity factor.

Table 9. Gender Differences on BPFS.

Males Females
(n = 414) (n = 516) 95% CI

Variable M SD M SD t(928) p LL UL Cohen’s d

BPFS 33.16 7.09 41.93 5.07 23.44 .001 –9.51 –8.04 1.42

Note. BPFS = Borderline Personality Features Scale; CI = confidence interval; LL = lower limit; UL = upper limit.

Table 9 indicated significant gender differences on BPFS. convergent validity for Factor B was .89. BPFS-11 and its
It indicated that borderline personality features are greater two dimensions showed good construct validity as all the
in females as compared to males. The value of Cohen’s d items have significant positive correlation with total scores.
indicated differences between the mean scores of two groups Both dimensions of BPFS-11 showed satisfactory level of
on BPFS-11. goodness-of-fit indices. The value of χ2 was 16.03; χ2/df
value was 1.336, which is less than its accepted standardized
value, that is, χ2/df value should be less than 3. Concerning
Discussion the chi-square test, the value of χ2/df = 1 is considered as
The current study was conducted to translate and validate the perfect; value of χ2/df that is fewer than 2 is considered
BPFS-11 in Urdu. Results showed satisfactory level of reli- as good value; if obtained value is lesser than 5, it is taken as
ability (.72). Results of EFA indicated a factor structure with acceptable value and if the obtained value is 5 or more, it is
four principal dimensions. CFA was used to analyze the fac- considered as an unacceptable value, this value of χ2/df is
tors, which showed good level of model fit indices for two related to the size of the sample (Marques et al., 2014).
factors of BPFS-11. The reliability values for two subscales Similarly, the obtained value for GFI was .995, for AGFI
were .79 and .84, respectively. Both factors of BPFS-11 .989, for CFI .998, for IFI .998, for TLI (Tucker–Lewis
showed good values for composite reliability and convergent index) .997, and for NFI (normed fit index) .993. All of these
validity. The estimated composite reliability for Factor A was values are greater than .90, which is a standardized criterion
.87, and the estimated value for convergent validity of Factor value. According to Schumacher and Lomax (2010), these
A was .61. Similarly, the calculated value of composite values range from 0 to 1, values near 1 indicate perfect fitting
reliability for Factor B was .84, and calculated value of of the model. Values from .90 to .95 range or above show
8 SAGE Open

good model fit (Hair et al., 2006). The obtained value for in adolescents. The results of CFA indicated multidimension-
root mean square error of approximation (RMSEA) was ality of the scale. BPFS-11 would be very helpful for clinical
.019, which is less than .05 that is the accepted standardized psychologists and psychiatrists to diagnose borderline fea-
value of RMSEA, this value should be less than .08 for tures in adolescents. The correlation with ALS, DSHI, and
acceptable model fit and for a good model fit this value NEU also provides great contributions in the literature. It
should be less than .05. In the present study, the obtained was concluded that BPFS-11 is a short, concise, and easily
value of RMSEA was .019, which shows good model fit of administered scale that has good and satisfactory psychomet-
the scale. A good characteristic of RMSEA is that it provides ric properties. It can enhance the development of patient’s
95% or 90% assurance that model is in the acceptable fit strength and enhance self-worth.
range (Hu & Bentler, 1999).
So, the BPFS-11 and its two dimensions indicated very Declaration of Conflicting Interests
good values on all three levels of model fit indices, that is,
The author(s) declared no potential conflicts of interest with
AGFI, IFI, and parsimonious fit. The analysis showed that respect to the research, authorship, and/or publication of this
Urdu translated scale of BPFS-11 has a significant positive article.
correlation with its original scale, that is, BPFS-11 original
English version. For measuring criterion-related validity of Funding
BPFS-11, three scales—ALS, DSHI, and NEU—were used
The author(s) received no financial support for the research, author-
for correlation with BPFS-11 as well as with its subscales.
ship, and/or publication of this article.
The results indicated significant positive correlation of all
subscales of BPFS-11 with ALS, DSHI, and NEU. These
results are supported by some of the previous studies. A Ethical Statement
study concluded high positive correlation between self-harm Prior ethical approval from heads of institutes has been taken for
inventory and borderline personality (Sansone et al., 1998). data collection.
Some other studies also concluded positive relationship
between non-suicidal self-harming behaviors and BPD Inform Consent
(Brickman et al., 2014; Sleuwaegen et al., 2017). Written informed consent has been taken from all participants to
Similarly, BPD has high positive correlation with ALS know about their willingness to participate in the study.
(Reich et al., 2014). Some recent studies found significant
positive correlation between affective lability and BPD ORCID iD
(Carpenter & Trull, 2013; Schoenleber et al., 2016).
Humaira Bibi https://orcid.org/0000-0002-0476-728X
Similarly, some other recent studies concluded strong
positive correlation between BPD and NEU (Few et al.,
2016; Saldanha-silva et al., 2019). References
Discriminant validity of BPFS-11 was estimated by com- Brickman, L. J., Ammerman, B. A., Look, A. E., Berman, M. E.,
parison of scores of normal adolescents and adolescents & McCloskey, M. S. (2014). The relationship between non-
having borderline personality features. Findings indicated suicidal self-injury and borderline personality disorder symp-
significant differences between scores of healthy individuals toms in a college sample. Borderline Personality Disorder
Emotional Dysregulation, 1, 14. https://doi.org/10.1186/2051-
and borderline patients on BPFS-11, as well as significant dif-
6673-1-14
ferences between scores of healthy individuals and borderline Brislin, R. W. (1976). Comparative research methodology: Cross-
patients were concluded on both dimensions of the scale. cultural studies. International Journal of Psychology, 11(3),
As a result, Urdu translation of BPFS-11 was found to be 215–229. https://doi.org/10.1080/00207597608247359
a reliable and valid measure for the assessment of borderline Brune, M. (2016). Borderline personality disorder: Why “fast and
personality features in adolescents. furious”? Evolution, Medicine, & Public Health, 2016(1),
52–66. https://academic.oup.com/emph/article/2016/1/52
/2802558
Limitations and Suggestions Carpenter, R. W., & Trull, T. J. (2013). Components of emotion
The present study has taken ALS, DSHI, and NEU for cor- dysregulation in borderline personality disorder: A review.
relation with BPFS-11; it is suggested that future research Current Psychiatry Reports, 15(1), 335. https://doi.org/10.1007
/s11920-012-0335-2
should include any opposite construct for correlation, to
Carreiras, D., Loureiro, M., Cunha, M., Sharp, C., & Castilho,
determine the divergent validity of the scale. P. (2020). Validation of the Borderline Personality Features
Scale for Children (BPFS-C) and for Parents (BPFS-P) for the
Conclusion and Implications Portuguese population. Journal of Child and Family Studies,
29, 3265–3275. https://doi.org/10.1007/s10826-020-01800-7
It was concluded that Urdu translation of BPFS-11 is a reliable Crick, N. R., Murray-Close, D., & Woods, K. (2005). Borderline
and valid tool for diagnosing borderline personality features personality features in childhood: A short-term longitudinal
Bibi and Kazmi 9

study. Development and Psychopathology, 17, 1051–1070. Children. Medical Science Monitor, 25, 3476–3484. https://
https://doi.org/10.1017/S0954579405050492 doi.org/10.12659/MSM.912662
Easley, D., & Kleinberg, J. (2010). Positive and negative relation- Marques, D., Pinheiro, M. R., Matos, A. P., & Marques, C. (2014).
ships. https://www.cs.cornell.edu/home/kleinber/networks-book/ Confirmatory factor analysis of the QRI father’s version in
networks-book-ch05.pdf a Portuguese sample of adolescents. Procedia–Social and
Few, L. R., Miller, J. D., Grant, J. D., Maples, J., Trull, T. J., Behavioral Sciences, 165, 267–274. https://doi.org/10.1016/j.
Nelson, E. C., Oltmanns, T. F. (2016). Trait-based assessment sbspro.2014.12.631
of borderline personality disorder using the NEO Five-Factor Marwaha, S. Z., Broome, M. R., Singh, S. P., Scott, J., Eyden, J.,
Inventory: Phenotypic and genetic support. Psychological & Wolke, D. (2014). How is affective instability defined and
Assessment, 28(1), 39–50. https://doi.org/10.1037/pas0000142. measured? A systematic review. Psychological Medicine,
Field, A. (2009). Discovering statistics using SPSS. Sage. 44(9), 1793–1808. http://wrap.warwick.ac.uk/58532/1/WRAP_
Fossati, A., Sharp, C., Borroni, S., & Somma, A. (2019). How%20is%20AI%20defined%20and%20measured%20R2.
Psychometric properties of the Borderline Personality pdf
Features Scale for Children–11 (BPFSC-11) in a sample of Mohammadi, M. R., Shamohammadi, M., & Salmanian, M. (2014).
community dwelling Italian adolescents. European Journal The prevalence of borderline personality symptoms in adoles-
of Psychological Assessment, 35(1), 70–77. https://doi.org cents. Iranian Journal of Psychiatry, 9(3), 147–151. https://
/10.1027/1015-5759/a000377 www.ncbi.nlm.nih.gov/pmc/articles/PMC4277804/
Furnham, A. F., & Crump, J. D. (2014). A bright side facet analy- Muehlenkamp, J. J., Claes, L., Havertape, L., & Plener, P. L. (2012).
sis of borderline personality disorder. Borderline Personality International prevalence of adolescent non-suicidal self-injury
Disorder and Emotional Dysregulation, 1, 7. https://doi.org and deliberate self-harm. Child and Adolescents Psychiatry
/10.1186/2051-6673-1-7 and Mental Health, 6(10). https://doi.org/10.1186/1753-2000-
Gratz, K. L. (2001). Measurement of deliberate self-harm: 6-10
Preliminary data on the Deliberate Self-Harm Inventory. Oliver, M. N. I., & Simons, J. S. (2004). The affective lability
Journal of Psychopathology and Behavioral Assessment, 23, scales: Development of a short-form measure. Personality &
253–263. https://doi.org/10.1023/A:1012779403943 Individual Differences, 37(6), 1279–1288. http://dx.doi.org
Gunderson, J., Zanarini, M. C., & Kisiel, C. L. (1996). Borderline /10.1016/j.paid.2003.12.013
personality disorder. In T. A. Widiger, A. J. Frances, H. A. Ramarajan, L. (2014). Past, present and future research on multiple
Pincus, R. Ross, M. B. First, & W. W. Davis (Eds.), DSM-IV identities: Toward an intrapersonal network approach. The
Sourcebook (Vol. 2., pp. 717–733). American Psychiatric Academy of Management Annals, 8(1), 589–659. https://doi.
Association. org/10.1080/19416520.2014.912379
Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, Reich, D. B., Zanarini, M. C., Hopwood, C. J., Thomas, K. M., &
R. L. (2006). Multivariate data analysis (6th ed.). Pearson. Fitzmaurice, G. M. (2014). Comparison of affective instability
Haltigan, J. D., & Vaillancourt, T. (2016). The Borderline in borderline personality disorder and bipolar disorder using
Personality Features Scale for Children (BPFS-C): Factor a self-report measure. Personality and Mental Health, 8(2),
structure and measurement invariance across time and sex in 143–150. https://onlinelibrary.wiley.com/doi/pdf/10.1002/
a community-based sample. Journal of Psychopathology and pmh.1247
Behavior Assessment, 31, 114–119. Saldanha-silva, R., Nunes, F. L., Rezende, H. A., & de Mansur-
Hasan, S., Ali, U., & Shaheen, A. (2011). Prevalence of person- alves, M. (2019). Maladaptive beliefs as mediators of the rela-
ality disorders during the years 2003-2009 at Institute of tionship between personality traits and borderline personality
Clinical Psychology, University of Karachi. Behria Journal of disorder symptoms. Estudos de Psicologia (Campinas), 36.
Professional Psychology, 9, 18–32. ISSN 1816-0840 - Institute https://doi.org/10.1590/1982-0275201936e180016
of Professional Psychology - Bahria . . . (yumpu.com) Salters-Pedneault, K. (2020). What is impulsivity? https://www.
Herpertz, S., Gretzer, A., Steinmeyer, E. M., Muehlbauer, V., verywellmind.com/impulsive-behavior-and-bpd-425483
Schuerkens, A., & Sass, H. (1997). Affective instability and Sanchez-Teruel, D., Robles-Bello, M. A., & Camacho-Conde, J. A.
impulsivity in personality disorder: Results of an experimental (2020). Self-inflicted injuries in adolescents and young adults:
study. Journal of Affective Disorders, 44(1), 31–37. https://doi. A longitudinal study. Psicothema, 32(3), 322–328. https://doi.
org/10.1016/S0165-0327(97)01444-4 org/10.7334/psicothema2019.347
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indices in Sansone, R. A., Wiederman, M. W., & Sansone, L. A. (1998). The
covariance structure analysis: Conventional criteria versus new Self-Harm Inventory (SHI): Development of a scale for identi-
alternatives. Structural Equation Modeling, 6, 1–55. https:// fying self-destructive behaviors and borderline personality dis-
doi.org/10.1080/10705519909540118 order. Journal of Clinical Psychology, 54(7), 973–983. https://
Hussain, W. (2018). Prevalent tendencies of mental disor- www.ncbi.nlm.nih.gov/pubmed/9811134
ders in Pakistan. Clínica y Salud, 29(1), 34–38. https://doi. Schoenleber, M., Berghoff, C. R., Tull, M. T., DiLillo, D.,
org/10.5093/clysa2018a6 Messman-Moore, T., & Gratz, K. L. (2016). Emotional labil-
John, O. P., Donahue, E. M., & Kentle, R. L. (1991). The Big Five ity and affective synchrony in borderline personality disorder.
Inventory–Versions 4a and 54. Institute of Personality and Personality Disorders, 7(3), 211–220. https://doi.org/10.1037/
Social Research, University of California, Berkeley. per0000145
Lui, P., & Wang, X. (2019). Evaluation of reliability and validity Schumacher, R. E., & Lomax, R. G. (2010). A beginner’s guide to
of Chinese-Version Borderline Personality Features Scale for structural equation modeling (3rd ed.). Routledge.
10 SAGE Open

Shaikh, U., Qamar, I., Jafry, F., Hassan, M., Shagufta, S., Odhejo, in borderline personality disorder: “Actions instead of words.”
Y. I., & Ahmed, S. (2017). Patients with borderline personality Comprehensive Psychiatry, 77, 80–88. https://doi.org/10.1016/j.
disorder in emergency departments. Frontiers in Psychiatry, 8, comppsych.2017.06.006
Article 136. https://doi.org/10.3389/fpsyt.2017.00136 Sollberger, D. (2013). On identity: From a philosophical point of
Sharp, C., Steinberg, L., Temple, J., & Newlin, E. (2014). An view. Child and Adolescents Psychiatry and Mental Health,
11-item measure to assess borderline traits in adolescents: 7(29). https://doi.org/10.1186/1753-2000-7-29
Refinement of the BPFSC using IRT. Personality Disorders: Somma, A., Sharp, C., Borroni, S., & Fossati, A. (2016). Borderline
Theory, Research, and Treatment, 5(1), 70–78. https://doi. personality disorder features, emotion dysregulation and non-
org/10.1037/per0000057 suicidal self-injury: Preliminary findings in a sample of com-
Siever, L. J., & Weinstein, L. N. (2009). The neurobiology of per- munity dwelling Italian adolescents. Personality and Mental
sonality disorders: Implications for psychoanalysis. Journal of Health, 11, 23–32. https://onlinelibrary.wiley.com/doi/pdf/10
the American Psychoanalytic Association, 57, 361–398. .1002/pmh.1353
Skodol, A. (2019). Borderline personality disorder: Epidemiology, Stanley, B., & Siever, L. J. (2010). The interpersonal dimension of
pathogenesis, clinical features, course, assessment and diagnosis. borderline personality disorder: Toward a neuropeptide model.
https://www.uptodate.com/contents/borderline-personality-dis- American Journal of Psychiatry, 167(1), 24–39. https://doi.
order-epidemiologypathogenesis-clinical-features-course-assess- org/10.1176/appi.ajp.2009.09050744
ment-and-diagnosis Winston, A. P. (2018). Recent developments in borderline personal-
Sleuwaegen, E., Houben, M., Claes, L., & Berens, A. (2017). The ity disorder. Advances in Psychiatric Treatment, 6(3), 211–217.
relationship between non-suicidal self-injury and alexithymia https://doi.org/10.1192/apt.6.3.211