Borderline Symptom Liste 95 (BSL-95)

Code: ___________________________ Date: |___|___|. |___|___|. 2 0 |___|___|

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... not at very

a little rather much
all strong

1 I felt stressed out 0 1 2 3 4

2 I suffered from insomnia 0 1 2 3 4

3 I felt like I was not noticed by others 0 1 2 3 4

4 I was suffering from massive states of anxiety 0 1 2 3 4

5 It was hard for me to concentrate 0 1 2 3 4

6 I didn’t know what to do with myself 0 1 2 3 4

7 I felt helpless 0 1 2 3 4

8 Everything felt tight inside of me 0 1 2 3 4

9 I was torn apart inside 0 1 2 3 4

10 I was afraid of making mistakes 0 1 2 3 4

11 I thought nobody could help me 0 1 2 3 4

I was absent-minded and unable to remember what I was
12 0 1 2 3 4
actually doing
13 I rejected other people that I used to like 0 1 2 3 4

14 I looked upon myself as an object, not as a human being 0 1 2 3 4

15 I felt depressed 0 1 2 3 4

16 I felt paralyzed 0 1 2 3 4

17 I could hardly talk 0 1 2 3 4

18 I was longing for death 0 1 2 3 4

19 I was envious of other people 0 1 2 3 4

© Bohus et al. Central Institute of Mental Health, Mannheim /Germany 06/2009 1
In the course of last week... not at very
a little rather much
all strong

20 I felt disgust 0 1 2 3 4

21 I was confident 0 1 2 3 4

22 I thought of hurting myself 0 1 2 3 4

23 It was difficult for me to perceive my emotions 0 1 2 3 4

24 There was no one to whom I was really important 0 1 2 3 4

I found myself in a certain place and was not able to remem-
25 0 1 2 3 4
ber how I got there
26 I was calm inside 0 1 2 3 4

27 I didn’t trust other people 0 1 2 3 4

28 I didn’t believe in my right to live 0 1 2 3 4

29 I was lonely 0 1 2 3 4

30 I experienced stressful inner tension 0 1 2 3 4

31 I was afraid of being abandoned by someone close to me 0 1 2 3 4

32 I had images that I was very much afraid of 0 1 2 3 4

33 I didn’t feel alive 0 1 2 3 4

34 I could not bear other people‘s closeness 0 1 2 3 4

35 I hated myself 0 1 2 3 4

36 I experienced parts of my body dissolving 0 1 2 3 4

37 Everyday decisions were difficult for me 0 1 2 3 4

38 I wanted to punish myself 0 1 2 3 4

39 I felt energetic 0 1 2 3 4

40 I was angry 0 1 2 3 4

41 I could hardly control my memories 0 1 2 3 4

42 It was hard for me to be alone 0 1 2 3 4

43 I couldn‘t feel parts of my body 0 1 2 3 4

44 I felt threatened 0 1 2 3 4

45 I terminated relationships all of a sudden 0 1 2 3 4

46 I had no idea of who I really was 0 1 2 3 4

47 I suffered from shame 0 1 2 3 4

© Bohus et al. Central Institute of Mental Health, Mannheim /Germany 06/2009 2

In the course of last week... not at very
a little rather much
all strong

48 I felt isolated from others 0 1 2 3 4

My mood rapidly cycled in terms of anxiety, anger, and de-
49 0 1 2 3 4
pression
50 I felt insecure 0 1 2 3 4

51 I felt abandoned 0 1 2 3 4

52 I felt the presence of someone who was not really there 0 1 2 3 4

53 I was aggressive 0 1 2 3 4

54 I felt kind of cut off from myself 0 1 2 3 4

55 I was happy 0 1 2 3 4

56 I found myself in emotional chaos 0 1 2 3 4

57 I was tortured by images 0 1 2 3 4

58 I felt empty inside 0 1 2 3 4

59 I was unable to touch parts of my body 0 1 2 3 4

60 I was irritated 0 1 2 3 4

61 It felt as if I was petrified 0 1 2 3 4

62 I suffered from suicidal thoughts 0 1 2 3 4

63 I was well-balanced 0 1 2 3 4

64 I had difficulties with other people 0 1 2 3 4

65 Nobody realized how I was really feeling 0 1 2 3 4

66 I suffered from voices and noises from outside my head 0 1 2 3 4

67 I suffered from voices and noises from inside my head 0 1 2 3 4

68 I felt free and easy 0 1 2 3 4

69 Criticism had a devastating effect on me 0 1 2 3 4

70 I needed to have someone with me 0 1 2 3 4

71 I felt as if I was standing beside myself 0 1 2 3 4

72 I felt powerful 0 1 2 3 4

73 I felt vulnerable 0 1 2 3 4

74 The idea of death had a certain fascination for me 0 1 2 3 4

75 I felt deficient 0 1 2 3 4

© Bohus et al. Central Institute of Mental Health, Mannheim /Germany 06/2009 3

In the course of last week... not at very
a little rather much
all strong

76 I had the feeling of being inadequate 0 1 2 3 4

77 I was full of despair 0 1 2 3 4

78 I suffered from nightmares 0 1 2 3 4

79 I was afraid people would see through me 0 1 2 3 4

80 I felt relaxed 0 1 2 3 4

81 I felt as if I had different people inside of me 0 1 2 3 4

82 I found my body completely unacceptable in its present state 0 1 2 3 4

83 I was suffering from feelings of guilt 0 1 2 3 4

84 I believed that nobody could understand me 0 1 2 3 4

85 Everything seemed senseless to me 0 1 2 3 4

86 I felt I had to give in to my bad thoughts 0 1 2 3 4

87 I was afraid of losing control 0 1 2 3 4

88 I felt disgusted by myself 0 1 2 3 4

89 I was not able to accept other people‘s help 0 1 2 3 4

90 I felt as if I was far away from myself 0 1 2 3 4

91 I was overwhelmed by my feelings 0 1 2 3 4

92 I felt numb 0 1 2 3 4

93 I felt hopeless 0 1 2 3 4

94 I felt worthless 0 1 2 3 4

95 I was content 0 1 2 3 4

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.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

(very bad) (excellent)

© Bohus et al. Central Institute of Mental Health, Mannheim /Germany 06/2009 4

 BSL - Supplement: Items for Assessing Behavior

Daily
During the last week..... Not at 2-3 4-6 or
once more
all times times
often

1 I hurt myself by cutting, burning, strangling, headbang- 0 1 2 3 4

ing etc.
2 I told other people that I was going to kill myself 0 1 2 3 4

3 I tried to commit suicide 0 1 2 3 4

4 I had episodes of binge eating 0 1 2 3 4

5 I induced vomiting 0 1 2 3 4

I displayed high-risk behavior by knowingly driving too

6 0 1 2 3 4
fast, running around on the roofs of high buildings, bal-
ancing on bridges, etc.
7 I got drunk 0 1 2 3 4

8 I took drugs 0 1 2 3 4

9 I took medication that had not been prescribed or if had 0 1 2 3 4

been prescribed, I took more than the prescribed dose
10 I had outbreaks of uncontrolled anger or physically at- 0 1 2 3 4
tacked others
11 I had uncontrollable sexual encounters of which I was 0 1 2 3 4
later ashamed or which made me angry.

Please double-check for missing answers

WE THANK YOU VERY MUCH FOR YOUR PARTICIPATION!

PLEASE RETURN THE QUESTIONNAIRE TO YOUR THERAPIST

© Bohus et al. Central Institute of Mental Health, Mannheim /Germany 06/2009 5