Borderline Personality Disorder Checklist Template

Efficiently assess and manage Borderline Personality Disorder with our comprehensive Borderline Personality Disorder Checklist Template.

By Liliana Braun on Jun 20, 2024.


Fact Checked by RJ Gumban.

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What is a Borderline Personality Disorder Checklist?

A Borderline Personality Disorder (BPD) Checklist is a structured tool designed to assist in the identification and assessment of symptoms associated with Borderline Personality Disorder. 

This comprehensive checklist typically includes key elements such as a Borderline Personality Disorder Symptoms Checklist outlining the hallmark features of the disorder. Users can systematically evaluate manifestations like emotional dysregulation, impulsivity, interpersonal difficulties, and disturbances in self-image. 

The Borderline Personality Disorder Checklist often incorporates a scoring system, allowing healthcare professionals to quantify the severity of symptoms and track changes over time. The borderline personality disorder checklist scoring system helps establish a baseline, monitor progress, and adapt treatment strategies accordingly. 

It provides a quantitative measure for each item on the checklist, aiding in a more nuanced understanding of the individual's BPD presentation. This checklist serves as a valuable tool for clinicians, facilitating a systematic and standardized approach to assessing Borderline Personality Disorder. It aids in efficiently identifying symptoms, contributing to accurate diagnosis and tailored treatment plans. 

Moreover, the checklist fosters communication among healthcare team members, enhancing collaborative efforts in managing individuals with Borderline Personality Disorder.

Printable Borderline Personality Disorder Checklist

Download this to assess and manage Borderline Personality Disorder with our comprehensive BPD template.

How does it work?

Steps involved with using a Printable Borderline Personality Disorder Checklist Template:

  1. Gather patient information: Before starting the Borderline Personality Disorder assessment, review the patient's medical history, including current medications, allergies, and past mental health diagnoses. This information provides context for the examiner's observations.
  2. Assess emotional dysregulation: Evaluate the patient's tendency to experience intense and unstable emotions, such as anger, sadness, and fear. Observe for mood swings, emotional reactivity, and difficulty managing emotions.
  3. Assess impulsivity: Evaluate the patient's tendency to engage in impulsive behaviors without considering the consequences. This may include risky sexual behavior, substance abuse, reckless driving, or sudden spending sprees.
  4. Assess interpersonal difficulties: Evaluate the patient's patterns of unstable and intense relationships. This may include idealizing others, devaluing others, and difficulty maintaining stable relationships.
  5. Assess self-image disturbances: Evaluate the patient's unstable self-image and sense of self. This may include a distorted body image, frequent changes in self-perception, and feelings of emptiness or worthlessness.
  6. Document findings: Clearly document all observations and findings in the  Borderline Personality Disorder template. This documentation serves as a record of the patient's  Borderline Personality Disorder symptoms and facilitates comparisons over time.
  7. Interpret findings: Analyze the collected information to identify the core symptoms of  Borderline Personality Disorder and assess the severity of the disorder. This interpretation guides further diagnostic testing and treatment planning.
  8. Discuss findings with the patient: Communicate the findings of the  Borderline Personality Disorder assessment to the patient in a clear and understandable manner. This discussion helps educate the patient about their  Borderline Personality Disorder symptoms and address any concerns.
  9. Develop a treatment plan: Based on the assessment findings and patient's needs, develop a comprehensive treatment plan that may include psychotherapy, medications, and lifestyle modifications.

Borderline Personality Disorder Checklist example (sample)

The Borderline Personality Disorder Template, functions as an invaluable tool within the mental health landscape, offering a systematic approach to assess and manage Borderline Personality Disorder. 

Serving as a comprehensive documentation tool, the Borderline Personality Disorder Template facilitates clear and seamless communication among individuals with Borderline Personality Disorder, their support networks, mental health professionals, and relevant stakeholders involved in the nuanced dynamics of Borderline Personality Disorder care. 

With its structured framework, the Borderline Personality Disorder Template ensures the efficient sharing and comprehension of critical information related to the assessment and management of Borderline Personality Disorder. By encapsulating key dimensions such as emotional regulation, interpersonal dynamics, and self-perception, this template provides a holistic understanding of the individual's Borderline Personality Disorder experience.

Borderline Personality Disorder Checklist example (sample)

When would you use this Template?

  • Initial assessment: When a patient first presents with symptoms that suggest Borderline Personality Disorder, a Borderline Personality Disorder template can be used to conduct a comprehensive initial assessment. This helps gather detailed information about the patient's symptoms, patterns of behavior, and personal history, providing a strong foundation for diagnosis and treatment planning.
  • Monitoring symptom severity: For patients diagnosed with Borderline Personality Disorder, Borderline Personality Disorder templates can be used regularly to monitor the severity of their symptoms. This allows healthcare professionals to track changes in the patient's emotional regulation, impulsivity, interpersonal relationships, and self-image, which helps assess the effectiveness of treatment and make necessary adjustments.
  • Guiding treatment decisions: The information gathered from Borderline Personality Disorder templates can inform treatment decisions and tailor interventions to each patient's specific needs. By identifying the predominant Borderline Personality Disorder symptoms and understanding their impact on the patient's life, healthcare professionals can choose appropriate psychotherapy techniques, consider medication options, and recommend lifestyle modifications.
  • Evaluating treatment effectiveness: Regularly using Borderline Personality Disorder templates allows healthcare professionals to evaluate the effectiveness of treatment over time. By comparing the patient's symptoms at different points in time, they can assess whether the treatment plan is working effectively, identify areas where progress is needed, and make adjustments accordingly.
  • Communicating with other providers: Borderline Personality Disorder templates can facilitate communication and collaboration between healthcare professionals involved in the patient's care. By sharing the documented assessment findings and treatment progress, providers can ensure continuity of care and that the patient receives consistent and informed treatment.

What do the results mean?

Common results of a Free Borderline Personality Disorder  Checklist Template and their meanings include:

Emotional dysregulation

Emotional dysregulation manifests through frequent and sudden changes in mood, encompassing rapid shifts between anger, sadness, fear, and joy. Individuals may experience mood swings, moving from intense happiness or euphoria to deep sadness or despair. 

Emotional reactivity is heightened sensitivity to external stimuli, resulting in exaggerated emotional responses. Managing emotions becomes challenging, with individuals struggling to control and express their feelings in a healthy and appropriate manner. 


Impulsivity involves engaging in risky behaviors without considering consequences, such as substance abuse, reckless driving, or unprotected sex. Poor impulse control leads to difficulty resisting urges or temptations, even when aware of negative consequences. Making impulsive decisions occurs without careful consideration or planning, often resulting in regretful choices. Financial difficulties may arise due to impulsive spending or poor financial management. 

Interpersonal difficulties

Interpersonal challenges include unstable relationships characterized by intense and chaotic dynamics, frequent conflicts, breakups, and makeups. Idealization and devaluation patterns involve initially idealizing others in relationships, followed by devaluation and criticism as the relationship progresses.

 Difficulty maintaining stable and healthy relationships stems from emotional volatility and impulsive behaviors. A fear of abandonment may lead to intense anxiety about being left alone, resulting in clingy or dependent behavior. 

Self-image disturbances

Disturbances in self-image include distorted body image, with individuals having an unrealistic or distorted perception of their physical appearance. Rapid and significant changes in self-perception and self-worth are common. 

Feelings of emptiness or worthlessness lead to a sense of hollowness, low self-esteem, and self-destructive behaviors. Identity disturbance is characterized by a struggle to maintain a consistent sense of self, confusing personal identity and goals.

Research & evidence

In navigating the complexities of Borderline Personality Disorder (BPD), the use of BPD checklists is crucial for an effective and systematic approach to care. Defined within cluster B personality disorders by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), BPD is marked by heightened sensitivity to rejection and instability in interpersonal relationships, self-image, affect, and behavior.

 With its significant prevalence, reaching 1.6% in the general population and 20% in the inpatient psychiatric population, BPD checklists emerge as indispensable tools. These checklists play a vital role in identifying and evaluating the multifaceted presentation of BPD, aligning seamlessly with objectives such as understanding epidemiology, describing patient presentation, outlining treatment options, and implementing interprofessional strategies. 

By integrating BPD checklists, healthcare professionals enhance care coordination and communication, advancing the comprehensive management of BPD and optimizing patient outcomes (Chapman et al., 2022).

In tandem with the intricate nature of diagnosing Borderline Personality Disorder (BPD), highlighted by its similarities to other conditions and its prevalence in both psychiatric and general practice, the importance of BPD checklists becomes even more pronounced. As a disorder characterized by heightened sensitivity to rejection and instability across various domains, BPD demands a nuanced and systematic approach to care. 

The utilization of BPD checklists aligns seamlessly with the diagnostic objectives outlined by the DSM-5, offering healthcare professionals a structured tool to navigate the complexities of BPD presentation. With prevalence rates soaring to 20% in psychiatric inpatients, the role of BPD checklists as indispensable instruments for timely identification and intervention cannot be overstated. 

These checklists not only aid in understanding the epidemiology and describing patient presentations but also serve as catalysts for outlining treatment options and implementing collaborative interprofessional strategies. In essence, incorporating BPD checklists into clinical practice elevates the standard of care, ensuring a targeted and comprehensive management approach that optimizes patient outcomes in the intricate landscape of BPD (Biskin & Paris, 2012).

Why use Carepatron as your Borderline Personality Disorder Checklist app?

In the realm of mental health care, particularly in the nuanced field of Borderline Personality Disorder management, precision and efficiency are paramount. Carepatron emerges as the optimal choice for your Borderline Personality Disorder Template application, offering a streamlined and user-friendly platform designed to elevate the efficiency of healthcare professionals. 

Boasting an intuitive design, Carepatron simplifies the process for healthcare professionals by providing easily downloadable Borderline Personality Disorder Template resources. The Borderline Personality Disorder Template app from Carepatron is a transformative tool, ensuring accessibility and ease in developing personalized checklists tailored to the specific needs of individuals navigating the complexities of Borderline Personality Disorder. 

The software's intuitive user interface facilitates seamless navigation, significantly reducing the time and effort required for creating comprehensive Borderline Personality Disorder checklists. Carepatron's Borderline Personality Disorder Template Software excels in efficiency and effectiveness, empowering healthcare professionals to address a spectrum of BPD-related considerations, from routine assessments to more complex cases. 

The software's versatility accommodates the diverse needs associated with individual experiences, family dynamics, and community factors, ensuring a comprehensive and integrated approach to Borderline Personality Disorder care. Carepatron stands as a reliable ally for healthcare professionals seeking precision and efficiency in the intricate landscape of Borderline Personality Disorder management.

Borderline Personality Disorder Checklist app


Biskin, R. S., & Paris, J. (2012). Diagnosing borderline personality disorder. Canadian Medical Association Journal, 184(16), 1789–1794. 

Chapman, J., Jamil, R. T., & Fleisher, C. (2022, June 2). Borderline Personality Disorder. National Library of Medicine; StatPearls Publishing. 

Melinda Smith. (2019). Borderline Personality Disorder (BPD).

How do you create a Borderline Personality Disorder Checklist?
How do you create a Borderline Personality Disorder Checklist?

Commonly asked questions

How do you create a Borderline Personality Disorder Checklist?

Carepatron has a ready-to-download and use Borderline Personality Disorder checklist template for your convenience.

When are Borderline Personality Disorder Checklists used?

Borderline Personality Disorder Checklists are used when healthcare professionals need to systematically assess and monitor the symptoms of borderline personality disorder.

How are the Borderline Personality Disorder Checklists used?

Healthcare professionals use Borderline Personality Disorder Checklists to evaluate various aspects of Borderline Personality Disorder, including emotional dysregulation, impulsivity, interpersonal difficulties, and self-image disturbances.

Who creates a Borderline Personality Disorder Checklist?

Borderline Personality Disorder Checklists can be created by healthcare professionals, organizations that develop standardized assessments, or software developers such as Carepatron.

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