(PS7-57) From Discrepancy to Agreement: The Efficacy of BPD Compass in Symptom Self-Assessment and How it Relates to Personality Functioning

Abstract Text: Borderline personality disorder (BPD) is characterized by disturbances in personality functioning and difficulties maintaining a stable identity. This research examined how individuals with BPD understand their symptoms relative to how clinicians rate them at the pre- and post- treatment assessment points, using the Zanarini Rating Scale for Borderline Personality Disorder (ZANBPD) (Zanarini et al., 2001). We also explored whether the magnitude of difference between patient and clinician ratings correspond with severity of personality functioning, assessed with the Level of Personality Functioning Scale (LPFS). Furthermore, we determined whether the agreement between participant and clinician scores improves after receiving BPD Compass, a modular cognitive-behavioral intervention that targets maladaptive personality traits most associated with BPD. We assessed 100 adults who met criteria for BPD and were on average; 28.13 (SD = 8.80) years old, White (n = 88:88.9%), identified as female (n = 73, 73.7%), and as sexual minorities (n = 64; 64.6%). First, we conducted a paired t-test to compare self-rated (SR) and clinician-rated (CR) ZAN-BPD scores before and after engaging in treatment. We then calculated the difference between SR and CR scores at both points before performing a regression analysis to determine if a larger discrepancy indicates worse personality functioning. Results from the pre-treatment data found there was a significant difference in scores between SR (M = 16.43, SD = 7.51) and CR (M = 14.48, SD = 6.70), t(92) = -2.933, p < 0.05, indicating participants rate their symptoms significantly higher than their clinician before completing BPD Compass. Conversely, the post-treatment assessment data showed no significant difference between self-rated (M = 6.33, SD = 5.625) and clinician rated (M = 6.94, SD = 6.005) scores, t(51) = 1.173, p > 0.05, suggesting that by the end of treatment, the self- and clinician ratings converged, reflecting a similar perception of BPD symptom severity. At both the pre- and post-treatment time points, discrepancies between SR and CR scores were not significantly correlated with levels of personality, (r(70) = 0.135, p = 0.265 and (r(45) = -0.042, p = 0.784), respectively. To evaluate the changes in agreement of SR and CR scores following treatment, a paired t-test revealed significant reduction in the difference between SR and CR scores from pre-treatment (M = 1.87, SD = 0.95) to post-treatment (M = -0.62, SD = 0.52), t(51) = 2.52, p < 0.05. In summary, these findings suggest participants self-rate their BPD symptoms more severely than their clinician before receiving treatment and share close agreement afterwards. Despite not having statistical significance, larger discrepancies in these ratings were highly correlated with personality dysfunction pre-treatment, while stronger agreement indicate lesser personality dysfunction post-treatment. Overall, BPD Compass effectively improves the agreement between SR and CR ZAN-BPD scores, fostering a more accurate self-perception for participants.