Adaptação transcultural da Borderline Personality Questionnaire (BPQ) para o contexto brasileiro

Abstract

Borderline Personality Disorder (BPD) is recognized in literature as a complex psychopathological condition characterized by wide symptomatic heterogeneity and a high prevalence of comorbidities, factors that hinder diagnosis and directly influence clinical management. The literature on BPD indicates that there are many impacts on the personal and social lives of affected individuals, as well as on the lives of their family members and close associates. Despite the relevance of the topic, some national instruments provide sufficient psychometric evidence for screening and clinical evaluation of BPD, justifying the need for cross-cultural adaptation of internationally recognized measures. To address this gap, this study aimed to perform a cross-cultural adaptation of the Borderline Personality Questionnaire (BPQ) for the Brazilian context. The BPQ is a self-report measure composed of 80 items that allows for the assessment of Borderline Personality traits based on nine subscales, according to the DSM-V-TR diagnostic criteria: impulsivity, affective instability, abandonment, relationships, self-image, suicide/self-harm, feelings of emptiness, intense anger, and paranoid ideation. Several countries have adapted to the requirements proposed by DSM-IV and V, such as Canada, Spain, Germany, Portugal, Turkey, and France. The process was extended according to the proposal by Borsa, Damásio, and Bandeira for the adaptation and validation of psychological instruments across cultures, which consists of a seven-step process: (1) translation of the instrument from the source language to the target language, (2) overview of the translated versions, (3) evaluation of the synthesis by expert judges, (4) evaluation of the instrument by the target audience; the authors also propose (5) back translation to the source language; (6) pilot study; and (7) evaluation of the instrument's factorial structure. However, this study does not include back-translation, pilot study, and factor analysis steps, which will be developed in future research to provide psychometric evidence. This research involved three groups: translators, expert judges, and those disseminated with TPB. The judges' evaluation was conducted using the Content Validity Coefficient (CVC), clearly analyzing the language, practical relevance, and theoretical pertinence. Patient responses were evaluated qualitatively to assess semantics. The results indicated good agreement among those evaluated and adequate representation of the item construction, although some items were clearly rejected and required linguistic and conceptual adjustments. The semantic analysis stage confirmed that the items were understandable and culturally appropriate to the Brazilian context. The study also detailed the ethical procedures, inclusion and exclusion criteria, as well as limitations. Among these, the difficulty of recruiting participants from public mental health services stood out, since patients treated in CAPS (Psychosocial Care Centers) presented recent suicidal ideation, preventing their inclusion. The technical product of this project is translation. In conclusion, the Brazilian version of the BPQ presents robust initial evidence of content validity and constitutes a promising tool for the assessment of borderline traits in Brazil, offering important support for clinical practice, research, and the improvement of diagnostic processes in the field of personality.