Borderline Personality Disorder Questionnaire
1.
What is your age?
Under 18
18-24
25-34
35-64
65+
2.
What is your gender?
Male
Female
Other
3.
Do you have a formal diagnosis of Borderline Personality Disorder (BPD)?
Yes
No
4.
Have you ever sought professional treatment for BPD?
Yes
No
Not applicable
5.
How often do you experience intense mood swings or emotional instability?
Never
Less than once a month
Once a month
A few times a month
About once a week
A few times a week
Every day
6.
How frequently do you engage in impulsive behaviors (e.g., reckless spending, unsafe driving, substance abuse)?
Never
Rarely
Sometimes
Often
Always
7.
Do you experience difficulty maintaining stable relationships with others?
Never
Rarely
Sometimes
Often
Always
8.
Have you participated in any form of therapy for BPD?
No
Yes, CBT
Yes, DBT
Yes, other
9.
How much do the symptoms of BPD affect your daily functioning (work, social life, etc.)?
Not at all
Slightly
Moderately
Significantly
Severely
10.
Do you feel that people with BPD are stigmatized by society?
Yes
No