DIB-R Companion: BPD-Specific Domain Summary 

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DIB-R Companion: BPD-Specific Domain Summary

Mark Zauss, LMHC, LPC, CCMHC, NBCC, BC-TMC, ASDCS, NATC, CCTP, CCTP II, ADHD-CCSP, C-DBT, C-PD

Double Board Certified Counseling Services, Inc.

Client / Assessment Information

Client Name

Date

Primary clinical concern

Clinical Anchor

Use this BPD-specific companion page to summarize clinical severity across affect, cognition, impulse-action patterns, and relationships.

Proprietary-tool note: This page is not the official DIB-R and does not reproduce DIB-R items. It is an original clinical domain summary page.

BPD-Specific Domains

1. Affect regulation: intensity, instability, emotional flooding, and return-to-baseline difficulty

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / supporting evidence

2. Cognitive symptoms under stress: suspiciousness, dissociation, derealization, depersonalization, or stress-linked cognitive disruption

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / supporting evidence

3. Impulse-action patterns: urgent behavior, self-damaging choices, crisis actions, or difficulty pausing

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / supporting evidence

4. Interpersonal relationships: attachment instability, fear of abandonment, conflict cycles, rupture-repair difficulty, or unstable closeness/distance

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / supporting evidence

Score + Generate Clinical Summary Download / Print as PDF

Score and clinical summary will appear here.