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Validation of the Quality of Work Life Questionnaire in individuals with borderline personality disorder

This study validates the construct validity and reliability of the Quality of Work Life (QWL) questionnaire for assessing work experiences among employed individuals with borderline personality disorder, confirming its utility as a valuable tool for both research and clinical occupational interventions.

Original authors: Nadine Larivière, Marc Corbière

Published 2026-07-07

📖 5 min read🧠 Deep dive

CC BY 4.0

Original authors: Nadine Larivière, Marc Corbière

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

The Big Picture: Why This Study Matters

Imagine work as a long, sometimes bumpy road trip. For most people, this road has potholes and traffic, but they can usually navigate it. For people with Borderline Personality Disorder (BPD), the road can feel much more treacherous. While having a job can be a huge boost to their recovery and self-esteem, the stress of the workplace can also trigger their symptoms or make them feel overwhelmed.

The researchers wanted to know: How do we measure the "comfort level" of this road trip for people with BPD?

They tested a specific tool called the Quality of Work Life (QWL) Questionnaire. Think of this questionnaire as a "dashboard" or a "health check-up" for a person's work life. The goal was to see if this dashboard gives an accurate reading specifically for drivers with BPD.

The Experiment: Who and How?

The researchers gathered a group of 130 adults who:

Have a confirmed diagnosis of BPD.
Are currently working or in the process of returning to work.
Can read French (the study took place in Quebec, Canada).

They asked these participants to fill out a survey with 40 questions. These questions were like checking different parts of a car to see how it's running.

The Two Main "Engines" of Work Life

The survey wasn't just a random list of questions. The researchers found that the 40 questions naturally grouped into two big categories (or "engines") that drive a person's work experience:

1. The Structural & Physical Engine (The Hardware)
This is the "hard stuff" of the job. It includes:

The actual tasks you do.
The working conditions (hours, pay, benefits).
The physical office or environment.
The rules and management style of the company.
Analogy: This is like checking the tires, the engine oil, and the road surface. Is the car built to handle the terrain?

2. The Intra- & Interpersonal Engine (The Software & Relationships)
This is the "soft stuff" involving feelings and people. It includes:

How you see yourself as a worker (Do I feel competent?).
Your relationship with your coworkers.
Your relationship with your boss.
Do you feel like you belong to the team?
Analogy: This is like the driver's mood, the radio playlist, and how well everyone in the car is getting along. Are you enjoying the ride, or is everyone arguing?

What They Found: The Dashboard Works!

The researchers ran the numbers to see if this "dashboard" was accurate for people with BPD. Here is what the data showed:

It's Reliable: When they checked the consistency of the answers, the results were strong. The "Structural" engine had a reliability score of 0.84, and the "Interpersonal" engine scored an even higher 0.94.
- Simple translation: If you asked the same person the same questions a few times, they would give similar answers. The tool is stable and trustworthy.
It Fits the Data: The way the questions were grouped (into the two engines mentioned above) matched the reality of the participants' experiences very well.
One Small Glitch: One specific part of the "Structural" engine (the "Work Environment" questions) was a little shaky (score of 0.57). It's like a sensor that sometimes gives a fuzzy reading, but the rest of the dashboard is working perfectly.

The Results in Plain English:
The study concluded that this questionnaire is a valid tool. It accurately measures how people with BPD feel about their work life. It successfully separates the "hard" job factors from the "relational" job factors.

What the Participants Actually Said

When the researchers looked at the average scores:

People felt best about their own self-perception (feeling like a "good worker") and their relationships with colleagues.
They felt least satisfied with the organizational management (the rules and how the company is run).
Overall, the group reported a positive quality of work life, but there is room for improvement in how companies are managed.

The Bottom Line

This paper proves that we can now use this specific 40-question survey to understand the work lives of people with Borderline Personality Disorder. It confirms that their work experience is shaped by two main things: the physical/structural reality of the job and the relationships/self-perception within it.

Important Note on Limits:
The authors were careful to say that this tool works for people who are currently employed. It might need tweaking for people who are self-employed or working alone, as some questions (like "relationship with colleagues") don't apply to them. Also, while the tool measures how they feel now, the researchers noted that the next step is to see if these feelings can predict how long someone will keep their job in the future.

In short: The tool works, the map is accurate, and we now have a better way to understand the work journey for people with BPD.

Technical Summary: Validation of the Quality of Work Life Questionnaire in Individuals with Borderline Personality Disorder

Problem Statement
Employment serves as a critical lever for personal and social recovery for individuals with mental disorders, including Borderline Personality Disorder (BPD). However, the workplace can also expose these individuals to symptom-related challenges (e.g., emotional dysregulation, impulsive behaviors) and environmental stressors (e.g., stigmatization). While the concept of Quality of Work Life (QWL) is recognized as vital for understanding the worker-environment relationship, existing assessments in mental health practice have predominantly focused on job satisfaction rather than directly measuring QWL. Although the Quality of Work Life Questionnaire (QWL) has demonstrated good internal consistency and test-retest reliability among individuals with severe mental illness in social enterprises, its construct validity has not yet been established. Furthermore, the instrument lacks specific validation for individuals with BPD, a population characterized by distinct interpersonal and self-perception challenges that may influence work experiences differently than other psychiatric groups.

Methodology
The study employed a cross-sectional design to examine the psychometric properties of the QWL questionnaire among a clinical sample of 130 adults diagnosed with BPD who were either currently employed or in a return-to-work process. Participants were recruited from specialized personality disorder programs and community mental health organizations across Quebec, Canada.

Instrument: The QWL questionnaire consists of 40 items rated on a four-point Likert scale. The items are organized into eight subscales grouped into two macro-dimensions:
1. Structural and Physical Elements: Work tasks, working conditions, work environment, and organizational management.
2. Intra- and Interpersonal Components: Perception of being a good worker, relationships with colleagues, relationship with one's manager, and sense of belonging to the organization.
Procedure: Data were collected via an online survey between November 2021 and March 2024. Participants also completed sociodemographic and clinical questions.
Analysis: The study utilized Confirmatory Factor Analysis (CFA) using EQS software to test the fit of the two macro-dimensions. Reliability was assessed using Cronbach's alpha coefficients. The analysis followed recommended indices for model fit, including Chi-square/degrees of freedom ratio ( $\chi^2/df$ ), RMSEA, NNFI, and CFI.

Key Results
The study confirmed the construct validity of the QWL questionnaire for the BPD population, supporting the two-dimensional structure.

Model Fit:
- Structural and Physical Dimension: The model with correlations between subscales (Model 1b) demonstrated an excellent fit ( $\chi^2/df = 1.11$ , CFI = 0.98, RMSEA = 0.03).
- Intra- and Interpersonal Dimension: Initial models showed lower fit. However, a modified model (Model 2c) allowing for correlated measurement errors between specific items (#10 and #37) achieved satisfactory fit indices ( $\chi^2/df = 1.48$ , CFI = 0.93, RMSEA = 0.06).
Reliability:
- Both macro-dimensions showed strong internal consistency: Structural/Physical ( $\alpha = 0.84$ ) and Intra-/Interpersonal ( $\alpha = 0.94$ ).
- Subscale reliability varied. Within the Structural/Physical dimension, the "Work environment" subscale showed lower internal consistency ( $\alpha = 0.57$ ), while others ranged from 0.61 to 0.90. The Intra-/Interpersonal subscales ranged from 0.79 to 0.94.
Descriptive Findings: The total mean QWL score was high ( $M = 2.99/4$ ), indicating an overall positive quality of work life. Participants reported higher scores for relational aspects (e.g., perception of being a good worker, $M=3.29$ ) compared to structural aspects (e.g., organizational management, $M=2.78$ ).

Key Contributions

Psychometric Validation: This study establishes the construct validity of the QWL questionnaire specifically for individuals with BPD, confirming that the tool's two-factor structure (structural/physical and intra-/interpersonal) is applicable to this clinical group.
Clinical Utility: The validation provides occupational therapists and clinicians with a validated self-report measure to evaluate the work experiences of individuals with BPD, moving beyond simple job satisfaction metrics.
Differentiation of Dimensions: The results highlight that while individuals with BPD may perceive relational aspects of work positively (potentially influenced by therapeutic interventions targeting interpersonal processes), structural and physical work elements remain areas of lower satisfaction, suggesting a need for comprehensive intervention strategies.

Significance and Future Directions
The authors posit that the QWL questionnaire is a valuable tool for both research and clinically oriented work-related interventions. It can help identify key factors influencing the work experience of individuals with BPD, thereby supporting the development of personalized strategies for sustainable employment.

The paper modestly frames its conclusions, noting that while the construct validity and internal consistency are established, further psychometric testing is required. Specifically, the authors identify the need to examine the predictive validity of the questionnaire in relation to job tenure. Additionally, the study acknowledges limitations, including the lower reliability of the "Work environment" subscale and the exclusion of self-employed workers, suggesting that future research should address these gaps and explore comparative analyses by gender and diverse cultural backgrounds.