Neurocognitive deficits in decision-making and planning of patients with DSM-III-R borderline personality disorder

2002 ◽  
Vol 32 (8) ◽  
pp. 1395-1405 ◽  
Author(s):  
E. BAZANIS ◽  
R. D. ROGERS ◽  
J. H. DOWSON ◽  
P. TAYLOR ◽  
C. MEUX ◽  
...  
Keyword(s):  
Decision Making ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Recognition Memory ◽  
Frontal Lobe ◽  
Visual Recognition ◽  
Borderline Personality ◽  
Neurocognitive Deficits ◽  
Visual Recognition Memory ◽  
History Of

Background. Repeated, self-damaging behaviour occurring in the context of borderline personality disorder (BPD) may reflect impairments in decision-making and planning cognition. However, there has been no systematic neuropsychological examination of these particular cognitive functions in patients diagnosed with BPD. Such investigations may improve our understanding of the possible role of brain dysfunction in BPD and improve the characterization of the psychological difficulties associated with this disorder.Method. Forty-two psychiatric patients with a diagnosis of DSM-III-R BPD (41 of whom gave a history of self-harm), without a history of specified ‘psychoses’ or current major affective disorder, were clinically assessed before completing computerized tasks of decision-making and planning previously shown to be sensitive to frontal lobe dysfunction, and tests of spatial and pattern visual recognition memory previously shown to be sensitive to frontal lobe damage and temporal lobe damage respectively. The performance of the BPD patient group was compared with that of a non-clinical control group consisting of 42 subjects.Results. The performance of the BPD patients on the decision-making task was characterized by a pattern of delayed and maladaptive choices when choosing between competing actions, and by impulsive, disinhibited responding when gambling on the outcome of their decisions. BPD patients also showed impairments on the planning task. There was no evidence of impaired visual recognition memory. Additional analyses suggested only limited effects of current medication and history of previous substance use disorder.Conclusions. These findings suggest that BPD is associated with complex impairments in dissociable cognitive processes mediated by circuitry encompassing the frontal lobes. These impairments may mediate some of the behavioural changes evident in BPD. Further work is needed to examine the specificity of these findings.

Factors associated with borderline personality disorder in major depressive patients and their relationship to bipolarity

2013 ◽  
Vol 28 (8) ◽  
pp. 463-468 ◽  
Author(s):  
J.M. Azorin ◽  
A. Kaladjian ◽  
M. Adida ◽  
E. Fakra ◽  
R. Belzeaux ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Age At Onset ◽  
Borderline Personality ◽  
First Episode ◽  
Contributory Factor ◽  
Structured Interviews ◽  
Major Depressive ◽  
History Of ◽  
Depressive Patients

AbstractObjectiveTo analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.MethodsAs part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD−).ResultsCompared to BPD (−), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.ConclusionsThe hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.

Comorbid Bipolar Disorder and Borderline Personality Disorder and History of Suicide Attempts

2014 ◽  
Vol 28 (3) ◽  
pp. 358-364 ◽  
Author(s):  
Mark Zimmerman ◽  
Jennifer Martinez ◽  
Diane Young ◽  
Iwona Chelminski ◽  
Theresa A. Morgan ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
History Of

Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature

2014 ◽  
Vol 32 (1) ◽  
pp. 21-30 ◽  
Author(s):  
J. Cotter ◽  
M. Kaess ◽  
A. R. Yung
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Trauma ◽  
Psychotic Disorders ◽  
Functional Disability ◽  
Clinical Work ◽  
Borderline Personality ◽  
Response To Treatment ◽  
Neurocognitive Deficits

ObjectivesWe aimed to examine the association between childhood trauma and functional impairment in psychotic disorders, bipolar disorder and borderline personality disorder, to speculate on possible mechanisms that underlie this association and discuss the implications for clinical work.MethodsNarrative review of the peer-reviewed English language literature in the area.ResultsHigh rates of childhood trauma in psychotic disorders, bipolar disorder and borderline personality disorder were identified. This was associated with impaired social and occupational functioning in both the premorbid and established phases of each of these psychiatric disorders over and above the deficits typically observed in these populations. Possible mechanisms mediating this relationship include neurocognitive deficits, insecure attachment, higher rates of comorbidities and problems with adherence and response to treatment.ConclusionsRoutine clinical inquiry about childhood maltreatment should be adopted within mental health settings. This has potentially important treatment implications for identifying those individuals at elevated risk of functional disability. While there is no clear guidance currently available on how to target childhood trauma in the treatment of psychotic disorders, bipolar disorder or borderline personality disorder, there are several promising lines of enquiry and further research is warranted.

scholarly journals Psychosocial morbidity associated with bipolar disorder and borderline personality disorder in psychiatric out-patients: Comparative study

2015 ◽  
Vol 207 (4) ◽  
pp. 334-338 ◽  
Author(s):  
Mark Zimmerman ◽  
William Ellison ◽  
Theresa A. Morgan ◽  
Diane Young ◽  
Iwona Chelminski ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
College Graduates ◽  
Borderline Personality ◽  
Structured Interviews ◽  
Public Health Perspective ◽  
Repeated Calls ◽  
History Of ◽  
Psychosocial Morbidity

BackgroundThe morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders.AimsTo compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder.MethodPatients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder.ResultsThe patients with borderline personality disorder less frequently were college graduates, were diagnosed with more comorbid disorders, more frequently had a history of substance use disorder, reported more suicidal ideation at the time of the evaluation, more frequently had attempted suicide, reported poorer social functioning and were rated lower on the Global Assessment of Functioning. There was no difference between the two patient groups in history of admission to psychiatric hospital or time missed from work during the past 5 years.ConclusionsThe level of psychosocial morbidity associated with borderline personality disorder was as great as (or greater than) that experienced by patients with bipolar disorder. From a public health perspective, efforts to improve the detection and treatment of borderline personality disorder might be as important as efforts to improve the recognition and treatment of bipolar disorder.

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