Suboptimal Decision Making in Borderline Personality Disorder: Effect of Potential Losses

2014 ◽  
Vol 17 ◽  
Author(s):  
Juan P. Sánchez-Navarro ◽  
Joshua A. Weller ◽  
Jose M. López-Navarro ◽  
Jose M. Martínez-Selva ◽  
Antoine Bechara
Keyword(s):  
Decision Making ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Comparison Group ◽  
Borderline Personality ◽  
Risky Decision ◽  
Increased Risk ◽  
Disorder Effect ◽  
Matched Comparison ◽  
Underlying Processes

AbstractThis research explored the underlying processes mediating risky decisions for individuals with Borderline Personality Disorder (BPD). We tested whether BPD patients were more apt to take risks compared to a matched comparison group. We used two controlled tasks designed to assess risky decision-making, both to achieve gains and to avoid losses. Overall, BPD patients showed increased risk-taking compared to the comparison group (p = .011, η2 = .224), and were especially likely to be risk-seeking when the decision was framed as a potential loss (p < .0001, d = 1.77). When the outcome involved pure losses, BPD patients were insensitive to the relative expected value between choice options resulting in suboptimal decision making (p = .004, d = 1.24), but did not differ from the comparison group when taking risks to achieve gains (p = .603, d = 0.21). We discuss these results in the context of behavioral and neuropsychiatric research suggesting abnormalities BPD patients’ ability to effectively regulate affect.

Risky decision-making in borderline personality disorder

2012 ◽  
Vol 197 (1-2) ◽  
pp. 112-118 ◽  
Author(s):  
Jennifer Svaldi ◽  
Alexandra Philipsen ◽  
Swantje Matthies
Keyword(s):  
Decision Making ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Risky Decision Making ◽  
Risky Decision

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.

Suicidal and Nonsuicidal Self-Injury in Borderline Personality Disorder

2017 ◽  
Author(s):  
Margaret S. Andover ◽  
Heather T. Schatten ◽  
Blair W. Morris
Keyword(s):  
Risk Factors ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Attempted Suicide ◽  
Borderline Personality ◽  
Modifiable Risk Factors ◽  
Self Injury ◽  
Increased Risk ◽  
Suicide Attempted ◽  
Nonsuicidal Self Injury

Individuals diagnosed with borderline personality disorder (BPD) are at an elevated risk for engaging in self-injurious behaviors, including suicide, attempted suicide, and nonsuicidal self-injury (NSSI). The purpose of this chapter is to provide an overview of research on self-injurious behaviors among individuals with BPD. Definitions and prevalence rates are provided for NSSI, suicide, and attempted suicide. Clinical correlates of and risk factors for the behaviors, as well as associations between specific BPD criteria and self-injurious behaviors, are discussed, and a brief overview of treatments focused on reducing self-injurious behaviors among BPD patients is provided. By understanding risk factors for attempted suicide and NSSI in BPD, we can better identify patients who are at increased risk and focus treatment efforts on addressing modifiable risk factors.

scholarly journals Recent developments in psychosocial interventions for borderline personality disorder

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 561
Author(s):  
Christina M Temes ◽  
Mary C Zanarini
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Treatment Options ◽  
Specific Treatment ◽  
Psychosocial Interventions ◽  
Borderline Personality ◽  
Post Traumatic Stress ◽  
Treatment Needs ◽  
Specific Patient ◽  
Increased Risk

Borderline personality disorder (BPD) is a serious psychiatric disorder that affects multiple symptomatic domains and is associated with an increased risk of suicidality. Several empirically supported treatments for BPD have been developed in recent years for adults with BPD. More recent work has focused on tailoring or applying (or both) these existing treatments to specific patient populations, including patients with certain types of comorbidity (for example, BPD and post-traumatic stress disorder or antisocial personality disorder) and younger patients. Other work has involved developing treatments and models of treatment delivery that address concerns related to access of care. Relatedly, new adjunctive and technology-assisted interventions have been developed, adding to the growing repertoire of treatment options for these patients. Advances in the last several years address specific treatment needs and offer cost-efficient options for this diverse patient population.

Altered Emotional Decision-Making in Prisoners with Borderline Personality Disorder

2007 ◽  
Vol 21 (3) ◽  
pp. 243-261 ◽  
Author(s):  
Tim Kirkpatrick ◽  
Eileen Joyce ◽  
John Milton ◽  
Conor Duggan ◽  
Peter Tyrer ◽  
...  
Keyword(s):  
Decision Making ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality

scholarly journals Etiological features of borderline personality related characteristics in a birth cohort of 12-year-old children

2012 ◽  
Vol 24 (1) ◽  
pp. 251-265 ◽  
Author(s):  
Daniel W. Belsky ◽  
Avshalom Caspi ◽  
Louise Arseneault ◽  
Wiebke Bleidorn ◽  
Peter Fonagy ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Family Environment ◽  
Borderline Personality ◽  
Environmental Mediation ◽  
Increased Risk ◽  
The Family ◽  
Poor Cognitive Function ◽  
History Of ◽  
Stress Models

AbstractIt has been reported that borderline personality related characteristics can be observed in children, and that these characteristics are associated with increased risk for the development of borderline personality disorder. It is not clear whether borderline personality related characteristics in children share etiological features with adult borderline personality disorder. We investigated the etiology of borderline personality related characteristics in a longitudinal cohort study of 1,116 pairs of same-sex twins followed from birth through age 12 years. Borderline personality related characteristics measured at age 12 years were highly heritable, were more common in children who had exhibited poor cognitive function, impulsivity, and more behavioral and emotional problems at age 5 years, and co-occurred with symptoms of conduct disorder, depression, anxiety, and psychosis. Exposure to harsh treatment in the family environment through age 10 years predicted borderline personality related characteristics at age 12 years. This association showed evidence of environmental mediation and was stronger among children with a family history of psychiatric illness, consistent with diathesis–stress models of borderline etiology. Results indicate that borderline personality related characteristics in children share etiological features with borderline personality disorder in adults and suggest that inherited and environmental risk factors make independent and interactive contributions to borderline etiology.

10-Year Outcome of Suicidal Behavior in Borderline Personality Disorder

2019 ◽  
Vol 33 (1) ◽  
pp. 82-100 ◽  
Author(s):  
Paul H. Soloff ◽  
Laurel Chiappetta
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychosocial Functioning ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Lower Socioeconomic ◽  
Increased Risk ◽  
Core Symptoms ◽  
Predominately Female

Prospective predictors of suicide attempts were assessed in 118 subjects with borderline personality disorder (BPD) after 10 or more years of follow-up. Mean (SD) time to follow-up was 14.4 (4.7) years. Subjects were predominately female (78.8%), Caucasian (81.4%), and of lower socioeconomic status. Initial recruitment was evenly balanced between inpatient, outpatient, and non-patient (community) sources. In the 10-year interval, 55 subjects (46.6%) attempted suicide. Compared to baseline, suicidal ideation, number of attempts, and non-suicidal self-injury diminished markedly. Core symptoms of BPD, substance abuse, and alcohol use disorders decreased significantly; however, major depressive disorder (MDD) remained constant at 50%. Forty-four percent of subjects had poor psychosocial, vocational, and economic outcomes. Psychosocial outcome was independent of suicide history and any treatment. Increased risk was associated with interval hospitalization prior to any attempt (illness severity), as well as poor social, vocational, and psychosocial functioning at baseline.

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