Altered psychophysiological correlates of risk‐taking in borderline personality disorder

Abstract

Elevated levels of risk‐taking behavior as well as affective instability are both cardinal features of Borderline Personality Disorder (BPD). To our knowledge, there are no studies which directly investigate underlying affective processes of risk‐taking behavior in BPD, despite the centrality of affect in BPD symptomatology, and indications of affective dysregulation contributing to increased risk‐taking behavior in BPD. Here, we examined risk‐taking behavior in BPD and its underlying affective processes, using skin conductance responses (SCRs) as a proxy. Twenty‐three individuals with BPD and 24 healthy controls performed a modified version of the Balloon Analogue Risk Task, where decisions take place over a time scale of several seconds, enabling us to investigate a continuous integral of SCRs in anticipation of decisions. We used trial‐by‐trial mixed model analyses to account for within‐ and between‐participant effects, as well as large variability that are often observed in SCRs. In contrast to healthy controls, who showed elevated SCRs in response to high risk, individuals with BPD did not show differential physiological sensitivity towards different risk levels. In addition, increased SCRs––under low risk––were related to more cautious risk‐taking behavior in HCs. However, increased SCRs under low risk in BPD were related to greater risk‐taking behavior. Alterations in the processing of affective signals, such as SCRs in the context of risk, may impair adaptation to environmental demands and may lead to increased risk‐taking behavior in BPD.

Altered interaction of physiological activity and behavior affects risky decision-making in ADHD

“…There was, however, no group difference and both ADHD and HC showed greater risky behavior under high reward conditions. Similar results were also shown in studies on ADHD and on Borderline Personality Disorder, arguing that the range between reward conditions was too narrow ( Luman et al, 2008 ; Hüpen et al, 2020 ).…”

“…The BART has been demonstrated to induce naturalistic risky DM (Lejuez et al, 2002). Moreover, the modified version was designed to trigger emotional arousal and intuitive guided behavior, and to investigate DM depending on the reward magnitude (Hüpen et al, 2019(Hüpen et al, , 2020. Additionally, questionnaires were used to investigate self-assessment of risky behavior and emotional competence.…”

Impulsivity and Emotional Dysregulation Predict Choice Behavior During a Mixed-Strategy Game in Adolescents With Borderline Personality Disorder

“…Pathological processes in BPD (namely, impulsivity and emotional dysregulation) could affect strategic choice behavior in several ways. Impaired affective and RL processes could contribute to strategic choice behavior through outcome evaluation processes including; (1) Blunted reward prediction error (RPE) and/or affective signaling ( Hüpen et al, 2020 ; Neville et al, 2021 ) that could lead to insensitivity to changing reward contingencies and/or a deficit updating the value of actions on a trial-by-trial basis, which in this context, may actually result in fewer choice biases (and therefore, potentially enhanced performance as one may better evade exploitation by the opponent); and/or (2) Exacerbated RPE and/or affective signals could lead to amplified biases (and therefore, potentially diminished performance as the opponent would exploit these biases as they emerge), either of which may be more prominent for either positive (WS) and/or negative (LS) outcomes ( Schuermann et al, 2011 ; Paret et al, 2016 ; Neville et al, 2021 ). We hypothesized that group differences would be more pronounced in individuals with higher levels of impulsivity in either group, measured using the BIS ( Patton et al, 1995 ), and emotion dysregulation in the BPD group, measured using the DERS ( Gratz and Roemer, 2004 ).…”

Impulsivity and Emotional Dysregulation Predict Choice Behavior During a Competitive Multiplayer Game in Adolescents with Borderline Personality Disorder

“…Impaired affective and RL processes could contribute to strategic choice behavior through outcome evaluation processes in the following ways; 1. Blunted reward prediction error (RPE) and/or affective signaling (Hüpen et al, 2020;Neville et al, 2021) that could lead to insensitivity to changing reward contingencies and/or a deficit updating the value of actions on a trial-bytrial basis, which in this context, may actually result in fewer choice biases (and therefore, potentially enhanced performance as one may better evade exploitation by the opponent); and/or 2. Exacerbated RPE and/or affective signals could lead to amplified biases (and therefore, potentially diminished performance as the opponent would exploit these biases as they emerge), either of which may be more prominent for either positive (WS) and/or negative (LS) outcomes (Neville et al, 2021;Paret et al, 2016;Schuermann et al, 2011).…”