Executive functions in borderline personality disorder

Hagenhoff, Meike; Franzen, Nele; Koppe, Georgia; Baer, Nina; Scheibel, Niki; Sammer, Gebhard; Gallhofer, Bernd; Lis, Stefanie

doi:10.1016/j.psychres.2013.05.016

Cited by 55 publications

(41 citation statements)

References 62 publications

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“…The great majority of studies using behavioral inhibition tasks such as go/no-go or stop-signal tasks did fail to reveal performance deficits as this should be indicated by increased commission error rates in go/no-go tasks or by increased stop-signal reaction time in stop-signal tasks in patients with BPD [Nigg et al, 2005; Lampe et al, 2007; Ruchsow et al, 2008; Völker et al, 2009; Jacob et al, 2010; LeGris et al, 2012; Hagenhoff et al, 2013; but see Ruocco et al (2012) for deficits in patients with BPD in a continuous performance tasks measuring response inhibition, vigilance, and sustained attention]. This suggests that patients with BPD do not display behavioral deficits in behavioral inhibition as captured with neutral response inhibition tasks [for a review see Sebastian et al (2013a)], at least under baseline non-stressed, non-emotional conditions (Krause-Utz et al, 2013; Cackowski et al, 2014).…”

Section: Prefrontal Cortex Functioning Underlying Components Of Impulmentioning

confidence: 99%

Frontal Dysfunctions of Impulse Control â€“ A Systematic Review in Borderline Personality Disorder and Attention-Deficit/Hyperactivity Disorder

Sebastian

Jung

Krause-Utz

et al. 2014

Front. Hum. Neurosci.

131

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Disorders such as borderline personality disorder (BPD) or attention-deficit/hyperactivity disorder (ADHD) are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary function. Recent findings from behavioral and cognitive neuroscience studies suggest related but dissociable components of impulse control along functional domains like selective attention, response selection, motivational control, and behavioral inhibition. In addition, behavioral and neural dissociations are seen for proactive vs. reactive inhibitory motor control. The prefrontal cortex with its sub-regions is the central structure in executing these impulse control functions. Based on these concepts of impulse control, neurobehavioral findings of studies in BPD and ADHD were reviewed and systematically compared. Overall, patients with BPD exhibited prefrontal dysfunctions across impulse control components rather in orbitofrontal, dorsomedial, and dorsolateral prefrontal regions, whereas patients with ADHD displayed disturbed activity mainly in ventrolateral and medial prefrontal regions. Prefrontal dysfunctions, however, varied depending on the impulse control component and from disorder to disorder. This suggests a dissociation of impulse control related frontal dysfunctions in BPD and ADHD, although only few studies are hitherto available to assess frontal dysfunctions along different impulse control components in direct comparison of these disorders. Yet, these findings might serve as a hypothesis for the future systematic assessment of impulse control components to understand differences and commonalities of prefrontal cortex dysfunction in impulsive disorders.

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Section: Prefrontal Cortex Functioning Underlying Components Of Impulmentioning

confidence: 99%

Frontal Dysfunctions of Impulse Control â€“ A Systematic Review in Borderline Personality Disorder and Attention-Deficit/Hyperactivity Disorder

Sebastian

Jung

Krause-Utz

et al. 2014

Front. Hum. Neurosci.

131

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“…A challenge faced by studies on emotions and memory is that BPD patients may also exhibit impaired general cognitive functioning [132,137,138]. However, most studies on working memory and declarative memory cited in this article carefully controlled for possible group differences in cognitive functioning using a standardized test [45,46,48,49,52,53,54,55,56,69] or at least considered education level [43,50,68,70,73].…”

Section: Limitations Of Studies On Emotions and Memory In Bpdmentioning

confidence: 99%

Emotions and Memory in Borderline Personality Disorder

Winter

Elzinga²,

Schmahl³

2013

Psychopathology

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Memory processes such as encoding, storage, and retrieval of information are influenced by emotional content. Because patients with borderline personality disorder (BPD) are particularly susceptible to emotional information, it is relevant to understand whether such memory processes are altered in this patient group. This systematic literature review collects current evidence on this issue. Research suggests that emotional information interferes more strongly with information processing and learning in BPD patients than in healthy controls. In general, BPD patients do not seem to differ from healthy control subjects in their ability to memorize emotional information, but they tend to have specific difficulties forgetting negative information. Also, BPD patients seem to recall autobiographical, particularly negative events with stronger arousal than healthy controls, while BPD patients also show specific temporo-prefrontal alterations in neural correlates. No substantial evidence was found that the current affective state influences learning and memory in BPD patients any differently than in healthy control subjects. In general, a depressive mood seems to both deteriorate and negatively bias information processing and memories, while there is evidence that dissociative symptoms impair learning and memory independently of stimulus valence. This review discusses methodological challenges of studies on memory and emotions in BPD and makes suggestions for future research and clinical implications.

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“…Some studies link working memory deficits with self-reported impulsiveness (Cheung et al, 2004;Stanford et al, 2009). Consistent with this notion, n-back performance is reported to be poor in people with borderline personality disorder (BPD: Hagenhoff et al, 2013), suicidality (Keilp et al, 2013), and attention-deficit/hyperactivity disorder (ADHD: McCarthy et al, 2014). When performing n-back tasks, ADHD patients reportedly activate bilateral middle frontal, cerebellar, occipital and parietal areas less than do controls (Valera et al, 2005;Bayerl et al, 2010).…”

mentioning

confidence: 87%

n-Back task performance and corresponding brain-activation patterns in women with restrictive and bulimic eating-disorder variants: Preliminary findings

Israël

Kleín

Pruessner

et al. 2015

Psychiatry Research: Neuroimaging

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Eating disorder (ED) variants characterized by "binge-eating/purging" symptoms differ from "restricting-only" variants along diverse clinical dimensions, but few studies have compared people with these different eating-disorder phenotypes on measures of neurocognitive function and brain activation. We tested the performances of 19 women with "restricting-only" eating syndromes and 27 with "binge-eating/purging" variants on a modified n-back task, and used functional magnetic resonance imaging (fMRI) to examine task-induced brain activations in frontal regions of interest. When compared with "binge-eating/purging" participants, "restricting-only" participants showed superior performance. Furthermore, in an intermediate-demand condition, "binge-eating/purging" participants showed significantly less event-related activation than did "restricting-only" participants in a right posterior prefrontal region spanning Brodmann areas 6-8-a region that has been linked to planning of motor responses, working memory for sequential information, and management of uncertainty. Our findings suggest that working memory is poorer in eating-disordered individuals with binge-eating/purging behaviors than in those who solely restrict food intake, and that observed performance differences coincide with interpretable group-based activation differences in a frontal region thought to subserve planning and decision making.

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Executive functions in borderline personality disorder

Cited by 55 publications

References 62 publications

Frontal Dysfunctions of Impulse Control â€“ A Systematic Review in Borderline Personality Disorder and Attention-Deficit/Hyperactivity Disorder

Frontal Dysfunctions of Impulse Control â€“ A Systematic Review in Borderline Personality Disorder and Attention-Deficit/Hyperactivity Disorder

Emotions and Memory in Borderline Personality Disorder

n-Back task performance and corresponding brain-activation patterns in women with restrictive and bulimic eating-disorder variants: Preliminary findings

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