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

Bazanis, E.; Rogers, Robert D.; Dowson, J. H.; Taylor, Pamela J.; Meux, Clive; Staley, Carole; Nevinson-Andrews, D.; Taylor, Colin; Robbins, Trevor W.; Sahakian, Barbara J.

doi:10.1017/s0033291702006657

Cited by 152 publications

(155 citation statements)

References 29 publications

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“…Decision making has been a research target in substance and alcohol misuse disorders (Bechara et al, 2001;Ersche et al, 2008;Rogers et al, 1999b;Rogers and Robbins, 2001), unipolar depression and bipolar disorder (Chandler et al, 2009;Murphy et al, 2001), suicidaility (Dombrovski et al, 2010;Jollant et al, 2005), and impulsive personality disorders (Bazanis et al, 2002;Kirkpatrick et al, 2007). Adjunctive work has explored the idea that impairments in decision making can serve as markers for likely relapse (Adinoff et al, 2007;Bechara et al, 2001) and facilitate the exploration of therapeutic interventions (Rahman et al, 2006;Robbins and Arnsten, 2009).…”

Section: Introductionmentioning

confidence: 99%

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

Rogers

2010

Neuropsychopharmacol

202

130

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Neurophysiological experiments in primates, alongside neuropsychological and functional magnetic resonance investigations in humans, have significantly enhanced our understanding of the neural architecture of decision making. In this review, I consider the more limited database of experiments that have investigated how dopamine and serotonin activity influences the choices of human adults. These include those experiments that have involved the administration of drugs to healthy controls, experiments that have tested genotypic influences upon dopamine and serotonin function, and, finally, some of those experiments that have examined the effects of drugs on the decision making of clinical samples. Pharmacological experiments in humans are few in number and face considerable methodological challenges in terms of drug specificity, uncertainties about pre-vs post-synaptic modes of action, and interactions with baseline cognitive performance. However, the available data are broadly consistent with current computational models of dopamine function in decision making and highlight the dissociable roles of dopamine receptor systems in the learning about outcomes that underpins value-based decision making. Moreover, genotypic influences on (interacting) prefrontal and striatal dopamine activity are associated with changes in choice behavior that might be relevant to understanding exploratory behaviors and vulnerability to addictive disorders. Manipulations of serotonin in laboratory tests of decision making in human participants have provided less consistent results, but the information gathered to date indicates a role for serotonin in learning about bad decision outcomes, non-normative aspects of risk-seeking behavior, and social choices involving affiliation and notions of fairness. Finally, I suggest that the role played by serotonin in the regulation of cognitive biases, and representation of context in learning, point toward a role in the cortically mediated cognitive appraisal of reinforcers when selecting between actions, potentially accounting for its influence upon the processing salient aversive outcomes and social choice.

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Section: Introductionmentioning

confidence: 99%

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

Rogers

2010

Neuropsychopharmacol

202

130

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“…One way to meet this challenge will be to integrate properly different kinds of methodologies in order to establish how cognitive deficits in these disorders interact with other aspects of their pathophysiology. For example, recent research has suggested that altering 5-HT function in healthy volunteers can alter performance of the decision-making task used in Bazanis et al (2002). Since there is now increasing evidence that 5-HT function is compromised in borderline PD (including the neuromodualtion of the prefrontal cortex ; Soloff et al 2000), we can test the hypothesis that the impaired decisionmaking associated with borderline PD involves altered neuromodulation of cognitive processes mediated by the prefrontal cortex.…”

Section: Resultsmentioning

confidence: 98%

Neuropsychological investigations of the impulsive personality disorders

Rogers¹

2003

Psychol. Med.

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There has been revived interest within the last few years in neuropsychological investigations of personality disorders (PDs) associated with impulsive and/or anti-social behaviour. Neuropsychological studies of such PDs offer two potential benefits: (i) an improving characterization of the cognitive and emotional difficulties experienced by individuals diagnosed with these disorders and, in particular, borderline PD and anti-social PD; (ii) the development of more precise hypotheses about the role of brain dysfunction in the aetiology and behavioural problems associated with these conditions. The most recent neuropsychological studies of impulsive PD have been interpreted against a background of accumulating evidence for structural (Driessen et al. 2000; Raine et al. 2000; Dolan et al. 2001), neurochemical (Coccaro & Siever, 1995; Steinberg et al. 1997; Leyton et al. 2001) and functional brain abnormalities (Donegan et al. 2003). Future studies of impulsive PDs will be able to exploit advances in structural imaging (e.g. diffusion tensor imaging/tract mapping, e.g. Hoptman et al. 2002), as well as pharmacological and behavioural genetics (McGuffin & Thapar, 1992; Lesch et al. 1996; Skodol et al. 2002).

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“…De nombreux auteurs soutiennent que les troubles de personnalité du DSM-IV sont en fait des manifestations d'altérations du fonctionnement exécutif (Bazanis et al, 2002 ;Kunert, 2003 ;Coolidge et al, 2004 ;Lenzenweger et al, 2004 ;Travers et King, 2005). Le terme de fonctions exécutives réfère au fait que les régions frontales et pré frontales du cerveau constituent le substrat neuroanatomique d'un en semble de fonctions qualifiées d'exécutives qui permettent l'organi sation, la planification, la flexibilité, l'abstraction et l'autocontrôle (Tableau 1).…”

Section: Déficits Des Fonctions Exécutives Chez Les Patients Avec Un Tplunclassified

“…Swirsky-Sacchetti et al (1993) obtiennent par ailleurs des résultats qui montrent une susceptibilité accrue à l'interférence en plus d'atteintes aux habiletés motrices, une pauvre mémoire non verbale et une difficulté d'intégration visuomotrice complexe chez les patients avec un TPL. Bazanis et al (2002) ont observé des atteintes significatives lors de tests exécutifs qui impliquent la prise de décision et la planification. Soulignons que ces auteurs ont choisi des tâches particulièrement associées aux aires orbitofrontales mais non pas aux aires dorsolatérales et dorsomédianes.…”

Section: Survol De La Recherche Sur Les Fonctions Exécutives Des Persunclassified

Intérêt clinique d’une conception neuroscientifique du trouble de personnalité limite : dysfonctionnements du système exécutif et de la théorie de l’esprit

Bouchard

Lemelin

Dubé

et al. 2011

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Le trouble de personnalité limite (TPL) est un problème psychopathologique complexe et les données récentes issues des neurosciences permettent une compréhension plus précise des bases neurobiologiques de ses manifestations. Cet article vise à étayer la proposition que le TPL dépend en partie d’un dysfonctionnement frontal et exécutif qui perturbe les mécanismes nécessaires au fonctionnement optimal des inférences propres à l’utilisation d’une « théorie de l’esprit ». Pour soutenir ce propos, quatre ensembles d’observations sont examinés : les parallèles entre la personnalité dite frontale et le TPL, la présence de déficits cognitifs de type frontal chez le TPL, les conséquences sur le développement cérébral d’une enfance marquée par l’abus et la négligence et enfin, les résultats des études d’imagerie cérébrale. Cet article s’inscrit dans un courant de pensée qui vise l’intégration de la perspective neuroscientifique du TPL aux conceptualisations psychopathologiques actuelles. L’objectif étant d’offrir une conceptualisation du TPL qui évite la traditionnelle dichotomie esprit/cerveau, psychologie/biologie et de dégager des points de convergence entre la psychologie clinique et la neurobiologie.Borderline personality disorder (BPD) is a complex psychopathology. Through recent developments, neuroscience is able to contribute to better understanding the neurobiological underpinnings of BPD manifestations. This article aims to demonstrate that BPD is in part due to executive and frontal dysregulation of the mechanisms responsible for the optimal functioning of inferences specific to theory of mind. To do so, four types of observations will be examined: parallels between frontal personality and BPD, the presence of frontal cognitive deficits in BPD, the consequences of childhood abuse and neglect on brain development and finally, the results of brain imagery in BPD. This article follows in the path of a growing interest in the integration of the neuroscientific perspective of BPD to current conceptualisations in psychopathology. The final aim is to try to offer an understanding of BPD manifestations that avoids the traditional splitting between mind and brain—psychology and biology—and to show the numerous associations between clinical psychology and neurobiology.El trastorno de la personalidad límite (TPL) es un problema psicopatológico complejo. Los datos recientes provenientes de las neurociencias permiten una comprensión más precisa de las bases neurobiológicas de sus manifestaciones. Este artículo busca apoyar la proposición de que el TPL depende en parte de una disfunción frontal y ejecutiva que perturba los mecanismos necesarios para el funcionamiento óptimo de las inferencias propias a la utilización de una “teoría de la mente”. Para sostener esta propuesta, se examinan cuatro grupos de observaciones: los paralelos entre la personalidad frontal y el TPL, la presencia de déficits cognitivos de tipo frontal en el TPL, las consecuencias en el desarrollo cerebral de una infancia marcada por el abuso y la negligen...

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

Cited by 152 publications

References 29 publications

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

The Roles of Dopamine and Serotonin in Decision Making: Evidence from Pharmacological Experiments in Humans

Neuropsychological investigations of the impulsive personality disorders

Intérêt clinique d’une conception neuroscientifique du trouble de personnalité limite : dysfonctionnements du système exécutif et de la théorie de l’esprit

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