Neuropsychological function in borderline personality disorder

Abstract

To evaluate the possibility of an underlying dimension of organicity in borderline personality disorder (BPD), a carefully diagnosed group of borderline patients was assessed across a wide range of neuropsychological functions and then was compared to an age-and education-matched nonpatient control group. The BPD group had significantly lower Verbal, Performance, and Full Scale IQ scores on the WAIS-R. The BPD group also was impaired significantly on motor skills, figural memory, complex visuomotor integration, social or interpersonal intelligence, and on a measure of susceptibility to interference. This pattern of deficits localized to the fronto-temporal regions and became more pronounced when a subgroup analysis was performed. This study suggests that subtle organic factors may be operative in some, but not all, BPD patients. The clinical literature on borderline personality disorder (BPD) contains frequent references to problems these patients have with attention/concentration (M. Murray,

Neuropsychological functioning in patients with borderline personality disorder

“…Additionally, the cognitive functioning of patients with BPD was not impaired by emotional stimuli. These results failed to replicate previous findings with regard to the Stroop (Carpenter et al, 1993;Swirsky-Sacchetti et al, 1993) or Trails B (Carpenter et al, 1993;van Reekum et al, 1993) The one expected finding was that depressed patients demonstrated psychomotor slowing compared to the other groups (although only one of the differences was significant using covariates) and generally poorer performance on story recall. However, the performance of depressives was not impacted by emotional stimuli.…”

“…Order of lists and interference conditions were counterbalanced to control for learning effects. The neutral interference consisted of serial sevens (i.e., counting backwards from 100 by 7) while the emotional interference required subjects to tell a story about Thematic Apperception Card #13 MF, which often evokes stories about rape or murder (Swirsky-Sacchetti et al, 1993).…”

“…Part I Preliminary work suggests that at least a portion of patients with BPD demonstrate evidence of frontal-lobe system dysfunction (Swirsky-Sacchetti et al, 1993;van Reekum et al, 1993). The focus of Part I of this study was on tasks sensitive to deficits in frontallobe functioning, including motor performance, visuomotor integration, and inhibition of automatic verbal responses.…”

“…While some studies have found that patients with BPD have deficits on tasks such as copy and recall of a complex figure, story recall, the Stroop Color-Word Test (Stroop, 1935) and the Wechsler Adult Intelligence Scale (WAIS-R; Wechsler, 1981), others have failed to find significant decrements in performance compared to normals on some of these tasks (Carpenter, Gold, & Fenton, 1993;Judd & Ruff, 1993;O'Leary, Brouwers, Gardner, & Cowdry, 1991;Swirsky-Sacchetti et al, 1993;van Reekum, Conway, Gansler, White, & Bachman, 1993). Reasons for the inconsistencies include small sample sizes (generally less than 20 patients) and differing samples (e.g., inpatients vs. outpatients, males vs. females, medicated vs. medication free), selection criteria, and diagnostic assessments.…”

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

“…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.…”