Brief reportExecutive functioning among patients with borderline personality disorder (BPD) and their relatives
Introduction
Borderline personality disorder (BPD) patients were found to have deficits in executive functioning (EF) in most (LeGris and van Reekum, 2006), though not all, studies (Kunert et al., 2003, Sprock et al., 2000). Their most significant deficit may be in cognitive planning, as a meta-analysis conducted by Ruocco (2005) points toward. Since EF is considered to be an important determinant of self-regulation (Schmeichel, 2007), deficits in these functions are assumed to underlie the phenotypic features of BPD, such as increased impulsivity, suicidal and self-destructive behaviors (Bazanis et al., 2002, Burgess, 1991).
Although executive dysfunctions have been suggested as markers of familial vulnerability in various disorders (Conklin et al., 2000, Delorme et al., 2007), studies focusing on the EF of relatives with BPD patients are currently lacking. Moreover, only few studies have examined EF in BPD as compared to other disorders (e.g., Dowson et al., 2004). Since studies have shown the substantial heritability of BPD, examining whether BPD patients and their relatives share executive dysfunctions may shed light on the potential role of these deficits as markers of familial vulnerability to BPD. Thus, the present study sought to investigate EF in BPD patients and their unaffected parents. Three domains of EF were assessed: cognitive planning, sustained attention, and working memory. We predicted that BPD patients would show deficits in EF and that their parents would share similar impairments in these functions.
Section snippets
Participants
The present study assessed four groups: BPD patients (BPD), their healthy controls (HC), parents of BPD patients (BPD-P), and their healthy controls (HC-P). Inclusion criteria for the BPD group were: diagnosis of BPD, which was confirmed by a senior psychiatrist using the structured clinical interview for the DSM-IV axis-II personality disorders (SCID-II; First et al., 1995). The lack of an active axis I disorder (Spitzer et al., 1992) was the exclusion criteria (For clinical data, see Table S1
BPD as compared to HC
The ANCOVA revealed a significant group by difficulty level effect on this measure [F(3,159)=3.23, p=.024]. We explored this effect further by comparing the groups at each level of difficulty. The analyses revealed that the groups differed in all difficulty levels (2–5 move stages; p=.001, p=.003, p=.002, p=.000, respectively), indicating that BPD patients had a significantly shorter initial thinking time than the HC group in each level of the ToL task. In addition, the groups differed on the
Discussion
Our findings revealed a profile of generalized executive dysfunctions among BPD patients, which is consistent with previous reports (LeGris and van Reekum, 2006). Importantly, our results of impaired planning in BPD patients is consistent with the meta analysis conducted by Ruocco (2005), who found that the largest deficit in EF of BPD patients was in the planning domain. Given that the frontal lobes have been implicated in tests of EF (Owen et al., 1990), these findings lend support to the
Role of funding source
The authors of this study received no special funds for this research Uncited reference.
Conflict of interest
The authors do not have any conflict of interest in the conduct and reporting of this research.
Acknowledgments
The Center would like to thank Anna Wexler for providing editorial assistance during the preparation and revision of the manuscript.
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2015, European PsychiatryCitation Excerpt :Interestingly, the finding of short deliberation time in the ToL task is in accordance with a recent study also conducted by our research group. In this study, BPD patients as well as their unaffected parents, devoted less time to planning [16]. Furthermore, in another recent study, relatives of BPD patients displayed atypically fast reaction times to target stimuli in their performance on the CPT, an attribute which, according to the authors, could be characterized as genuinely impulsive [36].