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Impulsivity in patients with borderline personality disorder: a comprehensive profile compared with healthy people and patients with ADHD

Published online by Cambridge University Press:  23 August 2019

Pavla Linhartová Open the ORCID record for Pavla Linhartová [Opens in a new window] ,
Adéla Látalová ,
Richard Barteček ,
Jan Širůček ,
Pavel Theiner ,
Anastasia Ejova ,
Pavlína Hlavatá ,
Barbora Kóša ,
Barbora Jeřábková  and
Martin Bareš
...Show all authors
Pavla Linhartová*
Affiliation:
Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
Adéla Látalová
Affiliation:
Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
Richard Barteček
Affiliation:
Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
Jan Širůček
Affiliation:
Faculty of Social Studies, Institute for Research on Children, Youth and Family, Masaryk University, Brno, Czech Republic
Pavel Theiner
Affiliation:
Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
Anastasia Ejova
Affiliation:
Faculty of Science, School of Psychology, University of Auckland, Auckland, New Zealand
Pavlína Hlavatá
Affiliation:
Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic Behavioral and Social Neuroscience Research Group, CEITEC – Central European Institute of Technology, Masaryk University, Brno, Czech Republic
Barbora Kóša
Affiliation:
Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
Barbora Jeřábková
Affiliation:
Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
Martin Bareš
Affiliation:
First Department of Neurology, St. Anne's Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic Department of Neurology, Faculty of Medicine, University of Minnesota, Minneapolis, MN, USA
Tomáš Kašpárek
Affiliation:
Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
*
Author for correspondence: Pavla Linhartová, E-mail: [email protected]
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Abstract

Background

Impulsivity is a core symptom of borderline personality disorder (BPD). Impulsivity is a heterogeneous concept, and a comprehensive evaluation of impulsivity dimensions is lacking in the literature. Moreover, it is unclear whether BPD patients manifest impaired cognitive functioning that might be associated with impulsivity in another patient group, such as ADHD, a frequent comorbidity of BPD.

Methods

We tested 39 patients with BPD without major psychiatric comorbidities and ADHD, 25 patients with ADHD, and 55 healthy controls (HC) using a test battery consisting of a self-report measure of impulsivity (UPPS-P questionnaire), behavioral measures of impulsivity – impulsive action (Go/NoGo task, stop signal task) and impulsive choice (delay discounting task, Iowa gambling task), and standardized measures of attention (d2 test), working memory (digit span), and executive functioning (Tower of London).

Results

Patients with BPD and ADHD, as compared with HC, manifested increased self-reported impulsivity except sensation seeking and increased impulsive choice; patients with ADHD but not BPD showed increased impulsive action and deficits in cognitive functioning. Negative urgency was increased in BPD as compared to both HC and ADHD groups and correlated with BPD severity.

Conclusions

Patients with BPD without ADHD comorbidity had increased self-reported impulsivity and impulsive choice, but intact impulsive action and cognitive functioning. Controlling for ADHD comorbidity in BPD samples is necessary. Negative urgency is the most diagnostically specific impulsivity dimension in BPD.

Keywords

ADHDattentionborderline personality disordercognitive functionsdecision makingexecutive functionsimpulsivityurgencyworking memory.
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 11 , August 2020 , pp. 1829 - 1838
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Copyright
Copyright © Cambridge University Press 2019

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