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Impact of stress on different components of impulsivity in borderline personality disorder

Published online by Cambridge University Press:  06 March 2014

S. Cackowski ,
A.-C. Reitz ,
G. Ende ,
N. Kleindienst ,
M. Bohus ,
C. Schmahl  and
A. Krause-Utz
S. Cackowski*
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
A.-C. Reitz
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
G. Ende
Affiliation:
Department of Neuroimaging, Central Institute of Mental Health, Mannheim, Germany
N. Kleindienst
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
M. Bohus
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
C. Schmahl
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
A. Krause-Utz
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
*
*Address for correspondence: S. Cackowski, M.A., Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, J5, D-68159 Mannheim, Germany. (Email: [email protected])
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Abstract

Background.

Previous research on impulsivity in borderline personality disorder (BPD) has revealed inconsistent findings. Impulsive behaviour is often observed during states of emotional distress and might be exaggerated by current attention deficit hyperactivity disorder (ADHD) symptoms in individuals with BPD. We aimed to investigate different components of impulsivity dependent on stress induction controlling for self-reported ADHD symptoms in BPD.

Method.

A total of 31 unmedicated women with BPD and 30 healthy women (healthy controls; HCs), matched for age, education and intelligence, completed self-reports and behavioural tasks measuring response inhibition (go/stop task) and feedback-driven decision making (Iowa Gambling Task) under resting conditions and after experimental stress induction. ADHD symptoms were included as a covariate in the analyses of behavioural impulsivity. Additionally, self-reported emotion-regulation capacities were assessed.

Results.

BPD patients reported higher impulsive traits than HCs. During stress conditions – compared with resting conditions – self-reported impulsivity was elevated in both groups. Patients with BPD reported higher state impulsivity under both conditions and a significantly stronger stress-dependent increase in state impulsivity. On the behavioural level, BPD patients showed significantly impaired performance on the go/stop task under stress conditions, even when considering ADHD symptoms as a covariate, but not under resting conditions. No group differences on the Iowa Gambling Task were observed. Correlations between impulsivity measures and emotion-regulation capacities were observed in BPD patients.

Conclusions.

Findings suggest a significant impact of stress on self-perceived state impulsivity and on response disinhibition (even when considering current ADHD symptoms) in females with BPD.

Keywords

Borderline personality disorderimpulsivitystress
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 15 , November 2014 , pp. 3329 - 3340
Copyright
Copyright © Cambridge University Press 2014 

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