This research explored the underlying processes mediating risky decisions for individuals with Borderline Personality Disorder (BPD). We tested whether BPD patients were more apt to take risks compared to a matched comparison group. We used two controlled tasks designed to assess risky decision-making, both to achieve gains and to avoid losses. Overall, BPD patients showed increased risk-taking compared to the comparison group (p = .011, η2 = .224), and were especially likely to be risk-seeking when the decision was framed as a potential loss (p < .0001, d = 1.77). When the outcome involved pure losses, BPD patients were insensitive to the relative expected value between choice options resulting in suboptimal decision making (p = .004, d = 1.24), but did not differ from the comparison group when taking risks to achieve gains (p = .603, d = 0.21). We discuss these results in the context of behavioral and neuropsychiatric research suggesting abnormalities BPD patients’ ability to effectively regulate affect.
