Impaired decision making and feedback evaluation in borderline personality disorder

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Impulsivity is a core feature of borderline personality disorder (BPD), impacting decision-making and planning.
• Neuropsychological studies link BPD to executive function impairments, potentially related to altered feedback processing.
• Limited research exists on executive functions in BPD, leaving underlying deficits unclear.

Purpose of the Study:

• To investigate if decision-making deficits in BPD are associated with altered feedback evaluation.
• To explore the relationship between executive functions, feedback processing, and impulsivity in BPD.

Main Methods:

• A modified Iowa Gambling Task was administered to 18 BPD patients and 18 controls.
• Electroencephalogram (EEG) recorded brain activity, focusing on feedback-related negativity (FRN) and P300.
• Behavioral performance and electrophysiological correlates of feedback evaluation were analyzed.

Main Results:

• BPD patients exhibited more risky choices and failed to improve performance compared to controls.
• BPD patients showed reduced FRN amplitudes, failing to differentiate between positive and negative feedback.
• Reduced FRN amplitudes in BPD correlated with increased impulsivity and risk-taking; P300 amplitudes to negative feedback were elevated.

Conclusions:

• BPD patients demonstrate impaired decision-making, likely due to dysfunctional feedback processing.
• Despite attending to negative consequences, BPD patients did not learn to avoid disadvantageous choices.
• Altered feedback evaluation contributes to decision-making deficits and risk-taking behavior in BPD.