Neuropsychological dysfunctions in personality borderline disorder: detection strategies

Abstract

Introduction. Borderline personality disorder (BPD) is characterized by emotional instability and impulsivity. However, there is evidence that neurocognitive alterations have a relevant role in the clinical features of these patients. The present study investigates cognitive function in BPD in order to search for a specific profile of neuropsychological alterations.

Methods. Based on previous research and cognitive complaints reported by patients, a neuropsychological assessment protocol focused on prefrontal functioning was applied. The applied neuropsychological battery included tests assessing the following cognitive domains: memory (fixation, consolidation and recovery processes) categorical evocation, cognitive flexibility, sustained attention, processing rate, inhibitory control and working memory.

The patient sample was recruited from an outpatient BPD unit and was composed by 26 patients (14 women, 12 men) diagnosed of BPD.

Results. In comparison to the normative values, BPD patients have a deficit in the execution of most of the neuropsychological tests. This deficit was especially present in the following: recovery processes of the immediate and differed memory, working memory, sustained attention and processing rate, verbal fluency, impulse control, cognitive flexibility, abstraction and planning.

Conclusions. BPD patients could present a pattern of neurocognitive alterations that suggests a specific impairment of the prefrontal areas and requires a more detailed study. The neuropsychological dysfunctions could partially explain the behavioral alterations in BPD patients.