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

Authors
  • Linhartová, Pavla1
  • Látalová, Adéla1
  • Barteček, Richard1
  • Širůček, Jan2
  • Theiner, Pavel1
  • Ejova, Anastasia3
  • Hlavatá, Pavlína1, 4
  • Kóša, Barbora1
  • Jeřábková, Barbora1
  • Bareš, Martin5, 6
  • Kašpárek, Tomáš1
  • 1 Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic. , (Czechia)
  • 2 Faculty of Social Studies, Institute for Research on Children, Youth and Family, Masaryk University, Brno, Czech Republic. , (Czechia)
  • 3 Faculty of Science, School of Psychology, University of Auckland, Auckland, New Zealand. , (New Zealand)
  • 4 Behavioral and Social Neuroscience Research Group, CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic. , (Czechia)
  • 5 First Department of Neurology, St. Anne's Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic. , (Czechia)
  • 6 Department of Neurology, Faculty of Medicine, University of Minnesota, Minneapolis, MN, USA.
Type
Published Article
Journal
Psychological Medicine
Publisher
Cambridge University Press
Publication Date
Aug 01, 2020
Volume
50
Issue
11
Pages
1829–1838
Identifiers
DOI: 10.1017/S0033291719001892
PMID: 31439062
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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). 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. 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.

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