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Impulsivity in borderline personality disorder

  • V. Barker (a1), L. Romaniuk (a1), R. N. Cardinal (a2) (a3), M. Pope (a4), K. Nicol (a1) and J. Hall (a1) (a5) (a6)...

Abstract

Background

Impulsivity is a core feature of borderline personality disorder (BPD) and is most frequently measured using self-rating scales. There is a need to find objective, valid and reliable measures of impulsivity. This study aimed to examine performance of participants with BPD compared with healthy controls on delay and probabilistic discounting tasks and the stop-signal task (SST), which are objective measures of choice and motor impulsivity, respectively.

Method

A total of 20 participants with BPD and 21 healthy control participants completed delay and probabilistic discounting tasks and the SST. They also completed the Barratt Impulsiveness Scale (BIS), a self-rating measure of impulsivity.

Results

Participants with BPD showed significantly greater delay discounting than controls, manifest as a greater tendency to accept the immediately available lesser reward rather than waiting longer for a greater reward. Similarly they showed significantly greater discounting of rewards by the probability of payout, which correlated with past childhood trauma. Participants with BPD were found to choose the more certain and/or immediate rewards, irrespective of the value. On the SST the BPD and control groups did not differ significantly, demonstrating no difference in motor impulsivity. There was no significant difference between groups on self-reported impulsivity as measured by the BIS.

Conclusions

Measures of impulsivity show that while motor impulsivity was not significantly different in participants with BPD compared with controls, choice or reward-related impulsivity was significantly affected in those with BPD. This suggests that choice impulsivity but not motor impulsivity is a core feature of BPD.

Copyright

Corresponding author

* Address for correspondence: V. Barker, Division of Psychiatry, School of Molecular and Clinical Medicine, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, UK. (Email: Victoria.Barker@ed.ac.uk)

References

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Alderson, RM, Rapport, MD, Kofler, MJ (2007). Attention-deficit/hyperactivity disorder and behavioral inhibition: a meta-analytic review of the stop-signal paradigm. Journal of Abnormal Child Psychology 35, 745758.
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). American Psychiatric Association: Washington, DC.
Aron, AR, Poldrack, RA (2006). Cortical and subcortical contributions to stop signal response inhibition: role of the subthalamic nucleus. Journal of Neuroscience 26, 24242433.
Bari, A, Robbins, TW (2013). Inhibition and impulsivity: behavioral and neural basis of response control. Progress in Neurobiology 108, 4479.
Barkley, RA (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological Bulletin 121, 6594.
Bazanis, E, Rogers, RD, Dowson, JH, Taylor, P, Meux, C, Staley, C, Nevinson-Andrews, D, Taylor, C, Robbins, TW, Sahakian, BJ (2002). Neurocognitive deficits in decision-making and planning of patients with DSM-III-R borderline personality disorder. Psychological Medicine 32, 13951405.
Biederman, J (2004). Impact of comorbidity in adults with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry 65 (Suppl. 3), 37.
Bornovalova, MA, Daughters, SB, Hernandez, GD, Richards, JB, Lejuez, CW (2005). Differences in impulsivity and risk-taking propensity between primary users of crack cocaine and primary users of heroin in a residential substance-use program. Experimental and Clinical Psychopharmacology 13, 311318.
Cardinal, RN, Cheung, TH (2005). Nucleus accumbens core lesions retard instrumental learning and performance with delayed reinforcement in the rat. BMC Neuroscience 6, 9.
Cardinal, RN, Howes, NJ (2005). Effects of lesions of the nucleus accumbens core on choice between small certain rewards and large uncertain rewards in rats. BMC Neuroscience 6, 37.
Chanen, AM, Velakoulis, D, Carison, K, Gaunson, K, Wood, SJ, Yuen, HP, Yucel, M, Jackson, HJ, McGorry, PD, Pantelis, C (2008). Orbitofrontal, amygdala and hippocampal volumes in teenagers with first-presentation borderline personality disorder. Psychiatry Research 163, 116125.
Crean, JP, de Wit, H, Richards, JB (2000). Reward discounting as a measure of impulsive behavior in a psychiatric outpatient population. Experimental and Clinical Psychopharmacology 8, 155162.
Domes, G, Winter, B, Schnell, K, Vohs, K, Fast, K, Herpertz, SC (2006). The influence of emotions on inhibitory functioning in borderline personality disorder. Psychological Medicine 36, 11631172.
Dougherty, DM, Bjork, JM, Huckabee, HC, Moeller, FG, Swann, AC (1999). Laboratory measures of aggression and impulsivity in women with borderline personality disorder. Psychiatry Research 85, 315326.
Dougherty, DM, Mathias, CW, Marsh, DM, Papageorgiou, TD, Swann, AC, Moeller, FG (2004). Laboratory measured behavioral impulsivity relates to suicide attempt history. Suicide Life Threat Behaviour 34, 374385.
Evenden, J (1999 a). Impulsivity: a discussion of clinical and experimental findings. Journal of Psychopharmacology 13, 180192.
Evenden, JL (1999 b). Varieties of impulsivity. Psychopharmacology (Berlin) 146, 348361.
Faraone, SV, Biederman, J, Spencer, T, Wilens, T, Seidman, LJ, Mick, E, Doyle, AE (2000). Attention-deficit/hyperactivity disorder in adults: an overview. Biological Psychiatry 48, 920.
Fossati, A, Barratt, ES, Carretta, I, Leonardi, B, Grazioli, F, Maffei, C (2004). Predicting borderline and antisocial personality disorder features in nonclinical subjects using measures of impulsivity and aggressiveness. Psychiatry Research 125, 161170.
Fossati, A, Novella, L, Donati, D, Donini, M, Maffei, C (2002). History of childhood attention deficit/hyperactivity disorder symptoms and borderline personality disorder: a controlled study. Comprehensive Psychiatry 43, 369377.
Green, L, Myerson, J (2004). A discounting framework for choice with delayed and probabilistic rewards. Psychological Bulletin 130, 769792.
Ho, MY, Mobini, S, Chiang, TJ, Bradshaw, CM, Szabadi, E (1999). Theory and method in the quantitative analysis of “impulsive choice” behaviour: implications for psychopharmacology. Psychopharmacology (Berlin) 146, 362372.
Jacob, GA, Gutz, L, Bader, K, Lieb, K, Tuscher, O, Stahl, C (2010). Impulsivity in borderline personality disorder: impairment in self-report measures, but not behavioral inhibition. Psychopathology 43, 180188.
Kirby, KN (1997). Bidding on the future: evidence against addiction. Journal of Experimental Psychology 126, 5470.
Lampe, K, Konrad, K, Kroener, S, Fast, K, Kunert, HJ, Herpertz, SC (2007). Neuropsychological and behavioural disinhibition in adult ADHD compared to borderline personality disorder. Psychological Medicine 37, 17171729.
Lawrence, KA, Allen, JS, Chanen, AM (2010). Impulsivity in borderline personality disorder: reward-based decision-making and its relationship to emotional distress. Journal of Personality Disorder 24, 786799.
Lecrubier, Y, Braconnier, A, Said, S, Payan, C (1995). The Impulsivity Rating Scale (IRS): preliminary results. European Psychiatry 10, 331338.
LeGris, J, Links, PS, van Reekum, R, Tannock, R, Toplak, M (2012). Executive function and suicidal risk in women with borderline personality disorder. Psychiatry Research 196, 101108.
LeGris, J, van Reekum, R (2006). The neuropsychological correlates of borderline personality disorder and suicidal behaviour. Canadian Journal of Psychiatry 51, 131142.
Links, PS, Heslegrave, R, van Reekum, R (1999). Impulsivity: core aspect of borderline personality disorder. Journal of Personality Disorders 13, 19.
Logan, GD, Cowan, WB (1984). On the ability to inhibit thought and action: a theory of an act of control. Psychological Review 91, 295327.
Mattila-Evenden, M, Svanborg, P, Gustavsson, P, Asberg, M (1996). Determinants of self-rating and expert rating concordance in psychiatric out-patients, using the affective subscales of the CPRS. Acta Psychiatrica Scandinavica 94, 386396.
Mazur, JE (1987). An Adjusting Procedure for Studying Delayed Reinforcement. Erlbaum: Hillsdale, NJ.
Mazur, JE (1989). Theories of probabilistic reinforcement. Journal of the Experimental Analysis of Behaviour 51, 8799.
Mazur, JE (1995). Conditioned reinforcement and choice with delayed and uncertain primary reinforcers. Journal of the Experimental Analysis of Behaviour 63, 139150.
Mobini, S, Grant, A, Kass, AE, Yeomans, MR (2007). Relationships between functional and dysfunctional impulsivity, delay discounting and cognitive distortions. Personality and Individual Differences 43, 15171528.
Nelson, H (1982). The National Adult Reading Test (NART): Test Manual. NFER-Nelson: Windsor.
Oosterlaan, J, Logan, GD, Sergeant, JA (1998). Response inhibition in AD/HD, CD, comorbid AD/HD+CD, anxious, and control children: a meta-analysis of studies with the stop task. Journal of Child Psychology and Psychiatry 39, 411425.
Paris, J, Zweig-Frank, H, Kin, NM, Schwartz, G, Steiger, H, Nair, NP (2004). Neurobiological correlates of diagnosis and underlying traits in patients with borderline personality disorder compared with normal controls. Psychiatry Research 121, 239252.
Patton, JH, Stanford, MS, Barratt, ES (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology 51, 768774.
Rachlin, H, Logue, AW, Gibbon, J, Frankel, M (1986). Cognition and behavior in studies of choice. Psychological Review 93, 3345.
Rachlin, H, Raineri, A, Cross, D (1991). Subjective probability and delay. Journal of the Experimental Analysis of Behaviour 55, 233244.
Reynolds, B (2006). A review of delay-discounting research with humans: relations to drug use and gambling. Behavioural Pharmacology 17, 651667.
Richards, JB, Zhang, L, Mitchell, SH, de Wit, H (1999). Delay or probability discounting in a model of impulsive behavior: effect of alcohol. Journal of the Experimental Analysis of Behaviour 71, 121143.
Rosval, L, Steiger, H, Bruce, K, Israel, M, Richardson, J, Aubut, M (2006). Impulsivity in women with eating disorders: problem of response inhibition, planning, or attention? International Journal of Eating Disorders 39, 590593.
Skodol, AE, Siever, LJ, Livesley, WJ, Gunderson, JG, Pfohl, B, Widiger, TA (2002). The borderline diagnosis II: biology, genetics, and clinical course. Biological Psychiatry 51, 951963.
Soloff, PH, Lynch, KG, Kelly, TM, Malone, KM, Mann, JJ (2000). Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: a comparative study. American Journal of Psychiatry 157, 601608.
Tomko, RL, Solhan, MB, Carpenter, RW, Brown, WC, Jahng, S, Wood, PK, Trull, TJ (2014). Measuring impulsivity in daily life: the Momentary Impulsivity Scale. Psychological Assessment 26, 339349.
Trull, TJ, Sher, KJ, Minks-Brown, C, Durbin, J, Burr, R (2000). Borderline personality disorder and substance use disorders: a review and integration. Clinical Psychology Review 20, 235253.
Wilens, TE, Faraone, SV, Biederman, J (2004). Attention-deficit/hyperactivity disorder in adults. Journal of the American Medical Association 292, 619623.
Wrege, J, Schmidt, A, Walter, A, Smieskova, R, Bendfeldt, K, Radue, EW, Lang, UE, Borgwardt, S (2014). Effects of cannabis on impulsivity: a systematic review of neuroimaging findings. Current Pharmaceutical Design 20, 21262137.

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