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

Pavla Linhartová*, Adéla Látalová, Richard Barteček, Jan ŠirÅček, Pavel Theiner, Anastasia Ejova, Pavlína Hlavatá, Barbora Kóša, Barbora JeÅábková, Martin Bareš, Tomáš Kašpárek

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background

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.

Methods

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).

Results

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.

Conclusions

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.

Original languageEnglish
Pages (from-to)1829-1838
Number of pages10
JournalPsychological Medicine
Volume50
Issue number11
Early online date23 Aug 2019
DOIs
Publication statusPublished - Aug 2020
Externally publishedYes

Keywords

  • ADHD
  • attention
  • borderline personality disorder
  • cognitive functions
  • decision making
  • executive functions
  • impulsivity
  • urgency
  • working memory.

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