Impulsivity in patients with borderline personality disorder

Dowson, Jonathan; Bazanis, Evangelos; Rogers, Robert; Prevost, Andrew; Taylor, Pamela; Meux, Clive; Staley, Christopher; Nevison-Andrews, David; Taylor, Celia; Robbins, Trevor; Sahakian, Barbara

doi:10.1016/j.comppsych.2003.09.013

« Previous Next »Comprehensive Psychiatry
Volume 45, Issue 1 , Pages 29-36, January 2004

Impulsivity in patients with borderline personality disorder

Jonathan Dowson
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
- Address reprint requests to Jonathan Dowson, M.D., Ph.D., University of Cambridge, Department of Psychiatry, Box 189, Addenbrooke’s Hospital, Cambridge, CB2 2QQ UK
Evangelos Bazanis
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
Robert Rogers
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
Andrew Prevost
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
Pamela Taylor
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
Clive Meux
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
Christopher Staley
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
David Nevison-Andrews
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
Celia Taylor
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
Trevor Robbins
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK
Barbara Sahakian
- Departments of Psychiatry, Experimental Psychology, and Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Psychiatry, University of Oxford, Oxford, UK; Institute of Psychiatry, London, UK; Broadmoor Hospital, Crowthorne, UK; St. Andrew’s Hospital, Northampton, UK; and Kneesworth Hospital, Royston, UK

Abstract

This study investigated features of impulsivity in patients with borderline personality disorder (BPD) using the self-report Attention-Deficit Scales for Adults (ADSA) and computer-administered neurocognitive tasks. Forty-one patients with DSM-III-R BPD and 35 nonclinical control subjects were assessed by the ADSA, the National Adult Reading Test, and two computerized tasks mediated by the frontal lobes. Mean scores for seven ADSA scales (six of which relate to aspects of impulsivity) were significantly higher in the patient group compared with the control group. Also, the ADSA ratings for impaired coordination were increased in the BPD patients. The findings indicate that a range of aspects of impulsivity, as well as impaired coordination, are associated with patients selected on the basis of BPD. Also, in the patient group, but not in the control group, associations of the neurocognitive tasks indicated that, first, performance on a planning task related to dorsolateral frontal lobe functioning is correlated with aspects of impulsivity reflected by ADSA scale III ratings (involving disorganisation and lack of perseverance) and, second, performance on a decision-making task related to orbitofrontal functioning is correlated with ratings of impaired coordination. Further work is needed to establish the specificity of the findings.