Differential relations of executive functioning to borderline personality disorder presentations in adolescents

Abstract

Borderline personality disorder (BPD) in adolescents is highly complex and heterogeneous. Within the disorder, research has suggested the existence of at least two subgroups: one with predominantly internalizing psychopathology features and one with predominantly externalizing psychopathology features. One process that may differentiate these groups is executive functioning (EF), given that poor EF is linked to externalizing psychopathology. Against this background, the current study used a multi-informant approach to examine whether adolescent patients with predominantly externalizing BPD presentations experience greater deficits in EF than adolescent patients with predominantly internalizing presentations. The sample included inpatient adolescents ages 12-17 (M = 15.26; SD = 1.51). Analyses revealed that multiple EF domains distinguished the BPD subgroups. More specifically, adolescents with externalizing presentations exhibited greater difficulties in broad domains related to global executive functioning, metacognition and behavioural regulation and specific domains related to inhibitory control, working memory, planning/organizing, monitoring and organization of materials. While this study is the first to examine EF and adolescent BPD in the context of internalizing and externalizing psychopathology, alternative approaches to examining this question are discussed. Copyright © 2018 John Wiley & Sons, Ltd.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum

“…Under the antagonistic externalizing spectrum, the evidence of cognitive deficits is strong for borderline PD 189,190 , whereas findings concerning narcissistic, histrionic and paranoid PDs are mostly derived from symptom, descriptive and trait checklists 191,192 .…”

Pretreatment cognitive performance is associated with differential self-harm outcomes in 6 v. 12-months of dialectical behavior therapy for borderline personality disorder

“…In contrast, the CPT-3 assesses the ability to deliberately withhold a prepotent response (which falls in the domain of action impulsivity), and only about one-third of participants in the current study scored in the clinically elevated range. With this said, at least two studies have shown that subgrouping BPD patients based on profiles of self-reported executive function can lead to the identification of subgroup-specific symptom profiles (Hoermann, Clarkin, Hull, & Levy, 2005;Kalpakci, Ha, & Sharp, 2018) and the prognostic utility of these self-reported measures for predicting treatment outcomes may be investigated in the future.…”

A Cluster Analysis of Neuropsychological Impairment in Borderline Personality Disorder: Identifying a Neurocognitive Subtype Linked to Attention Deficit Hyperactivity Disorder

“…Despite the confirmation of these neurocognitive alterations in BPD, confirming deficits in memory processes, attention and mainly executive functions (EFs), a specific neuropsychological profile for these patients has not yet been established (López-Villatoro et al 2023;Ruocco et al 2012). According to some authors (Kalpakci, Ha, and Sharp 2015;López-Villatoro et al 2023), this lack of a concrete neuropsychological profile is mainly due to the lack of specificity of many neuropsychological tests and the heterogeneity of the disorder.…”