Impulsivity in Borderline Personality Disorder: Impairment in Self-Report Measures, but Not Behavioral Inhibition

Abstract

Background: Impulsivity is a core feature of borderline personality disorder (BPD). However, previous clinical and experimental studies investigating impulsivity in BPD rendered mixed results. In this study, impulsivity was assessed by self-report scales and behavioral inhibition tasks to compare different data levels. Sampling and Methods: Fifteen women with BPD and 15 matched healthy control subjects (HC) completed the Barratt Impulsiveness Scale, Eysenck’s Impulsivity Questionnaire and the UPPS (Urgency, Lack of Perseverance, Lack of Premeditation and Sensation Seeking) scale, and participated in a Stroop task, an antisaccade task and a stop signal task. Results: Patients with BPD scored significantly higher on self-report measures as compared to HC, but not in behavioral tests. In BPD patients, but not in HC, behavioral inhibition errors were correlated with more intense emotional state. Conclusion: We found a discrepancy between self-report and behavioral data. Further studies need to assess additional possible mechanisms underlying increased impulsivity, their relation to emotional instability, and their neurobiological underpinnings.

Emotional modulation of motor response inhibition in women with borderline personality disorder: an fMRI study

“…Accordingly, self-reports of impulsivity are generally elevated in patients with BPD compared with both healthy and clinical control groups. [14][15][16] However, well-controlled studies investigating inhibitory control with experimental tasks, such as the Stroop test, stop or go/no-go tasks, generally render mixed results. Some studies have reported performance deficits in go/no-go tasks, 17,18 while most others did not show impairments in patients with BPD.…”

“…Some studies have reported performance deficits in go/no-go tasks, 17,18 while most others did not show impairments in patients with BPD. 16,19,20 Recent behavioural studies suggest that general deficits of BPD regarding impulsive behaviours may occur more on the motivational level in domains such as decision-making and delay of gratification. [20][21][22] Clinically, emotion dysregulation and impulsivity are closely linked in BPD.…”

Impulsive Personality and Alcohol Use: Bidirectional Relations Over One Year

“…MPULSIVITY, THE TENDENCY TO ACT without adequate forethought or the propensity to engage in risky behaviors, has been found to relate to a number of negative outcomes and mental health difficulties, including risky sexual behavior (Deckman & DeWall, 2011;Zapolski et al, 2009), eating disorders , aggression and antisocial behavior (Lynam & Miller, 2004;Miller & Lynam, 2001), and personality disorders (Jacob et al, 2010;Whiteside et al, 2005). A large body of research has demonstrated the relevance of impulsive personality to substance use risk, because impulsive traits have been shown to relate to substance use/problems both concurrently and prospectively (Ball et al, 1994;Carlson et al, 2010;Corbin et al, 2011;Grau & Ortet, 1999;Horvath et al, 2004;Lynam & Miller, 2004;Milich et al, 2000;Miller et al, 2003;Puente et al, 2008;Schepis et al, 2008;Sher et al, 2000;Verdejo-García et al, 2007).…”

Using Functional Neuroimaging to Refine the Diagnostic Construct of Borderline Personality Disorder

“…Evidence supports this argument, with studies finding that while individuals with BPD endorse higher levels of impulsivity as measured by self-report, laboratory measures have yielded inconsistent and weak findings for impulsivity in emotionally neutral situations [135,136]. From this viewpoint, impulsive behaviors may be understood as maladaptive emotion regulation strategies [137,138] but not as a discrete dimension of the pathology.…”