The screen for cognitive impairment in psychiatry in patients with borderline personality disorder

Abstract

Cognitive deficits are common in borderline personality disorder (BPD) and appear to be associated with psychopathology, functioning and outcome. The availability of a cognitive screening instrument could be of use in clinical settings in order to assess neurocognition in BPD patients. The Screen for Cognitive Impairment for Psychiatry (SCIP) proved to be reliable in different psychiatric populations, but it has not yet been validated in personality disorders. The purpose of this study is therefore to evaluate its psychometric properties in a sample of 58 BPD patients. The SCIP was validated against the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Trail Making Test A and B (TMT A and B). The receiver operator curve analysis displayed an acceptable convergent validity (total score AUC: 0.78, 95% CI: 0.70-0.86; Se: 75%, Sp: 72%). A cut-off total score of 80 identified 81% of patients as cognitively impaired. The exploratory factor analysis displayed a one-factor solution explaining 55.8% of the total variance. The SCIP displayed adequate psychometric properties in BPD and could be integrated in the routine clinical assessment to provide a preliminary evaluation of cognitive features for BPD.

Cognitive remediation therapy: is it a feasible and acceptable psychological treatment for borderline personality disorder?

“…A cognitive screen for any impairment that may impact learning new skills could inform care planning in the initial assessment phase of care for people with BPD. 11,12 Cognitive remediation could be offered early in the care plan to optimise the benefit from subsequent therapies such as DBT or while waiting to be included in DBT. 13 The most common barriers to implementation of CR that were noted were of cost and time constraints.…”