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Impaired working memory and normal sustained attention in borderline personality disorder

Published online by Cambridge University Press:  24 June 2014

Matteo Lazzaretti ,
Niccolò Morandotti ,
Michela Sala ,
Miriam Isola ,
Sophia Frangou ,
Giulia De Vidovich ,
Elisa Marraffini ,
Francesca Gambini ,
Francesco Barale  and
Federico Zappoli
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Matteo Lazzaretti
Affiliation:
Interdepartmental Centre for research on Personality Disorders. Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy Department of Mental Health, Azienda Ospedaliera Ospedale di Circolo di Busto Arsizio, Presidio Ospedaliero di Saronno, Saronno, Italy
Niccolò Morandotti
Affiliation:
Interdepartmental Centre for research on Personality Disorders. Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Michela Sala
Affiliation:
Interdepartmental Centre for research on Personality Disorders. Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy Department of Mental Health, Azienda Sanitaria Locale Alessandria, Alessandria, Italy
Miriam Isola
Affiliation:
Department of Medical and Morphological Research, Section of Statistics, University of Udine, Udine, Italy
Sophia Frangou
Affiliation:
Psychosis Clinical Academic Group, Section of Neurobiology of Psychosis, Institute of Psychiatry, King's College London, London, UK
Giulia De Vidovich
Affiliation:
Interdepartmental Centre for research on Personality Disorders. Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Elisa Marraffini
Affiliation:
Interdepartmental Centre for research on Personality Disorders. Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Francesca Gambini
Affiliation:
Interdepartmental Centre for research on Personality Disorders. Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Francesco Barale
Affiliation:
Interdepartmental Centre for research on Personality Disorders. Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Federico Zappoli
Affiliation:
Service of Radiology, IRCCS Policlinico San Matteo, Pavia, Italy
Edgardo Caverzasi
Affiliation:
Interdepartmental Centre for research on Personality Disorders. Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
Paolo Brambilla
Affiliation:
DISM, University of Udine, Udine, Italy IRCCS ″E. Medea” Scientific Institute, Udine, Italy
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Extract

Lazzaretti M, Morandotti N, Sala M, Isola M, Frangou S, De Vidovich G, Marraffini E, Gambini F, Barale F, Zappoli F, Caverzasi E, Brambilla P. Impaired working memory and normal sustained attention in borderline personality disorder.

Objective: Although reports in the literature describe deficits in working memory in borderline personality disorder (BPD), the evidence is limited and inconsistent. The aim of this study was to evaluate further this cognitive dimension and its clinical correlates in BPD.

Method: We compared the performance of 15 BPD patients to 1:1 matched healthy controls on verbal working memory as determined by the sequential letter N-back test and sustained attention as measured using the continuous performance test (CPT).

Results: BPD patients performed significantly worse on the N-back test compared to healthy controls (p < 0.05), but not on the CPT. The N-back deficit was more pronounced and significant in the 3-back condition and inversely correlated with impulsivity.

Conclusions: These results suggest the presence of working memory deficits in BPD that may be linked to greater impulsivity and sustained by impairment in the dorsolateral prefrontal cortex.

Keywords

borderline personality disordercontinuous performance testimpulsivityN-back testsustained attentionverbal working memory
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 24 , Issue 6 , December 2012 , pp. 349 - 355
Copyright
Copyright © Cambridge University Press 2011

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References

1.Bazanis, E, Rogers, RD, Dowson, JH et al. Neurocognitive deficits in decision-making and planning of patients with DSM-III-R borderline personality disorder. Psychol Med 2002;32:1395–1405.CrossRefGoogle ScholarPubMed
2.Dinn, WM, Harris, CL, Aycicegi, A, Greene, PB, Kirkley, SM, Reilly, C.Neurocognitive function in borderline personality disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:329–341.CrossRefGoogle ScholarPubMed
3.Lenzenweger, MF, Clarkin, JF, Fertuck, EA, Kernberg, OF.Executive neurocognitive functioning and neurobehavioral systems indicators in borderline personality disorder: a preliminary study. J Pers Disord 2004;18:421–438.CrossRefGoogle ScholarPubMed
4.Monarch, ES, Saykin, AJ, Flashman, LA.Neuropsychological impairment in borderline personality disorder. Psychiatr Clin North Am 2004;27:67–82, viii–ix.CrossRefGoogle ScholarPubMed
5.Paris, J, Zelkowitz, P, Guzder, J, Joseph, S, Feldman, R.Neuropsychological factors associated with borderline pathology in children. J Am Acad Child Adolesc Psychiatry 1999;38:770–774.CrossRefGoogle ScholarPubMed
6.Travers, C, King, R.An investigation of organic factors in the neuropsychological functioning of patients with borderline personality disorder. J Pers Disord 2005;19:1–18.CrossRefGoogle ScholarPubMed
7.Fertuck, EA, Lenzenweger, MF, Clarkin, JF.The association between attentional and executive controls in the expression of borderline personality disorder features: a preliminary study. Psychopathology 2005;38:75–81.CrossRefGoogle ScholarPubMed
8.Kunert, HJ, Druecke, HW, Sass, H, Herpertz, SC.Frontal lobe dysfunctions in borderline personality disorder? Neuropsychological findings. J Pers Disord 2003;17:497–509.CrossRefGoogle ScholarPubMed
9.LeGris, J, van Reekum, R.The neuropsychological correlates of borderline personality disorder and suicidal behaviour. Can J Psychiatry 2006;51:131–142.CrossRefGoogle ScholarPubMed
10.Ruocco, AC.The neuropsychology of borderline personality disorder: a meta-analysis and review. Psychiatry Res 2005;137:191–202.CrossRefGoogle ScholarPubMed
11.Derryberry, D, Reed, MA.Temperament and attention: orienting toward and away from positive and negative signals. J Pers Soc Psychol 1994;66:1128–1139.CrossRefGoogle ScholarPubMed
12.Posner, MI, Rothbart, MK, Gerardi-Caulton, G.Exploring the biology of socialization. Ann N Y Acad Sci 2001;935:208–216.CrossRefGoogle ScholarPubMed
13.Silbersweig, D, Clarkin, JF, Goldstein, M et al. Failure of frontolimbic inhibitory function in the context of negative emotion in borderline personality disorder. Am J Psychiatry 2007;164:1832–1841.CrossRefGoogle ScholarPubMed
14.Burgess, JW.Relationship of depression and cognitive impairment to self-injury in borderline personality disorder, major depression, and schizophrenia. Psychiatry Res 1991;38:77–87.CrossRefGoogle ScholarPubMed
15.O'Leary, KM.Borderline personality disorder. Neuropsychological testing results. Psychiatr Clin North Am 2000;23: 41–60, vi.CrossRefGoogle ScholarPubMed
16.Stevens, A, Burkhardt, M, Hautzinger, M, Schwarz, J, Unckel, C.Borderline personality disorder: impaired visual perception and working memory. Psychiatry Res 2004;125: 257–267.CrossRefGoogle ScholarPubMed
17.Swirsky-Sacchetti, T, Gorton, G, Samuel, S, Sobel, R, Genetta-Wadley, A, Burleigh, B.Neuropsychological function in borderline personality disorder. J Clin Psychol 1993;49:385–396.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
18.Judd, PH.Neurocognitive impairment as a moderator in the development of borderline personality disorder. Dev Psychopathol 2005;17:1173–1196.CrossRefGoogle ScholarPubMed
19.Sprock, J, Rader, TJ, Kendall, JP, Yoder, CY.Neuropsychological functioning in patients with borderline personality disorder. J Clin Psychol 2000;56:1587–1600.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
20.van Reekum, R, Links, PS, Mitton, MJ, Fedorov, C, Patrick, J.Impulsivity, defensive functioning, and borderline personality disorder. Can J Psychiatry 1996;41:81–84.CrossRefGoogle ScholarPubMed
21.Seres, I, Unoka, Z, Bodi, N, Aspan, N, Keri, S.The neuropsychology of borderline personality disorder: relationship with clinical dimensions and comparison with other personality disorders. J Pers Disord 2009;23:555–562.CrossRefGoogle ScholarPubMed
22.Sala, M, Caverzasi, E, Marraffini, E et al. Cognitive memory control in borderline personality disorder patients. Psychol Med 2009;39:845–853.CrossRefGoogle ScholarPubMed
23.Williams, JB, Gibbon, M, First, MB et al. The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test–retest reliability. Arch Gen Psychiatry 1992;49: 630–636.CrossRefGoogle ScholarPubMed
24.Gunderson, JG, Kolb, JE, Austin, V.The diagnostic interview for borderline patients. Am J Psychiatry 1981;138: 896–903.Google ScholarPubMed
25.Zanarini, MC, Vujanovic, AA, Parachini, EA, Boulanger, JL, Frankenburg, FR, Hennen, J.Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. J Pers Disord 2003;17:233–242.CrossRefGoogle ScholarPubMed
26.Oldfield, RC.The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 1971;9:97–113.CrossRefGoogle ScholarPubMed
27.Hamilton, M.A rating scale for depression. J Neurol Neurosurg Psychiatr 1960;23:56–62.CrossRefGoogle ScholarPubMed
28.Soloff, PH, Lynch, KG, Kelly, TM.Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. J Pers Disord 2002;16:201–214.CrossRefGoogle ScholarPubMed
29.Nuechterlein, KH, Asarnow, RF. Degraded stimulus continuous performance test. Los Angeles, CA: UCLA Department of Psychiatry, 1993.Google Scholar
30.Ruberto, G, Vassos, E, Lewis, CM et al. The cognitive impact of the ANK3 risk variant for bipolar disorder: initial evidence of selectivity to signal detection during sustained attention. PLoS One 2011;6:e16671.CrossRefGoogle ScholarPubMed
31.Cohen, JD, Perlstein, WM, Braver, TS et al. Temporal dynamics of brain activation during a working memory task. Nature 1997;386:604–608.CrossRefGoogle ScholarPubMed
32.Cliff, N.Answering ordinal questions with ordinal data using ordinal statistics. Multivariate Behavior Res 1996;31: 331–350.CrossRefGoogle ScholarPubMed
33.Sax, KW, Strakowski, SM, McElroy, SL, Keck, PE Jr., West, SA.Attention and formal thought disorder in mixed and pure mania. Biol Psychiatry 1995;37:420–423.CrossRefGoogle ScholarPubMed
34.Owen, AM, Herrod, NJ, Menon, DK et al. Redefining the functional organization of working memory processes within human lateral prefrontal cortex. Eur J Neurosci 1999;11:567–574.CrossRefGoogle ScholarPubMed
35.Callicott, JH, Mattay, VS, Bertolino, A et al. Physiological characteristics of capacity constraints in working memory as revealed by functional MRI. Cereb Cortex 1999;9:20–26.CrossRefGoogle ScholarPubMed
36.D'Esposito, M, Postle, BR, Rypma, B.Prefrontal cortical contributions to working memory: evidence from event-related fMRI studies. Exp Brain Res 2000;133:3–11.CrossRefGoogle ScholarPubMed
37.Gevins, AS, Morgan, NH, Bressler, SL et al. Human neuroelectric patterns predict performance accuracy. Science 1987;235:580–585.CrossRefGoogle ScholarPubMed
38.Jansma, JM, Ramsey, NF, Coppola, R, Kahn, RS.Specific versus nonspecific brain activity in a parametric N-back task. Neuroimage 2000;12:688–697.CrossRefGoogle Scholar
39.Heinzel, A, Northoff, G, Boeker, H, Boesiger, P, Grimm, S.Emotional processing and executive functions in major depressive disorder: dorsal prefrontal activity correlates with performance in the intra-extra dimensional set shift. Acta Neuropsychiatrica 2010;22:269–279.CrossRefGoogle ScholarPubMed
40.Mortensen, JA, Rasmussen, LA, Häberg, A.Trait impulsivity in female patients with borderline personality disorder and matched controls. Acta Neuropsychiatrica 2010;22:139–149.CrossRefGoogle ScholarPubMed
41.Baddeley, A.Working memory. Science 1992;255: 556–559.CrossRefGoogle ScholarPubMed
42.Skodol, AE, Gunderson, JG, McGlashan, TH et al. Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder. Am J Psychiatry 2002;159:276–283.CrossRefGoogle ScholarPubMed
43.Soloff, PH.Psychopharmacology of borderline personality disorder. Psychiatr Clin North Am 2000;23:169–192, ix.CrossRefGoogle ScholarPubMed
44.Brambilla, P, Soloff, PH, Sala, M, Nicoletti, MA, Keshavan, MS, Soares, JC.Anatomical MRI study of borderline personality disorder patients. Psychiatry Res 2004;131:125–133.CrossRefGoogle ScholarPubMed