The neuropsychology of borderline personality disorder: a meta-analysis and review.

The neuropsychological profile of borderline personality disorder (BPD) is unclear. Past investigations have produced seemingly inconsistent results concerning precisely what neuropsychological deficits characterize the patient with BPD. A meta-analysis of 10 studies was conducted comparing BPD and healthy comparison groups on selected neuropsychological measures comprising six domains of functioning: attention, cognitive flexibility, learning and memory, planning, speeded processing, and visuospatial abilities. BPD participants performed more poorly than controls across all neuropsychological domains, with mean effect sizes (Cohen's d) ranging from -0.29 for cognitive flexibility to -1.43 for planning. The results suggest that persons with BPD perform more poorly than healthy comparison groups in multiple neurocognitive domains and that these deficits may be more strongly lateralized to the right hemisphere. Although neuropsychological testing appears to be sensitive to the neurocognitive deficits of BPD, the clinical utility of these results is limited. Implications of these findings for future neurocognitive investigations of BPD are discussed.