Humboldt-Universität zu Berlin, Berlin, Germany.
Psychol Med. 2011 Sep;41(9):1917-27. doi: 10.1017/S003329171000262X. Epub 2011 Jan 24.
Increased impulsivity is considered to be a core characteristic of borderline personality disorder (BPD) and has been shown to play a significant role in decision making and planning. Neuropsychological studies in BPD revealed impairments of executive functions, and it is assumed that these deficits are related to altered feedback processing. However, research on executive functions in BPD is still limited and the underlying deficits remain an open question. The present study, therefore, explored whether decision-making deficits are related to altered feedback evaluation in BPD.
A total of 18 BPD patients and 18 matched healthy controls underwent a modified version of the Iowa Gambling Task while an electroencephalogram was recorded. Feedback processing was examined by measuring the feedback-related negativity (FRN) and the P300 as electrophysiological correlates of feedback evaluation.
Behavioural results revealed that BPD patients, relative to controls, made more risky choices and did not improve their performance. With regard to the FRN, amplitudes in BPD patients did not discriminate between positive and negative feedback information. Further, BPD patients showed reduced FRN amplitudes, which were associated with enhanced impulsivity and enhanced risk taking. In contrast, the P300 amplitudes following negative feedback were increased in BPD patients, relative to controls.
This study indicates that BPD patients are impaired in decision making, which might be related to a dysfunctional use of feedback information. Specifically, BPD patients did not learn to avoid disadvantageous selections, even though they attended to negative consequences.
冲动性增加被认为是边缘型人格障碍（BPD）的核心特征，并且已被证明在决策和计划中起着重要作用。BPD 的神经心理学研究显示出执行功能的损伤，并且假设这些缺陷与改变的反馈处理有关。然而，BPD 中执行功能的研究仍然有限，潜在的缺陷仍然是一个悬而未决的问题。因此，本研究探讨了决策缺陷是否与 BPD 中的改变的反馈评估有关。
总共 18 名 BPD 患者和 18 名匹配的健康对照组在进行修改后的爱荷华赌博任务时记录脑电图。通过测量反馈相关负波（FRN）和反馈评估的 P300 作为电生理相关性来检查反馈处理。
行为结果表明，BPD 患者相对于对照组做出更多的风险选择，并且没有改善他们的表现。关于 FRN，BPD 患者的振幅不能区分正反馈和负反馈信息。此外，BPD 患者的 FRN 振幅降低，与冲动性增强和风险承担增强有关。相比之下，BPD 患者的负反馈后的 P300 振幅相对于对照组增加。
本研究表明，BPD 患者在决策方面存在障碍，这可能与反馈信息的功能失调使用有关。具体来说，即使 BPD 患者注意到负面后果，他们也无法避免不利的选择。
