Department of Psychological and Brain Sciences, University of Massachusetts Amherst, United States.
Department of Psychological and Brain Sciences, University of Massachusetts Amherst, United States.
J Affect Disord. 2024 Oct 15;363:474-482. doi: 10.1016/j.jad.2024.07.072. Epub 2024 Jul 18.
Borderline personality disorder (BPD) has been associated with decision-making deficits, yet such deficits may be context dependent, particularly emotional state and social context. Reinforcement learning models offer an avenue to pinpoint decision-making impairments. The current study used reinforcement learning models to examine whether feedback type (social vs. nonsocial) or emotional state (neutral vs. negative) influence the association between BPD and decision making.
Adults (N = 131) with a range of BPD symptoms completed a diagnostic interview and a computerized learning task after neutral and negative emotion inductions. We examined accuracy, learning rate, and exploration.
We conducted linear models to examine the association between BPD criteria, feedback type, and emotional state on learning parameters and learning accuracy. We found that the negative emotion condition was associated with greater exploration, particularly for those with elevated BPD features. Furthermore, elevated BPD features were associated with impaired accuracy when aiming to avoid loss. A 3-way interaction between BPD, emotion, and feedback indicated that, for people with higher BPD features, learning performance was further impaired when receiving social feedback in the negative emotion condition.
Several limitations warrant mention, including a relatively homogenous sample, possible co-occurring diagnoses, and methodological consideration with the learning task.
The present study underscored the link between BPD and learning impairments. Amplified learning alterations under negative social contexts have important implications for identifying optimal venues to teach new skills (of relevance to treatment) for those with BPD.
边缘型人格障碍（BPD）与决策缺陷有关，但这种缺陷可能取决于具体情境，特别是情绪状态和社会情境。强化学习模型为确定决策障碍提供了一种途径。本研究使用强化学习模型来研究反馈类型（社交与非社交）或情绪状态（中性与负面）是否会影响 BPD 与决策之间的关联。
具有不同程度 BPD 症状的成年人（N=131）在中性和负面情绪诱发后完成了诊断访谈和计算机学习任务。我们检查了准确性、学习率和探索性。
我们进行了线性模型分析，以研究 BPD 标准、反馈类型和情绪状态与学习参数和学习准确性之间的关联。我们发现，负面情绪条件与更大的探索性有关，特别是对于那些具有较高 BPD 特征的人。此外，较高的 BPD 特征与避免损失时的准确性受损有关。BPD、情绪和反馈之间的三向交互表明，对于那些具有较高 BPD 特征的人来说，当他们在负面情绪条件下收到社交反馈时，学习表现会进一步受损。
需要注意几个局限性，包括样本相对同质、可能存在共病诊断以及学习任务的方法学考虑。
本研究强调了 BPD 与学习障碍之间的联系。在负面社交情境下，学习变化加剧，这对于确定教授 BPD 患者新技能（与治疗相关）的最佳场所具有重要意义。
