Exekutive Dysfunktionen bei Patientinnen mit Borderline-Persönlichkeitsstörung unter Berücksichtigung von Impulsivität und Depressivität

Zusammenfassung

Einleitung Ausgeprägte Impulsivität und affektive Dysregulation bei Personen mit Borderline-Persönlichkeitsstörung (BPS) weisen auf exekutive Dysfunktionen hin. Bisherige Befunde hierzu sind jedoch inkonsistent, unter anderem weil häufig nicht für komorbide Merkmale wie Impulsivität und Depressivität bzw. Medikation kontrolliert wurde. Ziel der vorliegenden Studie war es, exekutive Leistungen bei Patientinnen mit BPS unter Berücksichtigung von Impulsivität und im Vergleich zu einer depressiven Kontrollgruppe zu untersuchen. Methode Es wurden 24 unmedizierte BPS-Patientinnen und 24 hinsichtlich Alter, Geschlecht und einem Intelligenzkorrelat parallelisierte gesunde Kontrollprobandinnen sowie 22 Patientinnen mit einer depressiven Lebenszeitdiagnose untersucht. Alle Versuchsteilnehmer absolvierten eine umfangreiche neuropsychologische Testbatterie zur Erfassung der exekutiven Funktionen. Ergebnisse Es zeigten sich keine signifikanten Unterschiede zwischen der BPS-Gruppe und der gesunden bzw. depressiven Kontrollgruppe bezüglich exekutiver Leistungsparameter. Allerdings wiesen Personen mit BPS erhebliche Defizite in der Fähigkeit zum Belohnungsaufschub auf. Schlussfolgerung Die Ergebnisse legen nahe, dass BPS-Patientinnen vorwiegend Defizite in Funktionsbereichen, die eher motivational bedingt sind, aufweisen, wohingegen andere exekutive Funktionen nicht wesentlich eingeschränkt sind.

Abstract

Introduction Because of the presence of pronounced impulsiveness and affective dysregulation in subjects with Borderline Personality Disorder (BPD) executive dysfunctions have been suspected. Previous studies in this area revealed inconsistent results. However, most of these studies did not control for comorbidity (e. g. impulsiveness, depression) and current medication of participants. The aim of this study was, therefore, to investigate executive (dys)functions in patients with BPD and healthy controls controlling for impulsivity. Furthermore, a second control group with depression was included to test the specificity of the results. Method 24 unmedicated, female BPD patients as well as 24 healthy controls were matched for age, sex, and intelligence. Additionally, 22 female subjects with a life-time diagnosis of depression were included. All subjects completed a neuropsychological test battery assessing executive functions. Results No significant differences in executive functioning were found between the three groups. BPD patients showed, however, a decreased ability to delay a gratification compared with controls. Conclusion These results implicate that BPD patients have deficits in motivational areas while other executive functions are not or only marginally involved.

Borderline Personality Disorder - executive functions - impulsiveness - depression

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