Altered executive function domains in borderline personality disorder: a review of the literature

Abstract

Introduction: Borderline personality disorder (BPD) is a serious mental illness characterized by the presence of heterogeneous clinical patterns related to unstable emotions, impulsivity and difficulty in relating to others. Some association between this disorder and neuropsychological functions has been described. Among them, research on executive function and its relationship with the clinical symptoms present in patients with BPD requires a more detailed and systematic study. Objective: To determine the dimensions of executive functioning that are altered in borderline personality disorder from the systematic review of scientific literature. For this, a review of articles indexed in Scopus, PubMed and Scielo was carried out; 13 studies were found that met the inclusion criteria, with a total of 738 participants. Results: 85% of these studies showed that there is a deficit in certain domains of EF in people with BPD in contrast to other groups. 23% (n = 3) had an adequate level of significance in relation to the deficit in inhibition capacity. On the other hand, in 23% (of the studies) low scores were found in problem solving; and the same percentage was also attributed to disability in the domains of planning and decision making. Conclusions: Planning, problem solving and decision making are the domains of executive function that are most affected in BPD. Controversies were found regarding the deficit in the inhibition and flexibility domains, which could be associated with the characteristics of impulsivity and emotional dysregulation in BPD; however, the studies are not conclusive.