Affective instability is a core dimension of borderline personality
disorder. The somatic marker hypothesis suggests that emotions play a
crucial role in decision making. In this preliminary study, decision
making was assessed in individuals with borderline personality disorder.
Patients with borderline personality disorder (n = 20) and
healthy comparison subjects (n = 15) were tested with the Iowa
Gambling Task (IGT). The patients showed less advantageous choices on the
IGT than did the healthy comparison subjects. The results could not be
explained by indicators of general cognitive function or by symptoms of
depression. These findings demonstrate that deficits in decision making in
borderline personality disorder may manifest themselves in an ecologically
valid neuropsychological test. Future studies should address whether those
deficits are related to the behavioral characteristics of affective
dysregulation and/or impulsivity, to the proposed dysfunctions and
reduced volume of the orbitofrontal cortex and/or the amygdala, and to
other neuropsychological functions. (JINS, 2007, 13,
699–703.)