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50 Neuropsychological Functioning in Depression, Borderline Personality Disorder, and Suicidality
- Jacob W Koudys, Dean Carccone, Katherine Gardhouse, Anthony C Ruocco
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 922-923
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- Article
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Objective:
Depression and borderline personality disorder (BPD) are frequently comorbid psychiatric disorders that reliably share deficits in executive functioning (EF). In addition to EF, meta-analytic evidence indicates that processing speed and verbal memory are also affected in depression and BPD, but the impact of BPD further spans the domains of attention, nonverbal memory, and visuospatial abilities. Suicidality is a notable phenotypic commonality in depression and BPD. Neuropsychologically, there are consistent discrepancies between individuals who have and have not thought about suicide in global cognitive functioning, as well as between those who have attempted suicide and those who have just thought about suicide in EF. This study aims to replicate the effect size differences between these groups and explore whether neuropsychological functioning relates to dimensional measures of psychopathology.
Participants and Methods:Right-handed women between the ages of 18 and 55 were recruited into one of three diagnostic groups: a) current major depressive episode (MDD; n=22); b) current major depressive episode with comorbid BPD (MDD+BPD; n=19); and c) absence of current major depressive episode and BPD (controls; n=20). Groups were also classified based on historical suicide attempt and on the presence or absence of historical suicidal ideation. Exclusions included bipolar disorder, neurodevelopmental disorder, moderate/severe brain injury, neurological illness, serious physical illness, eating disorder, and moderate/severe alcohol/substance use disorder. Participants were administered the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), Beck Depression Inventory (BDI-II), Interpersonal Needs Questionnaire (INQ), UPPS-P Impulsive Behavior Scale, Everyday Memory Questionnaire, Brief Visuospatial Memory Test (BVMT), California Verbal Learning Test (CVLT), Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference Test, D-KEFS Trail Making Test, D-KEFS Verbal Fluency, Wechsler Adult Intelligence Scale-IV Coding and Digit Span subtests, Wechsler Memory Scale-IV Logical Memory, and Wechsler Test of Adult Reading.
Results:With one exception, analyses of raw scores indicated there were no significant neuropsychological differences between groups based on diagnosis, historical suicidal ideation, and suicide attempt (p>.05). However, individuals with MDD+BPD, historical suicidal ideation, or suicide attempt endorsed more memory complaints than the other groups with large effect size differences. Differences in self-reported impulsivity indicated large effects between controls and MDD+BPD, moderate to large effects when comparing controls to MDD and MDD to MDD+BPD, and moderate effects among the suicidal ideation and suicide attempt groups. Impulsivity was rated highest in those with MDD+BPD, historical suicidal ideation, or suicide attempt. These analyses applied false-discovery rate correction and adjusted for age. Using ridge regressions to separately predict depressive symptoms, BPD symptoms, and suicide risk factors, neuropsychological indices were most associated with suicide risk factors and explained 22.8% of INQ variance. Conversely, these indices explained 9.6% of ZAN-BPD variance and 0.6% of BDI-II variance.
Conclusions:The neuropsychological literature on BPD describes moderate crosscutting neuropsychological dysfunction, and clarifying the distinct cognitive alterations associated with comorbid psychiatric disorders and suicide phenomena offers novel avenues of research for investigating their mechanisms. While neuropsychological functioning may not strongly relate to psychiatric symptomatology, it may contribute to meaningful algorithms of suicide risk in individuals with depression and BPD.
Chapter 2 - Objective and Subjective Measurements in Affective Science
- from Section II - Measuring Emotional Responses
- Edited by Jorge Armony, McGill University, Montréal, Patrik Vuilleumier, Université de Genève
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- Book:
- The Cambridge Handbook of Human Affective Neuroscience
- Published online:
- 05 February 2013
- Print publication:
- 21 January 2013, pp 57-81
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Summary
The goal of affective neuroscience research is to integrate as many measures as possible when attempting to gauge affective experience. This chapter examines the value of objective and subjective measures used in affective neuroscience. It presents examples that showcase the use of the response indices, illustrating how objective and subjective measures operate uniquely and offer opportunities to investigate the properties of emotion from different vantage points. The chapter addresses some limitations to measurement and comments on work that is pushing research forward by combining measures with inventive methods. Future research that investigates deeply experiential aspects of the human emotional life will benefit from employing a network of measures to provide a more in-depth understanding of the neurophenomenology of emotion. The challenge before affective neuroscientists is to include and integrate multiple indices from both subjective and objective categories of measurement to best capture the mental and neural bases of emotional life.
List of Contributors
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- By Adam K. Anderson, Jorge Armony, Anthony P. Atkinson, Sonia Bishop, Carolin Brück, Roberto Cabeza, Frances S. Chen, Hugo D. Critchley, Mauricio R. Delgado, Ricardo de Oliveira-Souza, Gregor Domes, Judith Domínguez-Borràs, Joseph E. Dunsmoor, Thomas Ethofer, Dominic S. Fareri, Lesley K. Fellows, Sophie Forster, Katherine Gardhouse, Nathalie George, Jay A. Gottfried, Jung Eun Han, Ahmad R. Hariri, Neil A. Harrison, Markus Heinrichs, Alisha C. Holland, Andreas Keil, Elizabeth A. Kensinger, Johanna Kissler, Olga Klimecki, Stefan Koelsch, Sylvia D. Kreibig, Benjamin Kreifelts, Robert Kumsta, Kevin S. LaBar, Eamon J. McCrory, Aprajita Mohanty, Jorge Moll, John P. O’Doherty, Leticia Oliveira, Mirtes Pereira, Luiz Pessoa, K. Luan Phan, Pierre Rainville, David Sander, Annett Schirmer, Catherine L. Sebastian, Tania Singer, Chandra Sekhar Sripada, Peggy L. St. Jacques, Essi Viding, Patrik Vuilleumier, Dirk Wildgruber, Amy Winecoff, Roland Zahn
- Edited by Jorge Armony, McGill University, Montréal, Patrik Vuilleumier, Université de Genève
-
- Book:
- The Cambridge Handbook of Human Affective Neuroscience
- Published online:
- 05 February 2013
- Print publication:
- 21 January 2013, pp xi-xii
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- Chapter
- Export citation