Suboptimal decision making in borderline personality disorder: effect of potential losses

• Juan Pedro Sánchez Navarro ^[1] ; Joshua A. Weller ^[2] ; José Manuel López Navarro ^[3] ; José María Martínez Selva ^[1] ; Antoine Bechara ^[4]
  1. [1] Universidad de Murcia

     Universidad de Murcia

     Murcia, España

     
  2. [2] Idaho State University

     Idaho State University

     Estados Unidos

     
  3. [3] Hospital General Universitario Reina Sofía

     Hospital General Universitario Reina Sofía

     Murcia, España

     
  4. [4] University of Southern California

     University of Southern California

     Estados Unidos

     

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• Localización: The Spanish Journal of Psychology, ISSN 1138-7416, Vol. 17, 2014, págs. 1-9
• Idioma: inglés
• DOI: 10.1017/sjp.2014.39
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• Resumen

  • This research explored the underlying processes mediating risky decisions for individuals with Borderline Personality Disorder (BPD). We tested whether BPD patients were more apt to take risks compared to a matched comparison group. We used two controlled tasks designed to assess risky decision-making, both to achieve gains and to avoid losses. Overall, BPD patients showed increased risk-taking compared to the comparison group (p = .011, ?2 = .224), and were especially likely to be risk-seeking when the decision was framed as a potential loss (p < .0001, d = 1.77). When the outcome involved pure losses, BPD patients were insensitive to the relative expected value between choice options resulting in suboptimal decision making (p = .004, d = 1.24), but did not differ from the comparison group when taking risks to achieve gains (p = .603, d = 0.21). We discuss these results in the context of behavioral and neuropsychiatric research suggesting abnormalities BPD patients� ability to effectively regulate affect.

• Referencias bibliográficas
  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th Ed.). Washington, DC: Author.
  • Banks S. J., Eddy K. T., Angstadt M., Nathan P. J., & Phan K. L. (2007). Amygdala-frontal connectivity during emotion regulation. Social...
  • Bazanis E., Rogers R. D., Dowson J. H., Taylor P., Meux C., Staley C., ⋯ Sahakian J. (2002). Neurocognitive deficits in decision-making and...
  • Bechara A., Damasio H., Damasio A. R., & Lee G. P. (1999). Different contributions of the human amygdala and ventromedial prefrontal cortex...
  • Bechara A., Damasio H., Tranel D., & Damasio A. R. (1997). Deciding advantageously before knowing the advantageous strategy. Science,...
  • Cavedini P., Riboldi G., Keller R., D'Annucci A., & Bellodi L. (2002). Frontal lobe dysfunction in pathological gambling patients....
  • Crowell S. E., Beuchaine T. P., & Linehan M. M. (2009). A biosocial developmental model of borderline personality: Elabor ating and extending...
  • Damasio A. R. (1994). Descartes' error: Emotion, reason, and the human brain. New York, NY: Grosset/Putnam.
  • de Martino B., Kumaran D., Seymour B., & Dolan R. (2006). Frames, biases, and ration al decision-making in the human brain. Science, 313,...
  • First M. B., Spitzer R. L., Gibbon M., & Williams J. B. W. (1997a ). Structured clinical interview for DSM-IV personality disorders (SCID-II)....
  • First M. B., Spitzer R. L., Gibbon M., & Williams J. B. W. (1997b ). Structured clinical interview for DSM-I V-TR Axis i disorders, research...
  • Gehring W. J., & Willoughby A. R. (2002). The medial frontal cortex and the rapid processing of monetary gains and losses. Science, 295,...
  • Haaland V. O ., & Landrø N. I. (2007). Decision making as measured with the Iowa gambling task in patients with borderline personality...
  • Kahneman D., & Tversky A. (1979). Prospect theory: An analysis of decision under risk. Econometrica, 47, 263-292. http://dx.doi.org/10.2307/1914185
  • Kirkpatrick T., Joyce E., Milton J., Duggan C., Tyrer P., & Rogers R. D. (2007). Altered emotional decision-making in prisoners with borderline...
  • Koenigsberg H. W., Siever L. J., Lee H., Pizzarello S., New A. S., Goodman M., ⋯ Prohovnik I. (2009). Neural correlates of emotion processing...
  • Maurex L., Zaboli G., Wiens S., Asberg M., Leopardi R., & Öhman A. (2009). Emotionally controlled decision-making and a gene variant related...
  • Mohr P. N., Biele G., & Heekeren H. R. (2010). Neural processing of risk. Journal of Neuroscience, 30, 6613-6619. http://dx.doi.org/10.1523/JNEUROSCI.0003-10.2010
  • Mortensen J. A., Rausmussen I. A., & Håberg A. (2010). Trait impulsivity in female patients with border line personality disorder and...
  • Ruocco A. C., McCloskey M. S., Lee R., & Coccaro E. F. (2009). Indices of orbitofrontal and prefrontal function in Clusert B and Cluster...
  • Ruocco A. C., Medaglia J. D., Ayaz H., & Chute D. L. (2010). Abnormal prefrontal cortical response during affective processing in borderline...
  • Satterthwaite T. D.,Green L.,Myerson J.,Parker J.,Ramaratnam M.,Buckner R. L. 2007).Dissociable but inter-related systems of cognitive control...
  • Schmahl C., & Bremmer J. D. (2006). Neuroimaging in borderline personality disorder. Journal of Psychiatric Research, 40, 419-427. http://dx.doi.org/10.1016/j.jpsychires.2005.08.011
  • Schonberg T., Fox C. R., & Poldrack R. A. (2010). Mind the gap: Bridging economic and naturalistic risk-taking with cognitive neuroscience....
  • Schulze L., Domes G., Krüger A., Berger C., Fleischer M., Prehn K., ⋯ Herpertz S. C. (2011). Neuronal correlates of cognitive reappraisal...
  • Selby E. A., & Joiner Jr., T. E. (2009). Cascades of emotion: The emergence of borderline personality disorder from emotional and behavioral...
  • Seymour B., & Dolan R. (2008). Emotion, decision making, and the amygdala. Neuron, 58, 662-671. http://dx.doi.org/10.1016/j.neuron.2008.05.020
  • Sheehan D. V., L ecrubier Y., Harnett-Sheehan K., Amorim P., Janavs J., Weiller E., ⋯ Dunbar G. C. (1998). The MINI international neuropsychiatric...
  • Silbersweig D., Clarkin J. F., Goldstein M., Kernberg O. F., Tuescher O., Levy K. N., Stern E. (2007). Failure of frontolim bic inhibitory...
  • Skodol A. E., Gunderso n J. G., Pfohl B., Widiger T. A., Livesley W. J., & Siever L. J. (2002). The borderline diagnosis I: Psychopathology,...
  • Talmi D., Hurlemann R., Patin A., & Dolan R. J. (2010). Framing effect following bilateral amygdala lesion. Neuropsychologia, 48, 1823-1827....
  • Tull M. T., Gratz K. L., & Weiss N. H. (2011). Exploring associations between borderline personality disorder, crack/cocaine dependence,...
  • Tversky A., & Kahneman D. (1981). The framing of decisions and the psychology of choice. Science, 211, 453-458. http://dx.doi.org/10.1126/science.7455683
  • Weber E. U., & Johnson E. J. (2008). Decisions under uncertainty: Psychological, economic, and neuroeconomic explan ations. In P. Glimcher,...
  • Weller J. A., Levin I. P., & Denburg N. (2011). Traj ectory of advantageous decision making for risky gains and losses from ages 5 to...
  • Weller J. A., Levin I. P., Shiv B., & Bechara A. (2007). Neural correlates of adaptive decision making for risky gains and losses. Psychological...
  • Weller J. A., Levin I. P., Shiv B., & Bechara A. (2009). The effects of insula damage on advantageous decision making for risky gains...