Introduction
While many individuals have borderline personality disorder (BPD), the adverse implication of BPD on brain functioning has not been exhaustively comprehended. BPD is largely associated with cognitive dysfunction in memory, social cognition, problem-solving and executive functioning. Extensive research is required to ascertain the extent of cognitive impairment in BPD because there exist inconsistencies in the results thus far presented. This study will review the evidence linking BPD and cognitive impairment.
Impact of BPD on Cognitive
Memory problems
Borderline personality disorder (BPD)-related memory issues can severely negatively influence cognitive performance. A mental health disease, borderline personality disorder, is characterized by instability in emotions, behaviour, and relationships. BPD patients often experience memory issues affecting different aspects of cognitive function like attention, problem-solving, judgment, and executive function. Krause-Utz et al. (2017) discovered that BPD patients had an inferior operational memory than healthy controls. The ability to keep and exploit information in the mind, or working memory, is an essential aspect of mental function. The study further ascertained a positive correlation between working memory impairments. It intensified borderline personality disorder (BPD) symptoms, thereby hinting at a possible association between memory aberrations and the fundamental pathology of the disorder. A different investigation by Soloff et al. (2015) looked at how the dynamic environment affects brain activity during cognitive processing in BPD. According to the study, BPD sufferers vary from healthy controls. Their harmful emotional interference with cognitive processing is related to functional abnormalities in brain networks linked to structural or metabolic abnormalities (Soloff et al., 2015). The results also show that when disrupted by a hostile emotional environment, executive skills such as focused attention, decision-making, reaction inhibition, and episodic memory suffer as clinical consequences of functional impairment. This research demonstrates the major influence memory issues can have on cognitive performance in BPD patients. Memory impairment hinders tasks and relationships by affecting attention, decision-making, and problem-solving. Further complicating the management of the condition, memory issues may also contribute to the emotional dysregulation that characterizes BPD.
Social Cognition
BPD-related social cognition impacts cognition by making it more challenging to perceive social signals and resulting in unfavourable social evaluations accurately. To perceive, evaluate, and use social information to create opinions and make decisions about oneself and others is referred to as social cognition. Instability in interpersonal connections, self-image, and mood are traits of BPD. People with BPD frequently display social cognitive deficits, making it challenging to establish and sustain stable relationships. According to Brück et al. (2017), BPD patients demonstrated a negative bias in their interpretations of social cognition and relied more on the available nonverbal cues than controls. Shifts in the relative importance of nonverbal cues appeared to be rooted mainly in a reduced reliance on positive verbal cues presumably deemed less credible by BPD patients. This implies that individuals with BPD exhibit deficits in recognizing negative emotions in facial expressions and are less accurate in inferring the mental states of others based on nonverbal cues. Hanegraaf et al. (2021) also investigated systems for social processes in BPD. The findings showed significant deficits in the ability to identify facial emotions and infer the mental states of others in both BPD. Further, people with BPD displayed a higher ostracism effect following perceived social exclusion. Additionally, the findings revealed significant dysfunction amongst individuals with BPD across both self and other social processing constructs. The results support the proposition that social processing dysfunction may be considered a core transdiagnostic phenotype of BPD (Hanegraaf et al., 2021).
These results imply that people with BPD could struggle to correctly perceive social cues, which could result in misinterpretation and misconceptions in their social interactions. Additionally, they tend to see social information negatively, which results in biases in social judgments. They may struggle to establish and maintain healthy relationships due to these social cognitive deficits. Clinicians must consider social cognition when diagnosing and treating BPD since therapies that focus on social cognition may help those with BPD function more socially.
Decision Making
Borderline personality disorder (BPD)-related decision-making can significantly influence cognition. Decision-making and impulse control issues are frequent in BPD patients and impact their cognitive performance. People with BPD may face troubles in relations, work, and education due to spontaneous decisiveness and mental rigidity. Aslan et al. (2023) studied the between cognitive ability and impulsivity in those with BPD. Impulsivity correlated positively with BPD symptom severity. Further, Linhartová et al. (2019) showed that Patients with BPD, as compared with healthy controls, manifested increased self-reported impulsivity except for sensation seeking and increased impulsive choice. Negative urgency was increased in BPD as compared to healthy controls. In light of the underpinnings, negative urgency was BPD’s most diagnostically specific impulsivity dimension. A person’s life can be greatly impacted by the decision-making and impulse control issues that BPD is known to cause. For instance, people with BPD may act impulsively and engage in hazardous sexual conduct or drug addiction, which can have unfavourable effects. Additionally, people with BPD may have difficulty managing their emotions, suffer in interpersonal interactions, or make impulsive judgments. These issues could also affect how well they do in a classroom or a job.
BPD and Cognitive
Impairment
Emotional dysregulation
Borderline Personality Disorder (BPD) and emotional dysregulation can severely impair cognitive function. Emotional dysregulation is one of the symptoms of BPD. It is characterized by solid and irregular feelings, impulsive conduct, and trouble controlling emotional responses. It is well confirmed that emotional abnormality has an effect on cognitive abilities such as conclusion-making, working memory, and attention, all of which are crucial for everyday functioning. As a result of the intense emotional pain they feel, people with BPD may have issues focusing their attention, making decisions, and remembering information. Several investigate the association between emotional dysregulation and cognitive impairment. Research have been undertaken to performance in BPD. Choudhury et al.’s (2020) study, for example, revealed that emotional dysregulation was related to cognitive control deficiencies in BPD patients. The study’s authors concluded that emotional dysregulation hinders cognitive functions that call on the capacity to stifle undesirable information and behaviour. Niedtfeld et al. (2018) conducted a different investigation and discovered that emotional dysregulation in BPD was linked to decreased attentional control, shown by greater distractibility and poorer attentional shifting. According to Niedtfeld et al. (2018), emotional dysregulation may cause the brain network governing attentional processes to malfunction, impairing cognitive function. According to these investigations’ results, emotional dysregulation in BPD can profoundly impact cognitive performance. A vicious cycle of emotional and cognitive dysfunction may result from cognitive function impairment, which might worsen emotional dysregulation. It may be challenging to perform well in school or work, communicate with others in social situations, or make decisions due to cognitive deficits linked to emotional dysregulation in BPD.
Dissociation
Cognitive impairment can result from dissociation in BPD. Dissociation, defined as a transient. One of the acute symptoms of BPD is a disturbance in awareness, memory, or identity. BPD dissociation’s cognitive impairment can have a major impact on a person’s functioning and quality of life. People with BPD who recorded higher levels of disconnection had more harsh issues with principal function, memory, and attention, according to Krause-Utz et al. (2017). The inadequacies may be enkindled by interruptions in the brain networks involved in cognitive concocting, which can happen during disconnection states. These research findings imply that dissociation in BPD may significantly impair cognitive performance. This may influence a person’s position to work, study, and preserve relationships amid other facets of their life.
Impulsivity
Cognitive impairment can result from impulsivity in BPD. BPD is frequently characterized by impulsivity, which can impair cognitive performance. Impulsivity is the inability to restrain oneself from dangerous actions and acting without first thinking. Individuals diagnosed with borderline personality disorder (BPD) can exhibit difficulties sustaining focus over prolonged periods and experience challenges in decision-making processes and planning due to impulsivity. Numerous investigations have identified a correlation between impulsivity and cognitive dysfunction in BPD individuals, by the empirical research conducted by Kaiser et al. As per the literature of 2016, individuals diagnosed with BPD exhibit difficulties in maintaining focus and inhibiting distracting stimuli. The findings demonstrate a preference for unpleasant information, thus suggesting attentional biases toward such content. Based on the discovery obtained from these inquiries, it can be declared that instinctively can remarkably affect cognitive performance in individuals detected with BPD. Such significance can be interpreted as having a fundamentally unfavorable effect on these inhabitants. People confirmed with BPD are known to manifest impulsive tendencies that are known to blowback their care dimensions, capacity for decision-making, and preparation skills. As such, this population may experience obstacles in completing tasks and making sound decisions. The effect of the condition stated above could potentially balance one’s daily activities and, successively, the general quality of life.
Conclusion
Based on research, there is a relationship between BPD and cognitive decline, which can have an invalid effect on memory, social awareness, and decision-making capacity. Individuals with BPD have an emotional abnormality, which is worsened by memory struggle caused by cognitive abnormalities in areas like as attention, problem-solving, and executive function. These individuals struggle to form and maintain healthy relationships due to compromised social cognitive abilities. BPD individuals often display impulsive and rigid behaviors that can affect their daily life. Research shows a link between cognitive dysfunction and BPD.
References
Aslan, I. H., Grant, J. E., & Chamberlain, S. R. (2023). Cognition in adults with borderline personality disorder. CNS Spectrums, 1012(512), 1–6. https://doi.org/10.1017/s1092852923001177
Brück, C., Derstroff, S., Jacob, H., Wolf-Arehult, M., Wekenmann, S., & Wildgruber, D. (2017). Perception of Verbal and Nonverbal Emotional Signals in Women With Borderline Personality Disorder: Evidence of a Negative Bias and an Increased Reliance on Nonverbal Cues. Journal of Personality Disorders, 31(2), 221–231. https://doi.org/10.1521/pedi_2016_30_245
Choudhury, S., Sahoo, S., & Dash, S. R. (2020). Emotion Dysregulation in Patients with Major Depressive Disorder and Borderline Personality Disorder. Indian Journal of Public Health Research & Development, 11(1), 616. https://doi.org/10.37506/v11/i1/2020/ijphrd/193891
Hanegraaf, L., van Baal, S., Hohwy, J., & Verdejo-Garcia, A. (2021). A Systematic Review and Meta-Analysis of “Systems for Social Processes” in Borderline Personality and Substance Use Disorders. Neuroscience & Biobehavioral Reviews, 1012(512). https://doi.org/10.1016/j.neubiorev.2021.04.013
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Krause-Utz, A., Winter, D., Schriner, F., Chiu, C.-D., Lis, S., Spinhoven, P., Bohus, M., Schmahl, C., & Elzinga, B. M. (2017). Reduced amygdala reactivity and impaired working memory during dissociation in borderline personality disorder. European Archives of Psychiatry and Clinical Neuroscience, 268(4), 401–415. https://doi.org/10.1007/s00406-017-0806-x
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Niedtfeld, I., Kirsch, P., Schulze, L., Herpertz, S.C., Bohus, M. and Schmahl, C., 2012. Functional connectivity of pain-mediated affect regulation in borderline personality disorder. PloS one, 7(3), p.e33293.
Soloff, P. H., White, R., Omari, A., Ramaseshan, K., & Diwadkar, V. A. (2015). Affective context interferes with brain responses during cognitive processing in borderline personality disorder: fMRI evidence. Psychiatry Research: Neuroimaging, 233(1), 23–35. https://doi.org/10.1016/j.pscychresns.2015.04.006
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