Disinhibition and borderline personality disorder

Defining repetitive behaviours in frontotemporal dementia

Repetitive behaviours are common manifestations of frontotemporal dementia (FTD). Patients with FTD exhibit various types of repetitive behaviours with unique behavioural and cognitive substrates, including compulsivity, lack of impulse control, stereotypy and hoarding. Other sources of repetitive behaviours, such as restrictive interests and insistence on sameness, may also be seen in FTD. Although repetitive behaviours are highly prevalent and potentially discriminatory in this population, their expression varies widely between patients, and the field lacks consensus about the classification of these behaviours. Terms used to describe repetitive behaviours in FTD are highly heterogeneous and may lack precise definitions. This lack of harmonization of the definitions for distinct forms of repetitive behaviour limits the ability to differentiate between pathological behaviours and impedes understanding of their underlying mechanisms. This review examines established definitions of well-characterized repetitive behaviours in other neuropsychiatric disorders and proposes operational definitions applicable to patients with FTD. Building on extant models of repetitive behaviours in non-human and lesion work and models of social behavioural changes in FTD, we describe the potential neurocognitive bases for the emergence of different types of repetitive behaviours in FTD and their potential perpetuation by a predisposition towards habit formation. Finally, examples of distinct therapeutic approaches for different forms of repetitive behaviours are highlighted, along with future directions to accurately classify, measure and treat these symptoms when they impair quality of life.

Stimulus variability improves generalization following response inhibition training

The present study examined the effect of stimulus variability and practice order on generalization to novel stimuli following a single session of response inhibition training. Ninety-six young adults practiced the Go/No-go task online in three training conditions: (1) constant (N = 32)-inhibition practiced on one stimulus; (2) variable-blocked (N = 32)-inhibition practiced on 6 stimuli, each in a separate block; and (3) variable-random (N = 32)-inhibition practiced on 6 stimuli in random order. Generalization was measured by comparing groups on inhibition of novel stimuli and a trained stimulus immediately and 24 h after training. Consistent with our hypothesis, the variable-random and the variable-blocked groups showed better generalization to the novel items than the constant group, demonstrating the benefit of stimulus variability. The variable-random group also showed better generalization than the variable-blocked group, demonstrating the benefit of presenting stimuli in random order. Participants' capacity for working memory maintenance was found to modulate the effect of practice order. While the benefit of variability was retained 24 h after training, the effect of order was not. Results also show generalization to (1) different type of stimuli using the same task and (2) the same stimuli on a different response inhibition task (the Stop-Signal Task), however, the effect of variable practice and order were not evident in these cases. The study findings illustrate the advantage of using variable stimuli presented in random order for generalization and suggest that these principles of motor learning can be applied to learning of cognitive skills.

Clinical cut scores for the Persian version of the personality inventory for DSM-5

BACKGROUND

The cut points of psychological tools to diagnose clinical conditions are not universal and depend on the region and prevalence of the disorder. Thus, we aimed to identify the cutoff points of the Persian original version of the personality inventory for DSM-5 (PID-5; 220 items) that would optimally distinguish nonclinical from clinical groups.

METHODS

Both nonclinical (N = 634, 73% female, 34.0 ± 10.8 years) and clinical (N = 454, 29% female, 29.5 ± 7.4 years) samples from the West of Iran participated in the study. Data were analyzed using receiver operating characteristic (ROC) and Youden's index was used to determine the cutoff scores across the PID-5 domains and facets. The means and standard deviations of both the clinical male and female were compared with the nonclinical group using Cohen's d and independent t-tests.

RESULTS

All the PID-5 algorithms and facets significantly distinguished clinical from nonclinical samples with some unique findings for male and female samples. The mean score of all the PID-5 algorithms and facets in the clinical male and female samples were respectively 1.0-2.0 SD and 0.5-1.0 SD above the mean for the nonclinical counterparts. A score higher than 1.5 on ranging from 0 to 3 in each domain or facet indicated clinical status.

CONCLUSION

Raw cutting scores throughout the PID-5 algorithms can be well used to diagnose any pathology of personality and the severity of the disorder in clinical patients. The cut scores provide a useful tool for the clinical use of the original version of PID-5 in Iran.

Impulsiveness among Undergraduates from the United Arab Emirates and Jordan: Role of Socio-demographic Variables

BACKGROUND

Some undergraduate students may appear impulsive in their behavior without taking enough time to think, and impulsiveness may vary according to gender, academic specialization, and academic level.

OBJECTIVE

This study investigated the differences in impulsiveness between undergraduates of different gender, academic specializations, and academic years at three private universities in the United Arab Emirates and Jordan.

METHOD

The research design of the study was a survey in nature. The researchers collected data online using a translated Arabic version of the Barratt Impulsiveness Scale (BIS-11) as described in Patton et al..1 A sample of 334 undergraduates was selected using the convenient non-probability sample technique.

RESULTS

To analyze data, the researchers deployed descriptive and inferential statistics and found no significant differences between the students in the subscales of motor impulsiveness, non-planning, attentional impulsiveness, and the total scale score according to gender, academic specializations, and academic years variables.

CONCLUSION

The researchers concluded that undergraduates have a moderate level of impulsiveness; except for attentional impulsiveness, the results indicated that the average student's score on the subscale was low. Motor impulsiveness, non-planning impulsiveness, and attentional impulsiveness were not significantly different between males and females, academic specialization, academic year variables, and their interaction. The limitations and implications of these findings are discussed.

Motor synchronization and impulsivity in pediatric borderline personality disorder with and without attention-deficit hyperactivity disorder: an eye-tracking study of saccade, blink and pupil behavior

Shifting motor actions from reflexively reacting to an environmental stimulus to predicting it allows for smooth synchronization of behavior with the outside world. This shift relies on the identification of patterns within the stimulus - knowing when a stimulus is predictable and when it is not - and launching motor actions accordingly. Failure to identify predictable stimuli results in movement delays whereas failure to recognize unpredictable stimuli results in early movements with incomplete information that can result in errors. Here we used a metronome task, combined with video-based eye-tracking, to quantify temporal predictive learning and performance to regularly paced visual targets at 5 different interstimulus intervals (ISIs). We compared these results to the random task where the timing of the target was randomized at each target step. We completed these tasks in female pediatric psychiatry patients (age range: 11-18 years) with borderline personality disorder (BPD) symptoms, with (n = 22) and without (n = 23) a comorbid attention-deficit hyperactivity disorder (ADHD) diagnosis, against controls (n = 35). Compared to controls, BPD and ADHD/BPD cohorts showed no differences in their predictive saccade performance to metronome targets, however, when targets were random ADHD/BPD participants made significantly more anticipatory saccades (i.e., guesses of target arrival). The ADHD/BPD group also significantly increased their blink rate and pupil size when initiating movements to predictable versus unpredictable targets, likely a reflection of increased neural effort for motor synchronization. BPD and ADHD/BPD groups showed increased sympathetic tone evidenced by larger pupil sizes than controls. Together, these results support normal temporal motor prediction in BPD with and without ADHD, reduced response inhibition in BPD with comorbid ADHD, and increased pupil sizes in BPD patients. Further these results emphasize the importance of controlling for comorbid ADHD when querying BPD pathology.

Emotional working memory training improves cognitive inhibitory abilities in individuals with borderline personality trait: A randomized parallel-group trial

BACKGROUND

Cognitive inhibition impairment is one of the causes of impulsive behaviors in individuals with borderline personality disorder (BPD). This study aimed to investigate the effect of emotional working memory training (EWMT) on cognitive inhibition in individuals with a clinically significant borderline personality trait.

METHODS

In a randomized, parallel-group trial, 40 individuals with borderline personality trait, were selected out of 1000 screened individuals and were randomly assigned to the experimental (N = 20) and waiting-list control (N = 20) groups based on the score on the Borderline Personality Scale and the follow-up Structured Clinical Interview for DSM-IV Personality Disorders. The experimental group underwent 10 sessions of EWMT and the control group did not receive any intervention (waiting list). Participants completed the Stroop Color and Word Test (SCWT) and Go/No-Go task Before and after the intervention.

RESULTS

EWMT significantly reduced reaction time of incongruent trials in the SCWT and commission errors in the Go/No-Go task after the intervention only in the experimental group. Furthermore, the interference score in SCWT and commission error rate at the post-intervention time were significantly lower for the experimental vs the waitlist group.

LIMITATIONS

The single-blind design and absence of follow-up measures.

CONCLUSIONS

EWMT can improve cognitive inhibition in individuals with borderline personality trait and could be used for therapeutic purposes of impulsivity behavior in BPD.

Impulsivity and Emotional Dysregulation Predict Choice Behavior During a Mixed-Strategy Game in Adolescents With Borderline Personality Disorder

Impulsivity and emotional dysregulation are two core features of borderline personality disorder (BPD), and the neural mechanisms recruited during mixed-strategy interactions overlap with frontolimbic networks that have been implicated in BPD. We investigated strategic choice patterns during the classic two-player game, Matching Pennies, where the most efficient strategy is to choose each option randomly from trial-to-trial to avoid exploitation by one’s opponent. Twenty-seven female adolescents with BPD (mean age: 16 years) and twenty-seven age-matched female controls (mean age: 16 years) participated in an experiment that explored the relationship between strategic choice behavior and impulsivity in both groups and emotional dysregulation in BPD. Relative to controls, BPD participants showed marginally fewer reinforcement learning biases, particularly decreased lose-shift biases, increased variability in reaction times (coefficient of variation; CV), and a greater percentage of anticipatory decisions. A subset of BPD participants with high levels of impulsivity showed higher overall reward rates, and greater modulation of reaction times by outcome, particularly following loss trials, relative to control and BPD participants with lower levels of impulsivity. Additionally, BPD participants with higher levels of emotional dysregulation showed marginally increased reward rate and increased entropy in choice patterns. Together, our preliminary results suggest that impulsivity and emotional dysregulation may contribute to variability in mixed-strategy decision-making in female adolescents with BPD.

Impaired impulse inhibition of emotional stimuli in patients with borderline personality disorder

This study was aimed to investigate whether BPD patients showed impaired impulse inhibition of emotional and non-emotional stimuli and to explore relevant neuroelectrophysiological mechanisms. A total of 32 BPD patients and 32 matched healthy controls were recruited. Self-reported scales were used to measure psychiatric symptoms. The event-related potentials (ERPs) were recorded when subjects were performing neutral and emotional Stop Signal Task (SST). Group differences in self-reported scores, behavioral variables and ERPs were compared. The BPD group scored significantly higher on impulsivity, severity of BPD symptoms, levels of depression and anxiety than the control group. In neutral SST, no significant group differences were detected in the amplitude and latency of ERPs components induced. In emotional SST, the P2 amplitude of negative emotion was significantly larger than that of neutral emotion in Go trials. In Stop trials, the P2 amplitude of BPD group was significantly smaller than that of control group, and the N2 amplitude of BPD group was significantly greater than that of control group. BPD patients showed impaired inhibition of emotional stimuli rather than non-emotional stimuli. The deficits of emotional impulse control mainly exhibit at the early attention, stimulus evaluation and conflict detection stages.

Association of Prefrontal Cortex Thinning with High Impulsivity in Healthy Adults

OBJECTIVE

Studies have been conducted to identify brain structural alterations related to high impulsivity in psychiatric populations. However, research on healthy subjects is relatively less extensive. Therefore, we aimed to investigate the correlation between the cortical thickness of whole brain regions and the impulsivity level in a healthy population.

METHODS

We included 100 healthy participants aged 19-65 years. Their T1-weighted magnetic resonance images and the 23-item Barratt Impulsiveness Scale (BIS) score were obtained. The patients were divided into high and low impulsivity groups according to the 75th percentile score of the BIS in the sample. The thickness of each cortical region was calculated using the FreeSurfer, and the difference in cortical thickness of the whole brain between the high and low impulsivity groups was analyzed using one-way analysis of covariance including age, sex, education level, and total intracranial cavity volume as covariates.

RESULTS

The high impulsivity group showed significant cortical thinning in the left pars opercularis. The cortical thickness of the left pars opercularis significantly correlated negatively with the total, attention, and motor scores of the BIS scale.

CONCLUSION

Our findings suggest that prefrontal cortex thinning may play an important role in the development of high impulsivity in healthy adults.

Effortful Control - A Transdiagnostic Dimension Underlying Internalizing and Externalizing Psychopathology

Effortful control (EC) or self-regulation refers to the ability to regulate behavior, emotion, and cognition. It has been identified as a contributor to both adaptive and adverse outcomes in children, adolescents, and adults and this across many domains. As such, it could be considered as a transdiagnostic dimension underlying internalizing (e.g., mood and anxiety disorders) and externalizing (e.g., substance use disorders, ADHD) psychopathology. We aimed to examine the role of EC throughout the adult psychopathological spectrum by means of a literature search of studies published between 2008 and 2018. Overall, the results point to the role of EC in the development of a broad spectrum of psychiatric diagnosis, reflecting the transdiagnostic characteristic of this construct. This role may be both directly causal or as a mediator factor influencing outcomes of a specific disorder. Early assessment of EC and early interventions to improve EC might help to avoid or decrease the risk of developing psychopathology.

Emotion dysregulation in adults suffering from attention deficit hyperactivity disorder (ADHD), a comparison with borderline personality disorder (BPD)

BACKGROUND

Emotional dysregulation (ED) is now considered as an important symptom of attention deficit hyperactivity disorder (ADHD). It is believed to have a considerable impact on the severity of the disorder, one's global functioning, and the prognosis. Our research aimed to evaluate and compare ED and cognitive emotional regulation strategies between ADHD and borderline personality disorder (BPD) patients.

METHODS

Four hundred six French-speaking outpatients (N = 279 ADHD, N = 70 BPD, N = 60 BPD + ADHD) were assessed with the Emotion Reactivity Scale (ERS), the Cognitive Emotional Regulation Questionnaire (CERQ), The Basic Empathy Scale (BES-A), the Adult ADHD Self-Report Scale (ARSV-v1.1) and the Beck Depression Inventory II (BDI-II). ADHD, BPD and comorbid patients were compared with each other and with samples of controls extracted from already published data.

RESULTS

ADHD patients, although having higher ED than samples derived from the general population, had less ED, better control over their emotions with higher use of adaptive cognitive strategies and lesser use of non-adaptive strategies than BPD patients. However, ADHD subjects had similar scores as BPD subjects when looking at difficulties in perceiving self and others. ED generated considerable distress in all groups and was also positively associated with ADHD symptomatology. ADHD patients with comorbid BPD had the highest scores of ED.

CONCLUSIONS

Our results suggest that there may be similarly inefficient cognitive emotional regulation skills leading to ED in both disorders (ADHD and BPD). However, ADHD patients showed a higher use of adaptive cognitive emotional strategies and a lower level of ED than BPD patients.

Disinhibition as a unifying construct in understanding how personality dispositions undergird psychopathology

Disinhibition has been a construct of interest for decades, as evidenced by its inclusion in most prominent models of general personality functioning and its link to personality pathology, other psychopathology, health behaviors, and public health concerns. Disinhibition is manifest in behavioral, task based, and physiological measures, and common etiologies are a major reason for the coherence of the domain across a variety of assessment modalities. The current review will provide a summary of the conceptualization of the construct across prominent models, its link to psychopathology and maladaptive behaviors, and its etiology. Finally, we provide discussion on its clinical application utilizing disinhibition to aid in understanding comorbid psychopathology and through a description of its potential use in treatment.

The Modulating Role of Self-Referential Stimuli and Processes in the Effect of Stress and Negative Emotion on Inhibition Processes in Borderline Personality Disorder: Proposition of a Model to Integrate the Self-Concept and Inhibition Processes

Impulsivity is an important clinical and diagnostic feature of borderline personality disorder (BPD). Even though it has been reported that BPD individuals' inhibition performance is significantly reduced in the context of negative emotion or stress, this literature shows mixed results, raising questions about the possible role played by other factors. Winter (2016) proposed that negative emotion stimuli can be more disruptive for BPD individuals' attention control performance because they induce higher distractibility self-referential processes. This article aimed to systematically review the literature regarding the effect of stress and negative emotions on three main inhibition processes-prepotent response inhibition, resistance to distractor interference, and resistance to proactive interference-in BPD and to verify the putative modulating role of self-referential stimuli and processes on these inhibition processes. All English and French experimental studies published until August 2018 were searched in PsychINFO and PubMED databases. The following keywords were used: "borderline* AND inhibit* OR interference* OR forget* OR task* AND emotion* OR stress* OR affect*". A total of 1215 articles were included in the study. After full text revision, twenty-six papers were selected for review. The results of this review indicate that when stimuli or procedures involve self-reference stimuli or processes, BPD individuals' performance seems to be more disrupted in all three inhibition processes. A model based on Winter's and Kernberg's models is proposed with the aim of integrating the self-concept with inhibition processes in BPD.

Do all inhibitions act alike? A study of go/no-go and stop-signal paradigms

Response inhibition is frequently measured by the Go/no-go and Stop-signal tasks. These two are often used indiscriminately under the assumption that both measure similar inhibitory control abilities. However, accumulating evidence show differences in both tasks' modulations, raising the question of whether they tap into equivalent cognitive mechanisms. In the current study, a comparison of the performance in both tasks took place under the influence of negative stimuli, following the assumption that ''controlled inhibition'', as measured by Stop-signal, but not ''automatic inhibition'', as measured by Go/no-go, will be affected. 54 young adults performed a task in which negative pictures, neutral pictures or no-pictures preceded go trials, no-go trials, and stop-trials. While the exposure to negative pictures impaired performance on go trials and improved the inhibitory capacity in Stop-signal task, the inhibitory performance in Go/no-go task was generally unaffected. The results support the conceptualization of different mechanisms operated by both tasks, thus emphasizing the necessity to thoroughly fathom both inhibitory processes and identify their corresponding cognitive measures. Implications regarding the usage of cognitive tasks for strengthening inhibitory capacity among individuals struggling with inhibitory impairments are discussed.

Annual Research Review: On the relations among self-regulation, self-control, executive functioning, effortful control, cognitive control, impulsivity, risk-taking, and inhibition for developmental psychopathology

BACKGROUND

Self-regulation (SR) is central to developmental psychopathology, but progress has been impeded by varying terminology and meanings across fields and literatures.

METHODS

The present review attempts to move that discussion forward by noting key sources of prior confusion such as measurement-concept confounding, and then arguing the following major points.

RESULTS

First, the field needs a domain-general construct of SR that encompasses SR of action, emotion, and cognition and involves both top-down and bottom-up regulatory processes. This does not assume a shared core process across emotion, action, and cognition, but is intended to provide clarity on the extent of various claims about kinds of SR. Second, top-down aspects of SR need to be integrated. These include (a) basic processes that develop early and address immediate conflict signals, such as cognitive control and effortful control (EC), and (b) complex cognition and strategies for addressing future conflict, represented by the regulatory application of complex aspects of executive functioning. Executive function (EF) and cognitive control are not identical to SR because they can be used for other activities, but account for top-down aspects of SR at the cognitive level. Third, impulsivity, risk-taking, and disinhibition are distinct although overlapping; a taxonomy of the kinds of breakdowns of SR associated with psychopathology requires their differentiation. Fourth, different aspects of the SR universe can be organized hierarchically in relation to granularity, development, and time. Low-level components assemble into high-level components. This hierarchical perspective is consistent across literatures.

CONCLUSIONS

It is hoped that the framework outlined here will facilitate integration and cross-talk among investigators working from different perspectives, and facilitate individual differences research on how SR relates to developmental psychopathology.

Impulsivity and Cluster B Personality Disorders

PURPOSE OF REVIEW

Impulsivity is a multifaceted construct and an important personality trait in various mental health conditions. Among personality disorders (PDs), especially cluster B PDs are affected. The aims of this review are to summarize the relevant findings of the past 3 years concerning impulsivity in cluster B PDs and to identify those subcomponents of self-reported impulsivity and experimentally measured impulse control that are most affected in these disorders.

RECENT FINDINGS

All studies referred to antisocial (ASPD) or borderline PD (BPD), and none were found for narcissistic or histrionic PD. In ASPD as well as BPD, self-report scales primarily revealed heightened impulsivity compared to healthy controls. In experimental tasks, ASPD patients showed impairments in response inhibition, while fewer deficits were found in delay discounting. BPD patients showed specific impairments in delay discounting and proactive interference, while response inhibition was less affected. However, after inducing high levels of stress, deficits in response inhibition could also be observed in BPD patients. Furthermore, negative affect led to altered brain activation patterns in BPD patients during impulse control tasks, but no behavioral impairments were found. As proposed by the DSM-5 alternative model for personality disorders, heightened impulsivity is a core personality trait in BPD and ASPD, which is in line with current research findings. However, different components of experimentally measured impulse control are affected in BPD and ASPD, and impulsivity occurring in negative emotional states or increased distress seems to be specific for BPD. Future research could be focused on measures that assess impulsive behaviors on a momentary basis as this is a promising approach especially for further ecological validation and transfer into clinical practice.

The connection of temperament with ADHD occurrence and persistence into adulthood - An investigation in 18 year old males

BACKGROUND

This study intended to determine whether certain traits of temperament are associated with former and current ADHD symptomatology in a non-clinical sample of 18 year old males.

METHODS

We performed a cross sectional descriptive study of 3280 men during the examination for military service. The investigation included a socio-demographic questionnaire, screening for substance abuse, temperament (TEMPS-M), past (WURS) and current (ADHD symptom checklist) ADHD symptomatology.

RESULTS

We found a correlation of cyclothymic (p<.001), irritable (p<.001) and anxious (p<.05) temperament with occurrence and severity of past and present ADHD symptomatology. No significant correlation has been detected for hyperthymic and depressive temperament. Judged retrospectively, ADHD symptoms were strongly consistent over time.

LIMITATIONS

The sample consists of men only. These had to be fit enough to be enlisted for military service; men with severe mental or physical disorders were thus excluded. Furthermore, the cross-sectional study design does not allow making conclusions about the temporal relationships between ADHD symptoms and substance misuse.

CONCLUSIONS

These results indicate that a temperament based approach towards those affected by ADHD might be useful. Subtyping ADHD by integrating temperament profiles in diagnosis and treatment of the disorder could help explain some of the heterogeneity of the disease.

Women with borderline personality disorder do not show altered BOLD responses during response inhibition

Impulsivity is central to borderline personality disorder (BPD). Response inhibition, addressing the ability to suppress or stop actions, is one aspect of behavioral impulse control which is frequently used to assess impulsivity. BPD patients display deficits in response inhibition under stress condition or negative emotions. We assessed whether response inhibition and its neural underpinnings are impaired in BPD when tested in an emotionally neutral setting and when co-morbid attention-deficit/hyperactivity disorder (ADHD) is excluded. To this end, we studied response inhibition in unmedicated BPD patients and healthy controls (HC) in two independent samples using functional magnetic resonance imaging during Simon-, Go/nogo-, and Stopsignal tasks. BPD patients and HC did not differ significantly in their performance in the Go/nogo and the Stopsignal tasks. Response interference in the Simon task was increased in BPD patients in one sample, but this could not be replicated in the second sample. In both samples, no significant differences in brain activation patterns during any of the tasks were present while the neural impulse control network was robustly activated during the inhibition tasks in both groups. Our results provide evidence that under emotionally neutral conditions response inhibition is not impaired in patients with BPD without co-occurring ADHD.

Executive control signals in orbitofrontal cortex during response inhibition

Orbitofrontal cortex (OFC) lesions produce deficits in response inhibition and imaging studies suggest that activity in OFC is stronger on trials that require suppression of behavior, yet few studies have examined neural correlates at the single-unit level in a behavioral task that probes response inhibition without varying other factors, such as anticipated outcomes. Here we recorded from single neurons in lateral OFC in a task that required animals in the minority of trials to STOP or inhibit an ongoing movement and respond in the opposite direction. We found that population and single-unit firing was modulated primarily by response direction and movement speed, and that very few OFC neurons exhibited a response independent inhibition signal. Remarkably, the strength of the directional signal was not diminished on STOP trials and was actually stronger on STOP trials during conflict adaptation. Finally, directional signals were stronger during sessions in which rats had the most difficulty inhibiting behavior. These results suggest that "inhibition" deficits observed with OFC interference studies reflect deficits unrelated to signaling the need to inhibit behavior, but instead support a role for OFC in executive functions related to dissociating between two perceptually similar actions during response conflict.

Guanfacine enhances inhibitory control and attentional shifting in early abstinent cocaine-dependent individuals

OBJECTIVES

Attenuation of adrenergic drive and cognitive enhancement, via stimulation of alpha2 pre- and post-synaptic receptors, may selectively enhance executive performance in early abstinent cocaine-dependent individuals. As these cognitive processes underpin important treatment-related behaviors, the alpha2 agonist, guanfacine HCl, may represent an effective pharmaco-therapeutic intervention.

METHODS

Twenty-five early abstinent cocaine-dependent individuals were administered a battery of neurocognitive tasks on entry into treatment (baseline) and again following 3 weeks of either placebo or guanfacine treatment (up to 3 mg). Tasks included: Stop Signal, Stroop, 3-Dimentional Intra-dimensional/Extra-dimensional (IDED) task, Spatial Working Memory (SWM), Paired Associates Learning (PAL), Verbal Fluency and the Rey Auditory Verbal Learning Test (RAVLT).

RESULTS

Compared with placebo, the guanfacine group demonstrated attenuated anxiety and negative affect as well as improved performance on selective executive tests. This included fewer directional errors on the stop signal task, fewer errors on the extra-dimensional shift component of the IDED task and better attentional switching during verbal fluency. Guanfacine did not improve strategic working memory or peripheral memory.

CONCLUSION

Guanfacine improves selective cognitive processes which may underlie salient treatment-related regulatory behaviors. Alpha2 agonists may therefore represent important agents for cocaine dependence.

Frontal dysfunctions of impulse control - a systematic review in borderline personality disorder and attention-deficit/hyperactivity disorder

Disorders such as borderline personality disorder (BPD) or attention-deficit/hyperactivity disorder (ADHD) are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary function. Recent findings from behavioral and cognitive neuroscience studies suggest related but dissociable components of impulse control along functional domains like selective attention, response selection, motivational control, and behavioral inhibition. In addition, behavioral and neural dissociations are seen for proactive vs. reactive inhibitory motor control. The prefrontal cortex with its sub-regions is the central structure in executing these impulse control functions. Based on these concepts of impulse control, neurobehavioral findings of studies in BPD and ADHD were reviewed and systematically compared. Overall, patients with BPD exhibited prefrontal dysfunctions across impulse control components rather in orbitofrontal, dorsomedial, and dorsolateral prefrontal regions, whereas patients with ADHD displayed disturbed activity mainly in ventrolateral and medial prefrontal regions. Prefrontal dysfunctions, however, varied depending on the impulse control component and from disorder to disorder. This suggests a dissociation of impulse control related frontal dysfunctions in BPD and ADHD, although only few studies are hitherto available to assess frontal dysfunctions along different impulse control components in direct comparison of these disorders. Yet, these findings might serve as a hypothesis for the future systematic assessment of impulse control components to understand differences and commonalities of prefrontal cortex dysfunction in impulsive disorders.

Patient-reported outcomes in borderline personality disorder

Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable experimental measures to complement self-report data. Here, we provide an overview of currently used BPD outcome measures and discuss them from clinical, psychometric, experimental, and patient perspectives. In addition, we review the most promising leads to improve BPD PROs, including the DSM-5 Section III, the Recovery Approach, Ecological Momentary Assessments, and novel experimental measures of social functioning that are associated with functional and social outcomes.

Do cognitive measures of response inhibition differentiate between attention deficit/hyperactivity disorder and borderline personality disorder?

This study examined whether cognitive measures of response inhibition derived from the AX-CPT are able to differentiate between adult attention deficit/hyperactivity disorder (ADHD), borderline personality disorder (BPD), and healthy controls (HC). Current DSM-IV-TR symptoms of ADHD and BPD were assessed by structured diagnostic interviews, and parent developmental interviews were used to assess childhood ADHD symptoms. Patients (14 ADHD, 12 BPD, 7 ADHD and BPD, and 37 HC) performed the AX-CPT. Seventy percent of AX-CPT trials were target (AX) trials, creating a bias to respond with a target response to X probes in the nontarget (AY, BX, BY) trials. On BX trials, context, i.e. the non-'A' letter, must be used to inhibit this prepotent response tendency. On AY trials context actually causes individuals to false alarm. The effects of ADHD and BPD on AX-CPT outcome were tested using two-way ANOVA. BPD was associated with higher percentage of errors across the task and more errors and slower responses on BX trials, whereas ADHD was associated with slower responses on AY trials. The findings suggest response inhibition problems to be present in both ADHD and BPD, and patients with BPD to be particularly impaired due to poor context processing.

Common ground in Attention Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD)-review of recent findings

Considerable overlap in diagnostic criteria and shared psychopathologic symptoms in attention deficit hyperactivity disorder (ADHD) and borderline personality disorder (BPD) have stimulated research activities in this field. Longitudinal studies have shown that BPD is frequently diagnosed in adult patients who had been diagnosed with ADHD in childhood. The question of whether ADHD and BPD randomly co-occur as comorbidities, have similar origins or share common pathological mechanisms remains unresolved. Some authors suggest that ADHD contributes to the development of BPD via various mechanisms, and therefore consider it a risk factor for later BPD development. In this article the evidence for the co-occurrence of these disorders will be reviewed as well as studies on their common genetic and environmental influences. Temperamental and developmental issues will be reviewed, and shared features such as impulsivity and emotion dysregulation discussed. From a therapeutic perspective, few studies have investigated psychotherapeutic treatment of the comorbid condition, though the issue is highly important to the management of patients suffering from both disorders. Some thought is given to how therapeutic methods and approaches can be modified to benefit patients, and to their possible succession.

Executive functions in borderline personality disorder

Different domains of executive function such as working memory and response inhibition were investigated together with elementary cognitive processes in borderline personality disorder (BPD). Patients with BPD (N=28) were compared to nonpatient controls (NP, N=28) on eight tasks (e.g. n-back, Go/NoGo, CPT-AX). In order to separate impairments in different cognitive domains and to assess the influence of more elementary cognitive processes on executive functioning, tasks were embedded in a reaction-time-decomposition approach. BPD patients solved tasks with accuracies comparable to those of nonpatients. The only exception was the n-back task, for which working memory is required: here, error rates were higher and increased more prominently in BPD patients depending on working memory load. In most tasks, movement times were shorter for BPD patients than for nonpatients, while the quality of task-solving was comparable. The faster processing in the BPD group was observable starting with the simplest task, i.e. a simple reaction-time task. These findings suggest that domains of executive functioning are differentially affected in BPD. In contrast to load-dependent deficits in working memory, response inhibition processes were unimpaired. Faster action-related processes could be observed in BPD patients in a variety of tasks; however, these did not influence executive functioning.

ADHD, autism spectrum disorder, temperament, and character: phenotypical associations and etiology in a Swedish childhood twin study

OBJECTIVE

To explore the links between neurodevelopmental disorders - attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) - and personality in a population-based, genetically sensitive study of children.

METHOD

A population-based sample of 1886 twins aged 9 and 12, enriched for childhood mental health problems, was recruited from the Child and Adolescent Twin Study in Sweden (CATSS). Parents were interviewed over the telephone using the Autism-Tics, AD/HD and other Comorbidities (A-TAC) inventory, and in a second step they rated their children according to the Junior Temperament and Character Inventory (JTCI).

RESULTS

ADHD was strongly correlated with novelty seeking, while ASD was correlated positively with harm avoidance and negatively with reward dependence. The strongest associations between personality traits and neurodevelopmental disorders were negative correlations between the character dimensions of self-directedness and cooperativeness and ADHD and ASD alike. Cross-twin cross-trait correlations between ADHD, ASD, and personality dimensions in monozygotic twins were more than double those in dizygotic twins, indicating a strong genetic effect behind the phenotypic covariation between neurodevelopmental disorders and personality.

CONCLUSIONS

Neurodevelopmental disorders are linked specifically to particular temperament profiles and generally to hampered development of the self-governing strategies referred to as "character." Poor self-agency and cooperation may be core functional outcomes in the separation of children with handicapping conditions from those with traits only reminiscent of neurodevelopmental disorders. The associations between neurodevelopmental disorders and personality are at least partly due to genetic effects influencing both conditions. As a consequence, personality must be broadly considered in neuropsychiatry, just as neuropsychiatric disorders and their genetic, neurodevelopmental, and cognitive susceptibilities have to be in personality research and clinical treatment.

Emotion dysregulation and impulsivity additively predict borderline personality disorder features in Italian nonclinical adolescents

The present study aimed to test if measures of emotion dysregulation and impulsivity additively predicted dimensional scores of borderline personality disorder assessed using the Borderline Personality Disorder Scale of the Personality Diagnostic Questionnaire-4+ in two independent samples of Italian nonclinical adolescents. Hierarchical regression analyses showed that three dimensions of emotion dysregulation (difficulties controlling impulsive behaviours when distressed, limited access to effective emotional regulation strategies and lack of emotional clarity) were significantly associated with BPD features in both samples. Further, impulsivity scores accounted for a significant amount of additional variance in BPD features above and beyond emotion dysregulation.

On the relationship between retrospective childhood ADHD symptoms and adult BPD features: the mediating role of action-oriented personality traits

A number of studies have reported data suggestive of a significant association between ADHD and BPD, nevertheless, the nature of this relation has not been fully understood yet. In our study, we tried to evaluate if the relationship between retrospectively assessed ADHD symptoms and adult BPD features could mediated by selected temperament/personality traits. Four hundred forty-seven in- and outpatients consecutively admitted to the Clinical Psychology and Psychotherapy Unit of the Scientific Institute H San Raffaele of Milan, Italy, were administered the Italian versions of the following instruments: Structured Clinical Interview for DSM-IV Axis II Personality Disorders, Version 2.0 (SCID-II), Wender Utah Rating Scale (WURS), Temperament and Character Inventory-Revised (TCI-R), Barratt Impulsiveness Scale-11 (BIS-11), and Aggression Questionnaire (AQ). Our mediation analyses showed that the combination of impulsivity, aggression, novelty seeking, and juvenile conduct problems completely mediate the relationship between retrospectively assessed ADHD symptoms and current BPD features.

Aberrant pain perception in direct and indirect non-suicidal self-injury: an empirical test of Joiner's interpersonal theory

Using a community sample (N=148) we examined pressure pain perception in 3 study groups--people who engaged in non-suicidal self-injury, people who engaged in indirect forms of self-injury, and non-self-injuring controls. In so doing we tested hypotheses derived from Joiner's (2005) interpersonal theory of suicide. Consistent with previous studies and with Joiner's model, people who engaged in NSSI endured pain for significantly longer than non-self-injuring controls. Importantly, pain endurance in the Indirect self-injury group was comparable to that found in the NSSI group and significantly elevated relative to controls. This pattern of results suggests that abnormal pain perception may not be specific to forms of self-injury (e.g., NSSI) that involve immediate physical pain (e.g., cutting). Our findings further suggest that the concept of acquired capability for suicide might have relevance for both direct and indirect forms of self-injurious behavior.

Self-directedness and cooperativeness, psychosocial dysfunction and suffering in ESSENCE

Background. The acronym ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) highlights that children seeking clinical treatment are often multiply impaired, thus requiring treatment from several specialties. The aim was to map and relate, on a population level, ESSENCE to two salient predictors of health and adaptation to adversities, namely, Self-Directedness and Cooperativeness and also to dysfunction and suffering. Methods. Participants were twins (N = 1892) aged 9 or 12 whose parents were interviewed with the Autism-Tics, ADHD and other Comorbidities inventory (A-TAC), and the Junior Temperament and Character Inventory (J-TCI). The A-TAC was first used to discern four ESSENCE-related screening diagnoses: autism spectrum disorders, attention deficit hyperactivity disorder, learning disabilities, and developmental coordination disorder; second, to quantify dysfunction and suffering in important social areas. Results. ESSENCE symptoms were continuously and categorically associated with deficiency in Self-Directedness and Cooperativeness and higher ratings of dysfunction and suffering. The impact of ESSENCE symptoms on these measures of mental health was found in a milder form in about 16% of all children and in a severe form in about 2%. Conclusion. Therapeutic interventions focusing on Self-Directedness and Cooperativeness might provide a novel method for child psychiatry in its approach to ESSENCE.

Personality disorders and treatment drop out in the homeless

The homeless drop out of treatment relatively frequently. Also, prevalence rates of personality disorders are much higher in the homeless group than in the general population. We hypothesize that when both variables coexist - homelessness and personality disorders - the possibility of treatment drop out grows. The aim of this study was to analyze the hypotheses, that is, to study how the existence of personality disorders affects the evolution of and permanence in treatment. One sample of homeless people in a therapeutic community (N = 89) was studied. The structured clinical interview for the diagnostic and statistical manual of mental disorders (DSM-IV-TR) was administered and participants were asked to complete the Millon Clinical Multiaxial Inventory-II (MCMI-II). Cluster B personality disorders (antisocial, borderline, and narcissistic) avoided permanence in the treatment process while cluster C disorders, as dependent, favored adhesion to the treatment and improved the prognosis. Knowledge of these personality characteristics should be used to advocate for better services to support homeless people and prevent their dropping out before completing treatment.

Response inhibition signals and miscoding of direction in dorsomedial striatum

The ability to inhibit action is critical for everyday behavior and is affected by a variety of disorders. Behavioral control and response inhibition is thought to depend on a neural circuit that includes the dorsal striatum, yet the neural signals that lead to response inhibition and its failure are unclear. To address this issue, we recorded from neurons in rat dorsomedial striatum (mDS) in a novel task in which rats responded to a spatial cue that signaled that reward would be delivered either to the left or to the right. On 80% of trials rats were instructed to respond in the direction cued by the light (GO). On 20% of trials a second light illuminated instructing the rat to refrain from making the cued movement and move in the opposite direction (STOP). Many neurons in mDS encoded direction, firing more or less strongly for GO movements made ipsilateral or contralateral to the recording electrode. Neurons that fired more strongly for contralateral GO responses were more active when rats were faster, showed reduced activity on STOP trials, and miscoded direction on errors, suggesting that when these neurons were overly active, response inhibition failed. Neurons that decreased firing for contralateral movement were excited during trials in which the rat was required to stop the ipsilateral movement. For these neurons activity was reduced when errors were made and was negatively correlated with movement time suggesting that when these neurons were less active on STOP trials, response inhibition failed. Finally, the activity of a significant number of neurons represented a global inhibitory signal, firing more strongly during response inhibition regardless of response direction. Breakdown by cell type suggests that putative medium spiny neurons (MSNs) tended to fire more strongly under STOP trials, whereas putative interneurons exhibited both activity patterns.

Direct and indirect forms of non-suicidal self-injury: evidence for a distinction

Non-suicidal self-injury (NSSI) involves deliberate acts (such as cutting) that directly damage the body but occur without suicidal intent. However, other non-suicidal behaviors that involve people mistreating or abusing themselves but that do not deliberately and directly damage bodily tissue may have much in common with NSSI. Such 'indirect' methods of self-injury might include involvement in abusive relationships, substance abuse, risky or reckless behavior, or eating disordered behavior. Using a community sample (N=156) we compared individuals engaging in NSSI (n=50), indirect (non-suicidal) self-injurers (n=38), and healthy controls (n=68) on a range of clinical and personality characteristics. As predicted, non-suicidal self-injurers and indirect self-injurers showed more pathology than healthy controls on all measures. Comparisons of the NSSI and the Indirect self-injury groups revealed no significant differences on measures of dissociation, aggression, impulsivity, self-esteem, negative temperament, depressive symptoms, and borderline personality disorder. However, compared to people who engaged only in indirect forms of self-injury, those who engaged in NSSI were more self-critical, had higher scores on a measure of suicide proneness, and had a history of more suicide attempts. The findings suggest that NSSI and indirect self-injury are best viewed as separate and distinct clinical phenomena.

Out of control? Inhibition processes in eating disorders from a personality and cognitive perspective

OBJECTIVE

The present study examined the role of "a breakdown in inhibition" as a mechanism to explain differences in impulsivity between restrictive and bingeing/purging eating disorders (ED). Two types of inhibition (i.e., executive and reactive inhibition) were assessed by means of personality and neuropsychological tests.

METHOD

Forty-eight female in patients with ED completed the Effortful Control Scale, the BISBAS scales, and a set of neuropsychological tests.

RESULTS

The results showed that executive inhibition measures were able to differentiate restrictive from bingeing/purging ED subtypes. Patients with ED and bingeing/purging behavior scored significantly lower on the Effortful Control Scale, needed more time to finish the Trail Making Test/STROOP, and showed more reaction time variability on the Go No-Go task. We did not find significant associations between personality and neuropsychological measures of executive/reactive inhibition.

DISCUSSION

Insight in the breakdown of inhibition in bingeing/purging patients can increase our understanding of impulse-control disorders and guide the development of tools to improve effortful control.

Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1,233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8 to 10 and 10 to 13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10 to 13 and the rate of growth in ODD scores from 8 to 10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls.

Lifespan attention deficit/hyperactivity disorder and borderline personality disorder symptoms in female patients: a latent class approach

Attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) are frequently comorbid. To contribute to a better understanding of the associations regularly found between ADHD and BPD, on the one hand, and the developmental pathways for these disorders, on the other hand, latent class analyses (LCA) were undertaken to identify classes differing in profiles of childhood symptoms of ADHD and adult symptoms of ADHD and BPD. Diagnostic interviews with 103 female outpatients meeting the criteria for ADHD and/or BPD were used to assess current DSM-IV symptoms; childhood symptoms of ADHD were assessed in parent interviews. The latent classes were examined in relation to the DSM-IV conceptualizations of ADHD and BPD. And relations between childhood and adult classes were examined to hypothesize about developmental trajectories. LCA revealed an optimal solution with four distinct symptom profiles: only ADHD symptoms; BPD symptoms and only ADHD symptoms of hyperactivity; BPD symptoms and ADHD symptoms of inattention and hyperactivity; BPD symptoms and ADHD symptoms of inattention, hyperactivity and impulsivity. All patients with BPD had some ADHD symptoms in both adulthood and childhood. Hyperactivity was least discriminative of adult classes. Adult hyperactivity was not always preceded by childhood hyperactivity; some cases of comorbid ADHD and BPD symptoms were not preceded by significant childhood ADHD symptoms; and some cases of predominantly BPD symptoms could be traced back to combined symptoms of ADHD in childhood. The results underline the importance of taking ADHD diagnoses into account with BPD. ADHD classification subtypes may not be permanent over time, and different developmental pathways to adult ADHD and BPD should therefore be investigated.

Higher executive control and visual memory performance predict treatment completion in borderline personality disorder

BACKGROUND

Non-completion of a prescribed course of treatment occurs in 20-60% of individuals diagnosed with borderline personality disorder (BPD). While symptom severity, personality traits and environmental factors have been implicated as predictors of treatment non-completion (TNC), there have been no studies of neuropsychological predictors in this population.

METHODS

From a randomized controlled trial, a subsample of 31, unmedicated outpatients diagnosed with BPD with recent self-injurious behavior was assessed on 5 neuropsychological domains. Patients were also assessed for general IQ, demographic and other salient clinical variables. Patients were randomized to one of four treatment conditions, which lasted up to 1 year. Number of weeks in treatment (WIT) up to 1 year was utilized as the index of TNC.

RESULTS

Thirty-three percent of the subsample (n = 12) did not complete 1 year of treatment. However, more WIT were predicted by better baseline executive control (Trails B; p < 0.01) and visual memory performance (Benton visual retention; p < 0.001); other neuropsychological domains did not predict WIT.

CONCLUSION

In the treatment of outpatients with BPD, better executive control and visual memory performance predict more WIT. Assessing and addressing these neurocognitive factors in treatment may reduce TNC in this high-risk population.

Impaired Pavlovian conditioned inhibition in offenders with personality disorders

Certain types of violent offending are often accompanied by evidence of personality disorders (PDs), a range of heterogeneous conditions characterized by disinhibited behaviours that are generally described as impulsive. The tasks previously used to show impulsivity deficits experimentally (in borderline personality disorder, BPD) have required participants to inhibit previously rewarded responses. To date, no research has examined the inhibition of responding based on Pavlovian stimulus–stimulus contingencies, formally “conditioned inhibition” (CI), in PDs. The present study used a computer-based task to measure excitatory and inhibitory learning within the same CI procedure in offenders recruited from the “personality disorder” and the “dangerous and severe personality disorder” units of a high-security psychiatric hospital. These offenders showed a striking and statistically significant change in the expression of inhibitory learning in a highly controlled procedure: The contextual information provided by conditioned inhibitors had virtually no effect on their prepotent associations. Moreover, this difference was not obviously attributable to nonspecific cognitive or motivational factors. Impaired CI would reduce the ability to learn to control associative triggers and so could provide an explanation of some types of offending behaviour.

ADHD in adolescents with borderline personality disorder

BACKGROUND

The aims of this study were to assess the prevalence of a comorbid Attention Deficit Hyperactivity Disorder (ADHD) diagnosis in Borderline Personality Disorder (BPD), and its impact on the clinical presentation of BPD in adolescents, and to determine which type of impulsivity specifically characterizes adolescents with BPD-ADHD.

METHODS

ADHD diagnoses were sought in a sample of 85 DSM-IV BPD adolescents drawn from the EURNET BPD. Axis-I and -II disorders were determined with the K-SADS-PL and the SIDP-IV, respectively. Impulsivity was assessed with the BIS-11.

RESULTS

11% (N = 9) of BPD participants had a current ADHD diagnosis. BPD-ADHD adolescents showed higher prevalence of Disruptive disorders (Chi2 = 9.09, p = 0.01) and a non-significant trend for a higher prevalence of other cluster B personality disorders (Chi2 = 2.70, p = 0.08). Regression analyses revealed a significant association between Attentional/Cognitive impulsivity scores and ADHD (Wald Z = 6.69; p = 0.01; Exp(B) = 2.02, CI 95% 1.19-3.45).

CONCLUSIONS

Comorbid ADHD influences the clinical presentation of adolescents with BPD and is associated with higher rates of disruptive disorders, with a trend towards a greater likelihood of cluster B personality disorders and with higher levels of impulsivity, especially of the attentional/cognitive type. A subgroup of BPD patients may exhibit developmentally driven impairments of the inhibitory system persisting since childhood. Specific interventions should be recommended for this subsample of BPD adolescents.

Exploring the association between emotional abuse and childhood borderline personality features: the moderating role of personality traits

Most of the extant literature on borderline personality disorder has focused on the course, consequences, and correlates of this disorder among adults. However, little is known about childhood borderline personality (BP) features, or the factors associated with the emergence of BP pathology in childhood. A greater understanding of childhood BP features and associated risk factors has important implications for the development of primary and secondary prevention programs. The goal of the present study was to examine the interrelationships among two BP-relevant traits (affective dysfunction and impulsivity), a BP-relevant environmental stressor (emotional abuse), and BP features in a sample of 225 children aged 11 to 14 years. Results provide support for the role of both trait vulnerabilities and environmental stressors in childhood BP features. Further, findings highlight the moderating role of affective dysfunction in the relationship between emotional abuse and childhood BP features.

Emotional conditions disrupt behavioral control among individuals with dysregulated personality traits

The current study directly examined emotion-induced behavior dyscontrol among individuals scoring high on dysregulated tendencies, represented by impulsive-antisocial and borderline personality traits, using an emotional-linguistic go/no-go laboratory paradigm (Goldstein et al., 2007). We specifically examined the effects of these personality traits and emotional context on (a) overall behavior dyscontrol (slower reaction times [RTs] to emotional blocks relative to neutral blocks) and (b) duration of the dyscontrol (persistence or habituation of the effect of emotional context on behavior across blocks). We hypothesized that individuals high on borderline-antisocial traits would exhibit greater behavioral dyscontrol (slower RTs or lack of habituation across blocks) when responding during blocks of negative emotional cues. We also examined whether this emotional effect on behavioral control would be exacerbated by exposure to particularly salient emotional stimuli (diagnostically relevant negative affective words; e.g., abandon). Results indicated that high borderline-antisocial individuals showed greater initial behavioral control difficulties (slower RTs) to general negative affective words than to other word contents during the first block of trials, but this effect habituated by the second block. Importantly, slowed responses to diagnostically relevant word blocks persisted across time among high borderline-antisocial individuals, whereas low scorers showed habituated behavioral responses to emotional words across time.

Engagement of large-scale networks is related to individual differences in inhibitory control

Understanding which brain regions regulate the execution, and suppression, of goal-directed behavior has implications for a number of areas of research. In particular, understanding which brain regions engaged during tasks requiring the execution and inhibition of a motor response provides insight into the mechanisms underlying individual differences in response inhibition ability. However, neuroimaging studies examining the relation between activation and stopping have been inconsistent regarding the direction of the relationship, and also regarding the anatomical location of regions that correlate with behavior. These limitations likely arise from the relatively low power of voxelwise correlations with small sample sizes. Here, we pooled data over five separate fMRI studies of the Stop-signal task in order to obtain a sufficiently large sample size to robustly detect brain/behavior correlations. In addition, rather than performing mass univariate correlation analysis across all voxels, we increased statistical power by reducing the dimensionality of the data set using independent component analysis and then examined correlations between behavior and the resulting component scores. We found that components reflecting activity in regions thought to be involved in stopping were associated with better stopping ability, while activity in a default-mode network was associated with poorer stopping ability across individuals. These results clearly show a relationship between individual differences in stopping ability in specific activated networks, including regions known to be critical for the behavior. The results also highlight the usefulness of using dimensionality reduction to increase the power to detect brain/behavior correlations in individual differences research.