Salud Mental

Social cognition and executive function in borderline personality disorder: evidence of altered cognitive processes


Jonathan Adrián Zegarra-Valdivia
Brenda Nadia Chino Vilca


Introduction. Social cognition (SC) and executive function (EF) research in borderline personality disorder (BPD) has proven to be controversial and lack of sufficient information about deficit patterns.

Objective. Assess the contribution of SC and EF in the socio-emotional and cognitive patterns in BPD, as well as investigate the possible relationships between SC, EF, and clinic features in BPD.

Method. The study evaluated 20 females with BPD in ambulatory hospitalization and 20 healthy women in social cognition (“Reading the mind through the eyes” and the IOWA gambling task) and executive function (with the Wisconsin Card Sorting Test, verbal fluency tasks; digit spam test and numbers-and-letters of the WAIS-III, Trail Making Test Form A and B).

Results. The results show statistically-significant differences for the tasks evaluated in social cognition, the theory of mind (u: 181, p < .001**), and the IOWA gambling task, score IOWA 4 (p < .004*), and IOWA 5 p < .003*); and executive functioning, for example in the Wisconsin card sorting test, WCST1 were found (p < .003*), WCST2 (p < .004*), WCST3 (p < .018*) or WCST4 (p < .003*). Digit span test and verbal fluency had significant differences compared to controls.

Discussion and conclusion. The subdomains evaluated would be good endophenotypes as well as specific cognitive processes for research and rehabilitation.
Neuropsychology, borderline personality disorder, social cognition, executive function


Download data is not yet available.


American Psychiatric Association, 2013. (2013). Diagnostic and Stadistical Manual of Mental Disorders. Fifth Edition. Washington.

Andreou, C., Kelm, L., Bierbrodt, J., Braun, V., Lipp, M., Yassari, A. H., & Moritz, S. (2015). Factors contributing to social cognition impairment in borderline personality disorder and schizophrenia. Psychiatry Research, 229(3), 872–879.

Arntz, A., Bernstein, D., Oorschot, M., & Schobre, P. (2009). Theory of mind in borderline and cluster-C personality disorder. The Journal of Nervous and Mental Disease, 197(11), 801–807.

Arntz, A., & Haaf, J. Ten. (2012). Social cognition in borderline personality disorder: Evidence for dichotomous thinking but no evidence for less complex attributions. Behaviour Research and Therapy, 50(11), 707–718.

Arza, R., Díaz Marsá, M., López Micó, C., Fernández de Pablo1, N., López Ibor, J. J., & Carrasco, J. L. (2009). Rehabilitación neuropsicológica en pacientes con trastorno límite de personalidad: una serie de casos. Actas Españolas de Psiquiatria, 37(4), 236–239.

Baron-Cohen, S., Leslie, a M., & Frith, U. (1985). Does the autistic child have a “theory of mind”? Cognition, 21(1), 37–46.

Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the Mind in the Eyes” Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 42(2), 241–251.

Bechara, A., Damasio, A., Damasio, H., & Anderson, S. (1994). “Insensitivity to future consequences following damage to human prefrontal cortex”. Cognition, 50: 7-12.

Bechara, A. (2004). The role of emotion in decision-making: Evidence from neurological patients with orbitofrontal damage. Brain and Cognition, 55(1), 30–40.

Bechara, A. (2005). Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nature Neuroscience, 8(11), 1458–1463.

Bechara, A., Damasio, H., Tranel, D., & Damasio, A. (2005). The Iowa Gambling Task and the somatic marker hypothesis: some questions and answers. Trends in Cognitive Science, 9: 159-62.

Brevers, D., Bechara, A., Cleeremans, A., & Noël, X. (2013). Iowa Gambling Task (IGT): twenty years after - gambling disorder and IGT. Frontiers in Psychology, 4, 665.

Cullen, K., Vizueta, N., Thomas, K., Han, G., Lim, K., Camchong, J., Mueller, B., Bell, C., Heller, M., & Schulz, C. (2011). Amygdala Functional Connectivity in Young Women with Borderline Personality Disorder. Brain Connectivity, 1(1): 61-71. DOI: 10.1089/brain.2010.0001.

Damasio, A. (1994). Descartes Error. Chile: Editorail Adndés Bello.

De la Cruz, M. (2001. Test de Clasificación de Tarjetas de Wisconsin. Manual (2da. Edición). Madrid: Ediciones TEA.

Dyck, M., Habel, U., Slodczyk, J., et al. (2009). Negative bias in fast emotion discrimination in borderline personality disorder. Psychological Medicine, 39(5): 855–64.

Domes, G., Schulze, L., & Herpertz, S. C. (2009). Emotion recognition in borderline personality disorder-a review of the literature. Journal of Personality Disorders, 23(1), 6–19.

Fernández-Abascal, E. G., Cabello, R., Fernández-Berrocal, P., & Baron-Cohen, S. (2013). Test-retest reliability of the “Reading the Mind in the Eyes” test: a one-year follow-up study. Molecular Autism, 4(1), 33.

Fertuck, E. a, Jekal, a, Song, I., Wyman, B., Morris, M. C., Wilson, S. T., Stanley, B. (2009). Enhanced’Reading the Mind in the Eyes' in borderline personality disorder compared to healthy controls. Psychological Medicine, 39(12), 1979.

Fertuck, E. a., Lenzenweger, M. F., Clarkin, J. F., Hoermann, S., & Stanley, B. (2006). Executive neurocognition, memory systems, and borderline personality disorder. Clinical Psychology Review, 26(3), 346–375.

Forti, L., & Forti, A. (2012). Trastorno límite de la personalidad y conductas autolíticas. Revista Española de Medicina Legal, 38(4). doi: 10.1016/j.reml.2012.08.001.

Fonagy, P., & Bateman, A. (2008). The development of borderline personality disorder a mentalizing model. Journal of Personality Disorders, 22(1): 4–21.

Franzen, N., Hagenhoff, M., Baer, N., Schmidt, A., Mier, D., Sammer, G., Gallhofer, B., Kirsh, P., & Lis, S. (2011). Superior Theory of Mind in borderline personality disorder: an analysis of interaction behavior in a virtual trust game. Psychiatry Research, 187: 224–233.

Frick, C., Lang, S., Kotchoubey, B., Sieswerda, S., Dinu-Biringer, R., Berger, M., Barnow, S. (2012). Hypersensitivity in borderline personality disorder during mindreading. PLoS ONE, 7(8), 4–11.

Gavilán-Ibáñez, J. M., & García-Albea, J. E. (2013). Theory of mind and language comprehension in schizophrenia. Psicothema, 25(4), 440–445.

Gottesman, I., & Gould, T. (2003). The Endophenotype concept in psychiatry: Etymology and Strategic Intentions. Am J Psychiatry, 160:636-645

Gvirts, H., Harari, H., Braw, Y., Shefet, D., Shamay-Tsoory, S., & Levkovitz, Y. (2012). Executive functioning among patients with borderline personality disorder and their relatives. Journal of Affective Disorders, 143: 261–264.

Grosjean, B., & Tsai, G. (2007). NMDA neurotransmission as a critical mediator of borderline personality disorder. J Psychiatry Neurosci., 32(2): 103-115

Hagenhoff, M., Franzen, N., Koppe, G., Baer, N., Scheibel, N., Sammer, G., Gallhofer, B., & Lis, S. (2013). Executive functions in borderline personality disorder. Psychiatry Research, 210: 224-231.

Homberg, J. (2012). Serotonin and decision making processes. Neuroscience and Biobehavioral Reviews, 36: 218–236.

Hughes, A. E., Crowell, S. E., & Coan, J. a. (2012). A developmental neuroscience of borderline pathology: emotion dysregulation and social baseline theory.J Abnorm Child Psychol., 40(1): 21–33. DOI: 10.1007/s10802-011-9555-x.

Igarashi, H., Hasui, C., Uji, M., Shono, M., Nagata, T., & Kitamura, T. (2010). Effects of child abuse history on borderline personality traits, negative life events, and depression: A study among a university student population in Japan. Psychiatry Research, 180(2-3), 120–125.

Jaichenco, V., Wilson, M., Ruiz, A. (2007). Evaluación del lenguaje. En Burin D, Drake M, Harris P, (compiladoras). Evaluación neuropsicológica en adultos. Paidós: Argentina.

Jacob A., G. a., Zvonik, K., Kamphausen, S., Sebastian, A., Maier, S., Philipsen, A., Tüscher, O. (2013). Emotional modulation of motor response inhibition in women with borderline personality disorder: An fMRI study. Journal of Psychiatry and Neuroscience, 38(3), 164–172.

Klengel, T., Pape, J., Binder, E. B., & Mehta, D. (2014). The role of DNA methylation in stress-related psychiatric disorders. Neuropharmacology, 80, 115–132.

LeGris, J., Links, P. S., Van Reekum, R., Tannock, R., & Toplak, M. (2012). Executive function and suicidal risk in women with Borderline Personality Disorder. Psychiatry Research, 196(1), 101–108.

Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74–84.

Lynch, T., Rosenthal, M., Kosson, D., Cheavens, J., Lejuez, C., Blair, R. (2006) .Heightened sensitivity to facial expressions of emotion in borderline personality disorder. Emotion, 6(4): 647–55.

Maurex, L., Zaboli, G., Ohman, A., Asberg, M., & Leopardi, R. (2010). The serotonin transporter gene polymorphism (5-HTTLPR) and affective symptoms among women diagnosed with borderline personality disorder. European Psychiatry, 25: 19–25.

Maurex, L, Zaboli, G., Wiens, S., Asberg, M., Leopardi, R., & Ohman, A. (2009). Emotionally controlled decision-making and a gene variant related to serotonin synthesis in women with borderline personality disorder. Scandinavian Journal of Psychology, 50: 5–10.

McGowan, P. O., & Szyf, M. (2010). The epigenetics of social adversity in early life: Implications for mental health outcomes. Neurobiology of Disease, 39(1), 66–72.

McCloskeya, M., New, A., Siever, L., Goodman, M., Koenigsberg, H., Flory, J., & Coccaro, E. (2009). Evaluation of behavioral impulsivity and aggression task as endophenotypes of borderline personality disorder. J Psychiatr Res, 43(12): 1036–1048. DOI:10.1016/j.jpsychires.2009.01.002.

Mier, D., Lis, S., Esslinger, C., Sauer, C., Hagenhoff, M., Ulferts, J.,

Gallhofer, B., & Kirsch, P. (2013). Neuronal correlates of social cognition in borderline personality disorder. Social Cognitive and Affective Neuroscience, 8(5), 531–537.

Miller, E. The prefrontal cortex and cognitive control. Nat. Rev. Neurosci., 1: 59–65.

Montero, I., & León, O. G. (2007). A guide for naming research studies in Psychology. International Journal of Clinical and Health Psychology, 7(3), 847–862.

Mueller, S. T., & Piper, B. J. (2014). The Psychology Experiment Building Language (PEBL) and PEBL Test Battery. Journal of Neuroscience Methods, 222, 250–9.

O’Neill, A., D’Souza, A., Samson, A. C., Carballedo, A., Kerskens, C., & Frodl, T. (2014). Dysregulation between emotion and theory of mind networks in borderline personality disorder. Psychiatry Research, 231(1), 25–32.

Paris J. (2008). Treatment of Borderline Personality Disorder: Guide to Evidence Based Practice New York: Guilford Press.

Pope, H., Jonas, J., Hudson, J., et al. (1985). An empirical study of psychosis in borderline personality disorder. Am J Psychiatry, 142:1285–1290.

Preißler, S., Dziobek, I., Ritter, K., Heekeren, H. R., & Roepke, S. (2010). Social Cognition in Borderline Personality Disorder: Evidence for Disturbed Recognition of the Emotions, Thoughts, and Intentions of others, 4(December), 8.

Hernández, R., Fernández, C., Baptista, P. (2010). Metodología de la Investigación. 5ª.ed., México DF, Editorial Mc Graw Hill Interamericana.

Robin, M., Pham-Scottez, A., Curt, F., Dugre-Le Bigre, C., Speranza, M., Sapinho, D., Kedia, G. (2012). Decreased sensitivity to facial emotions in adolescents with Borderline Personality Disorder. Psychiatry Research, 200(2-3), 417–421.

Roepke, S., Vater, A., Preißler, S., Heekeren, H. R., & Dziobek, I. (2012). Social cognition in borderline personality disorder. Frontiers in Neuroscience, 6(JAN), 1–12.

Sabbagh, M. (2004). Understanding orbitofrontal contributions to theory-of-mind reasoning: implications for autism. Brain and Cognition, 55:209-219.

Svaldi, J., Philipsen, A., & Matthies, S. (2012). Risky decision-making in borderline personality disorder. Psychiatry Research, 197(1-2), 112–118.

Silvio, V. (2005). Funciones fronto-temporales en pacientes diagnosticados con trastorno límite de la personalidad. Archivos Venezolanos de Psiquiatría y Neurología, 15(104): 30-35.

Stevens, A., Burkhardt, M., Hautzinger, M., Schwarz, J., & Unckel, C. (2004). Borderline personality disorder: Impaired visual perception and working memory. Psychiatry Research, 125: 257–267.

Tajima, K., Montes, a., García-Andrade, R. F., Casado, a., Carrasco, J. L., & Diaz-Marsá, M. (2009). Estudios de neuroimagen en el trastorno límite de la personalidad. Actas Espanolas de Psiquiatria, 37(3), 123–127.

Tajima, M., y de Anta, L. (2009). Trastornos de Personalidad. En Munárriz, M., García-Portilla, P., y Roca, M. Manual del Residente en Psiquiatría I. Asociación Española de Psiquiatría (AEN), la Sociedad Española de Psiquiatría (SEP) y la Sociedad Española de Psiquiatría Biológica (SEPB), 2009. Madrid: España.

Tebartz, L., Hesslinger, B., Thiel, T., Geiger, E., Haegele, K., Lemieux, L., Lieb, K., Bohus, M., Hennig, J. & Ebert, D. (2003). Frontolimbic brain abnormalities in patients with borderline personality disorder: a volumetric magnetic resonance imaging study. Biological Psychiatry, 54: 163–171.

Toplak, M. E., Sorge, G. B., Benoit, A., West, R. F., & Stanovich, K. E. (2010). Decision-making and cognitive abilities: A review of associations between Iowa Gambling Task performance, executive functions, and intelligence. Clinical Psychology Review, 30(5), 562–581.

Unoka, Z., Fogd, D., Füzy, M., & Csukly, G. (2011). Misreading the facial signs: Specific impairments and error patterns in recognition of facial emotions with negative valence in borderline personality disorder. Psychiatry Research, 189(3), 419–425.

Vaskinn, A., Antonsen, B. T., Fretland, R. a., Dziobek, I., Sundet, K., & Wilberg, T. (2015). Theory of mind in women with borderline personality disorder or schizophrenia: differences in overall ability and error patterns. Frontiers in Psychology, 6(August), 1–7.

Villodre, R., Sánchez-Alfonso, A., Brines, L., Núñez, A., Chirivella, J., Ferri, J., Noé, E. (2006).Fluencia verbal: estudio normativo piloto según estrategias de «agrupación» y «saltos» de palabras en población española de 20 a 49 años. Neurología, 21(3):124-130.

Wechsler, D. (1997). WAISS-III Manual, San Antonio. The Psychological Corporation.

Wolf, R., Sambataro, F., Vasic, N., Schmid, M., Thomann, P., Bienentreu, S., Wolf, N. (2011). Aberrant connectivity of resting-state networks in borderline personality disorder. J Psychiatry Neurosci, 36(6):402-11. DOI: 10.1503/jpn.100150.

Yee, L., Korner, A., McSwiggan, S., et al. (2005). Persistent hallucinosis in borderline personality disorder. Compr Psychiatry, 46:147–154.

Zanarini, M. (2000). Childhood experiences associated with the development of borderline personality disorder. Psychiatric Clinics of North America, 23: 89-101.