Risky decision-making in borderline personality disorder

Impulsivity is a core feature of borderline personality disorder (BPD). Thereby, individuals with BPD are most often explicitly aware of the deleterious long-term consequences of their impulsive behaviors, but still engage in them. Therefore, the aim of the present study was to test decision-making in BPD. Female individuals with BPD (n = 21) and female controls without BPD (CG; n = 29) were compared on the Game of Dice Task (GDT) with regard to disadvantageous decision-making and feedback processing. In the GDT rules for reinforcement and punishment are explicitly clear and the outcome is defined by probabilities. By providing feedback about the outcome of previous decisions, the GDT is a valid measure to simulate decision-making in real life situations. Main results revealed that women with BPD make risky decisions significantly more often than the CG. Moreover, they show reduced capacities to advantageously utilize feedback. As deficits in decision-making were correlated with BPD symptom severity and impulsivity, risky decision-making may be a relevant maintenance factor for the disorder.