Abstract
M.A.
The relatively rapid development of biological approaches to various psychological
conditions, has prompted clinicians and researchers to investigate Borderline Personality
Disorder more thoroughly.
Research has evidenced the uniqueness of Borderline Personality Disorder in terms of
description, aetiology and treatment. Of the various aetiologies proposed, the
neuropsychological deficit approach is one which is still in its infancy and which may
have promise for new treatment strategies. Latest developments delineate
neuropsychological deficits in the areas of memory, perception and visuospatial ability.
These factors are important for psychotherapeutic purposes.
The purpose of this study was to further existing knowledge as regards the aetiology of
Borderline Personality Disorder in order to initiate new treatment modalities and
management strategies. The study examined whether a battery of neuropsychological
tests could detect organic dysfunction in the areas of construction, orientation and
attention, memory, perception and concept formation and reasoning in twenty inpatients
diagnosed according to DSM-IV criteria, with Borderline Personality Disorder. Two
control groups were used, one comprising twenty inpatients diagnosed according to
DSM-IV criteria with Personality Disorders from Axis II, Clusters A or C; and the other
comprising twenty normal volunteers. Neuropsychological functioning assessed, included
measures of attention, construction, visual and auditory-verbal memory, perception, and
concept-formation and reasoning.
Measurement instruments used in this study included the Digit Symbol subtest of the
WAIS-R; Rey Complex Figure; Logical Memory subtest of the WMS-R, Gottschaldt
Embedded Figures Test; and the Wisconsin Card Sorting Test.
(v)
Analysis of variance, multivariate analysis of variance and post hoc tests revealed
significant deficits in neuropsychological performance among the borderline personality
disorder group and the control group of other personality disorders but not the normal
volunteer group. Dysfunction was particularly significant in the areas of attention,
visuospatial ability, perceptual organization, and ability to maintain cognitive set. These
deficits do not appear to have been attributable to attention deficit disorder, attention
deficit hyperactivity disorder, temporal lobe epilepsy, head injury, a concurrent Axis I
diagnosis such as major depressive disorder, or current drug and/or alcohol abuse. The
observed deficits suggest new ways of understanding the development and maintenance
of Borderline Personality Disorder, and provide indications for treatment.
In conclusion, it is recommended that full use be made of the measurement instruments
used in this study as diagnostic aids to enhance the effectiveness of treatment modalities.
It is further recommended that research in this topic be repeated and extended using a
larger sample and matched controls.