Neuropsychological functions in women with borderline personality disorder and a history of suicide attempts

Borderline personality disorder (BPD) is a complex psychiatric disorder that leads to intense suffering for afflicted individuals, and extensive use of health care resources. Self-injurious and suicidal behaviors are common among individuals diagnosed with BPD, and as many as 10% of these will eventually die from suicide. BPD presents a clinical challenge as the condition is not well-understood, and has been notoriously difficult to treat. Recent research has confirmed the complex etiology and symptomatology of BPD, and a number of neurobiological and cognitive abnormalities have been indicated. Elucidating such underpinnings of BPD is called for in order to render effective treatment possible. Of great importance is to identify factors that contribute to the extraordinarily high rate of suicidal and self-injurious behavior, and the investigation of gene-environment interactions that occur when the effect of environmental stress is conditional on the genotype of the individual. In this thesis we examined executive functions such as social problem solving and decision-making, and we examined memory functions, and affective symptoms, in 51 (77 in Study IV) women with BPD who had made several suicide attempts. These factors were studied in relation to co-occurring diagnoses of depression and post-traumatic stress disorder (PTSD), traumatic experiences, suicidal and self-harming behavior, and variants of genes within the serotonergic system in order to examine possible associations between them. These results were compared with those of 30 non-clinical control participants who were matched to the BPD group for age and education. In Study I, we examined autobiographical memory in order to study whether the clinical impression that persons with BPD have problems in remembering specific details of their own experiences, holds good. We also studied the role of autobiographical memory in social problem solving, since specific personal memories provide a database of possible solutions to social dilemmas, and its relation to depression and PTSD, traumatic experiences, and level of suicidal and self-harming behavior. It was shown that the individuals in the BPD group produced significantly less specific autobiographical memories than controls. This was associated with difficulties in solving social problems, but not with concurrent diagnoses of depression or PTSD, traumatic experiences, or level of suicidal and self-harming behavior. In Study II, we investigated executive functions of concept formation, goal maintenance, planning ability and working memory in relation to suicidal and self-injurious behaviors. Executive dysfunctioning may be one risk factor for self-harming behavior because such functions are important determinants for adequate cognitive and emotional self-regulation. The BPD group showed greater problems with goal maintenance and planning ability than controls. In addition, deficits in planning ability were associated with life-time number of non-suicidal self-injurious events, and poor concept formation was associated with lifetime number of suicide attempts. In Study III, we examined emotionally controlled decision-making, indicated to be impaired in individuals with BPD. Serotonin dysfunction has been associated with both decision-making and BPD, and for this reason we also studied the relationship between impaired decision-making and a variant of the gene coding for tryptophan hydroxylase (TPH), the rate-limiting enzyme in serotonin synthesis. The results indicated decision-making problems in persons with BPD, and that these difficulties were associated with a specific haplotype of the TPH-1 gene. In Study IV, we tested for an association between variants of the serotonin transporter gene polymorphisms 5-HTTLPR and rs25531 and relevant clinical features of BPD. The presence of one or two copies of the short (s) allele of the 5-HTTLPR polymorphism, and the rs25531 G allele, have been associated with reduced serotonin transporter expression and function, and vulnerability to affective disorders. The study demonstrated that individuals with BPD who carried two s alleles of the 5-HTTLPR (including rs25531 G variants) reported more core borderline symptoms, depression, and anxiety, and obsessivecompulsive behavior, but not suicidal or self-injurious behavior. In conclusion: the present thesis describes specific impaired functions in individuals with BPD and a history of suicide attempts. These findings concern problems with autobiographical memory associated with the core difficulties of BPD in solving social problems. Further, we show that executive dysfunctions are coupled to some of the most distressing and clinically relevant symptoms of BPD, namely suicidal and selfharming behaviors. Some of the indicated impairments, together with several psychiatric symptoms, seem to be related to serotonin system gene variants, indicating serotonergic dysfunction. Based on these findings, we propose that the core problems of BPD, such as impaired emotionally relevant decision-making, are related to serotonergic function in prefrontal areas

Executive functions predict the success of top-soccer players.

While the importance of physical abilities and motor coordination is non-contested in sport, more focus has recently been turned toward cognitive processes important for different sports. However, this line of studies has often investigated sport-specific cognitive traits, while few studies have focused on general cognitive traits. We explored if measures of general executive functions can predict the success of a soccer player. The present study used standardized neuropsychological assessment tools assessing players' general executive functions including on-line multi-processing such as creativity, response inhibition, and cognitive flexibility. In a first cross-sectional part of the study we compared the results between High Division players (HD), Lower Division players (LD) and a standardized norm group. The result shows that both HD and LD players had significantly better measures of executive functions in comparison to the norm group for both men and women. Moreover, the HD players outperformed the LD players in these tests. In the second prospective part of the study, a partial correlation test showed a significant correlation between the result from the executive test and the numbers of goals and assists the players had scored two seasons later. The results from this study strongly suggest that results in cognitive function tests predict the success of ball sport players

Cognitive impairment has a strong relation to nonsomatic symptoms of depression in relapsing-remitting multiple sclerosis

It is unclear how cognitive impairment in multiple sclerosis (MS) is influenced by physical disability, fatigue, and depression. Our aim was to identify the strongest clinical predictors for cognitive impairment in relapsing-remitting MS (RRMS) patients. The clinical risk factors included in the analysis were physical disability (EDSS), fatigue (FSS), the somatic and nonsomatic components of depression (BDI), disease progression rate [Multiple Sclerosis Severity Score (MSSS)], and psychotropic medication. Cognitive impairment had a prevalence of 30.5% in patients affecting preferentially attention, executive functions, processing speed and visual perception/organization. MSSS was not associated with cognitive impairment, depression, or fatigue. In regression models, cognitive performance was best predicted by the nonsomatic symptoms of depression alone or in combination with physical disability. Exclusion of patients with any psychotropic medication did not influence the results. Our results underscore the importance of evaluating depressive symptoms when suspecting cognitive impairment in patients with RRMS

Data from: Core executive functions are associated with success in young elite soccer players

Physical capacity and coordination cannot alone predict success in team sports such as soccer. Instead, more focus has been directed towards the importance of cognitive abilities, and it has been suggested that executive functions (EF) are fundamentally important for success in soccer. However, executive functions are going through a steep development from adolescence to adulthood. Moreover, more complex EF involving manipulation of information (higher level EF) develop later than simple executive functions such as those linked to simple working memory capacity (Core EF). The link between EF and success in young soccer players is therefore not obvious. In the present study we investigated whether EF are associated with success in soccer in young elite soccer players. We performed tests measuring core EF (a demanding working memory task involving a variable n-back task; dWM) and higher level EF (Design Fluency test; DF). Color-Word Interference Test and Trail Making Test were performed on an exploratory level as they contain a linguistic element. The lower level EF test (dWM) was taken from CogStateSport computerized concussion testing and the higher level EF test (DF) was from Delis-Kaplan Executive Function System test battery (D-KEFS). In a group of young elite soccer players (n = 30; aged 12–19 years) we show that they perform better than the norm in both the dWM (+0.49 SD) and DF (+0.86 SD). Moreover, we could show that both dWM and DF correlate with the number of goals the players perform during the season. The effect was more prominent for dWM (r = 0.437) than for DF (r = 0.349), but strongest for a combined measurement (r = 0.550). The effect was still present when we controlled for intelligence, length and age in a partial correlation analysis. Thus, our study suggests that both core and higher level EF may predict success in soccer also in young players

Core executive functions are associated with success in young elite soccer players

<div><p>Physical capacity and coordination cannot alone predict success in team sports such as soccer. Instead, more focus has been directed towards the importance of cognitive abilities, and it has been suggested that executive functions (EF) are fundamentally important for success in soccer. However, executive functions are going through a steep development from adolescence to adulthood. Moreover, more complex EF involving manipulation of information (higher level EF) develop later than simple executive functions such as those linked to simple working memory capacity (Core EF). The link between EF and success in young soccer players is therefore not obvious. In the present study we investigated whether EF are associated with success in soccer in young elite soccer players. We performed tests measuring core EF (a demanding working memory task involving a variable n-back task; dWM) and higher level EF (Design Fluency test; DF). Color-Word Interference Test and Trail Making Test were performed on an exploratory level as they contain a linguistic element. The lower level EF test (dWM) was taken from CogStateSport computerized concussion testing and the higher level EF test (DF) was from Delis-Kaplan Executive Function System test battery (D-KEFS). In a group of young elite soccer players (n = 30; aged 12–19 years) we show that they perform better than the norm in both the dWM (+0.49 SD) and DF (+0.86 SD). Moreover, we could show that both dWM and DF correlate with the number of goals the players perform during the season. The effect was more prominent for dWM (<i>r</i> = 0.437) than for DF (<i>r</i> = 0.349), but strongest for a combined measurement (<i>r</i> = 0.550). The effect was still present when we controlled for intelligence, length and age in a partial correlation analysis. Thus, our study suggests that both core and higher level EF may predict success in soccer also in young players.</p></div

Core executive functions are associated with success in young elite soccer players - Fig 1

<p>Simple correlation tests using goals as outcome measure for (A) demanding working memory (dWM), (B) Design Fluency Total Correct (DF) and (C) composite measure of the two variables.</p

In Design Fluency (DF) the High Division (HD) players had significantly better scores than the Low Division players (LD).

<p>This difference was observed for both men and women. Note that both HD and LD players have superior scores compared with the standard population.</p