Executive Dysfunction and Working Memory in Borderline Personality Disorder and Their Association with Impulsivity and Self-injurious Behavior: A Cross-sectional Study.

Background: Borderline Personality Disorder (BPD) features impulsivity, emotional dysregulation, and self-injurious behaviors (SIB). Cognitive deficits, such as executive dysfunction (ED) and working memory (WM) impairments, may drive these symptoms, yet their roles remain underexplored. This study examined relationships among ED, WM, impulsivity, and SIB in BPD to identify cognitive predictors of these behaviors.

Methods: This cross-sectional study assessed 30 individuals with BPD per DSM-5 criteria. Participants completed the Barratt Impulsiveness Scale (BIS-11) for impulsivity, Deliberate Self-Harm Inventory (DSHI) for SIB, Wisconsin Card Sorting Test (WCST) for ED, and Letter-Number Sequencing (LNS) task for WM. Spearman's correlations and regression analyses evaluated associations between cognitive deficits, impulsivity, and SIB.

Results: Elevated impulsivity was linked to more WCST perseverative errors (ρ = 0.45, = .02) and lower LNS scores (ρ = -0.38, = .04). SIB correlated with ED (ρ = 0.41, = .03) but not WM (ρ = -0.20, > .05). High-impulsivity participants had greater WCST errors (median = 20 vs. 11, H = 8.12, < .05) and lower LNS scores (median = 6 vs. 10, H = 7.33, < .05) than low-impulsivity peers. Regression confirmed BIS-11 scores predicted WCST errors ( = 0.40, < .01) and LNS performance ( = -0.35, < .05).

Conclusions: The ED and WM impairments were linked to impulsivity, with ED also tied to SIB. Cognitive remediation may reduce these behaviors. Lacking a control group, longitudinal research is needed.