Executive function and suicidal risk in women with Borderline Personality Disorder

A range of executive function (EF) deficits have been associated with Borderline Personality (BPD), a disorder characterized by high rates of suicide. However, the role of EF and suicide risk in BPD has not been examined. This exploratory study compared working memory, Stroop interference, motor inhibition (SSRT) and Iowa Gambling Task (IGT) decision making performance in 42 women with BPD and 41 healthy controls. The sensitivity of EF to suicidal risk as assessed by the Suicide Behaviour Questionnaire-R (Osman et al., 2001) was also tested. Women with BPD performed similar to controls on all EF except decision making. Weaker Stroop interference control, however, was the only significant EF contributor to suicide risk, demonstrating near equivalent contributions to that of depression. EF and depression collectively explained 34% of the adjusted variance in total suicide risk. Contrary to expectations, IGT decision making and motor inhibition were not associated with overall suicide risk. Only Stroop interference control contributed significantly to lifetime suicide intent/attempt beyond depression or BPD severity. As prior suicide attempt remains the strongest predictor of future attempt (Soloff et al., 2003), the sensitivity of stroop performance to suicidal risk may be clinically important. Interference control may represent a "diathesis" for suicide that is independent of psychiatric diagnoses.