الفهرس 
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Abstract
The term ‘Borderline Personality Disorder’ (BPD) refers to a psychiatric syndrome that is characterized by emotional dysregulation, impulsivity, risk-taking behavior, irritability, feelings of emptiness, self-injury and fear of abandonment, as well as unstable interpersonal relationships. BPD is not only common in psychiatric populations but also more prevalent in the general community than previously thought, and thus represents an important public health issue. BPD has a lifetime prevalence of about 6%. Moreover, BPD is associated with severe suffering and burden on both those who have the disorder and those who are closest to them (Martin Brüne, 2016).
In the last several years, a number of studies have aimed at characterizing neurocognitive alterations in borderline personality disorder (BPD). Although BPD is not regarded as a typically neurocognitive disorder, previous studies proposed that neurocognitive impairments might constitute a key moderator in the development of BPD. The exact nature of such impairments is still under debate. Research suggests the existence of deficits in many cognitive processes, ranging from perceptual speed to memory, attention, and executive functions: that is, an unspecific generalized cognitive impairment (Hagenhoff et al., 2013).
Borderline Personality Disorder (BPD) patients’ characteristic emotion dysregulation and impulsivity becomes increasingly problematic over time due to deficits in their problem-solving abilities. Problem solving incorporates the executive functions, such as planning, organization, cognitive flexibility, decision-making, and inhibitory control.
Despite their assumed importance in psychotherapy, the executive functions are seldom examined in treatment research.
Another very important aspect is the emotional intelligence in patients with borderline personality disorder, research has found poor emotion management ability and trait was important in BPD and was negatively related to all BPD features/criteria (Gardner and Qualter, 2009). Poor emotional understanding was also important.
Our study aimed to better understand the affected cognitive domains and the inpatients with BPD in comparison with controls thus determining the role neurocognitive function play in the presentation of borderline personality disorder. Furthermore, we looked at the difference in the emotional intelligence between cases and controls w, thus finding a different approach in treating borderline personality from all aspects and improving their quality of life.
The current study recruited two groups (cases and control); for the cases, 40 of the patients admitted to the Institute of Psychiatry, Faculty of Medicine, Ain Shams University, aged 18-45 years, fulfilling the diagnosis of Borderline Personality disorder according to the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID II), were recruited to participate in the study. As for the control group, 50 apparently healthy groups of subjects were recruited from patients’ visitors and relatives in the general medical hospital, faculty of Medicine, Ain Shams University. All subjects were assessed using Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) to diagnose and screen for axis 1 diagnosis and Structured Clinical Interview for DSM-IV Axis II Disorders (SCID II) to diagnose the presence of Borderline personality disorder. Both groups were compared using General intellectual abilities using WAIS-R, Executive Functions using Wisconsin Card Sorting Test, Attention using The Trail Making Test, Memory functions using Wechsler Memory Scale and finally, Schutte self report emotional intelligence test (SSEIT).
Regarding our sample, the calculated mean age for patients and controls is 28.48 ± 5.13 and 29.08 ± 2.45 years old respectively so there was no statistical significance. However, for the gender, the sample comprised mostly of females; Cases consisted of 87.5% females and 12.5% males while controls consisted of 65 % females and 35% males. Moreover, regarding education, there was no statistical significance between cases and controls, with mean education years in cases 15.8 +0.97 and in controls 16 ± 0. Yet, when it came to occupation and employment there was significant difference between cases and controls; all controls were working (100%) and only 15% of cases were working. Furthermore, regarding past psychiatric history in cases, 45% had a history of substance use, 17.5% had history of mood disorders, 5% had history of anxiety and 5% had more than one disorder.
In the Wechsler adult intelligence scale, there was no statistically significant difference between patients with BPD and control on domains of the WAIS; Mean IQ of cases was 113.63 ± 8.73 while controls were 115.48 ± 6.98.
On the Wechsler Memory Scale, patients with borderline personality disorder showed significantly lower scores compared with on all the subtests; verbal memory, working memory, visual immediate recall and visual delayed recall, verbal immediate recall and last but not least verbal delayed recall.
Furthermore, On the Wisconsin Card Sorting Test, controls obtained significantly higher scores than patients with borderline personality disorder on the total correct scores, total errors, % errors, categories completed, and % conceptual level response, reflecting that they were better in conceptualization, planning, and problem solving. Additionally controls scored significantly better than cases in preservative responses, % preservatives errors, and non preservative errors, reflecting that patients with borderline personality disorder were worse on tasks measuring shifting and cognitive flexibility.
As for the trail making test, there was a highly statistically significant difference between cases and controls (p<0.001); cases scored higher on both part A and B meaning that they required more time to complete the task, revealing greater impairment.
Additionally, when comparing the mean results of the Schutte self report emotional intelligence scale (SSEIT) in both groups; a highly statistically significant difference was shown between cases an controls with controls having higher scores in regulation of emotions, utilization of emotions and the overall emotional intelligence score. However, in the appraisal and expression, controls scored higher than cases, but the difference was non significant.
Putting all the results into consideration, it is revealed that patients diagnosed with borderline personality disorders have significantly more impaired cognitive functions than apparently healthy controls across memory and executive functions, while general intelligence showed no significant difference. Moreover, it was apparent that there are impairments in the emotional regulation and utilization in patients with borderline personality disorder. Consequently, In clinical practice, we suggest that it should be mandatory to screen for and treat cognitive dysfunctions and emotional intelligence in addition to the borderline symptoms to better improve their prognosis and their day-to-day functions.