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Poor decision-making is a feature of borderline personality disorder (BPD) and bipolar disorder (BD). Twenty women with BPD, 20 women with BD, and 20 healthy females completed a risky choice task. Those with BPD exhibited altered processing of information about potential gains and losses, with a bias toward large compared to small gains, large compared to small losses, and a tendency to choose outcomes with a negative expected value. This failure to use explicit reinforcement signals was not observed in those with BD. Difficulties using reward information to make decisions may impair day-to-day function. Such impairments offer new treatment targets in BPD.

Original publication




Journal article


Journal of personality disorders

Publication Date





530 - 544


University Department of Psychiatry, Warneford Hospital, Oxford, U. K.


Humans, Risk, Case-Control Studies, Risk-Taking, Reinforcement (Psychology), Reward, Decision Making, Choice Behavior, Bipolar Disorder, Borderline Personality Disorder, Sex Characteristics, Games, Experimental, Adult, Middle Aged, Female