'Trust Game' May Shed Light On Common Mental Illness

This made it difficult to determine how the subjects with BPD actually felt about how they were dealt with in the game, said Montague. "They probably see all gestures as being threatening and grossly unfair."

Montague expressed the hope that his study, which appears in the most recent issue of Science, would help people understand that BPD has biological origins, and is not the result of someone being difficult.

"These have not traditionally been considered organic problems with the brain," he said.

He also speculated that this study might help with diagnosis and treatment of BPD in the future.

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While he called the findings interesting, Dr. Donald Black, a psychiatrist at the University of Iowa who frequently treats patients with BPD, expressed skepticism regarding how soon, if at all, the study's results could be put into practice.

"It's a potentially important finding, but right now it's at the level of a research finding that is unlikely to have a practical implication anytime soon."

At the same time, he hoped it would bring more attention to the illness.

"I don't want to minimize the importance either, because BPD…is a brain disorder and probably has a genetic basis as well," he said. "A lot of psychiatrists and researchers tend to trivialize it, but it's widespread and pretty disabling.

"We need better ways to treat these patients. I think this study is consistent with that viewpoint and may spur additional research."

A Common Illness, Commonly Ignored

Much of the difficulty in getting doctors to treat BPD, according to Black, lies in the fact that there is no specific pill or course of treatment.

"That tends to make doctors uncomfortable," he said. "They often prefer diagnoses that are associated with specific treatments."

Also, said Black, because of the constellation of symptoms that can affect patients with BPD, the doctor may diagnose it as something else, like bipolar disorder or major depression.

"I think because of the constellation of symptoms that it has, to some doctors, suggests other conditions," he said. "From my perspective, those doctors are certainly picking out the various pieces of the puzzle, but they're not assembling the puzzle. They're seeing various pieces, not the whole thing."