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Klimes-Dougan B, Wiglesworth A, Başgöze Z, Cullen KR. Seeing adolescents grow from many angles using a multilevel approach: A tribute to the contributions of Dante Cicchetti to the field of developmental psychopathology. Dev Psychopathol 2024:1-13. [PMID: 39363720 DOI: 10.1017/s0954579424001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
Dante Cicchetti propelled forward the field of developmental psychopathology by advancing this framework and championing new methods, including emphasizing the central role that multilevel analysis holds for explicating pathways of risk and resilience. His work continues to change the face of existing science. It has also paved the way for the formation of new projects, like the Research Domain Criteria initiative. This paper uses our laboratory's work on multilevel approaches to studying adolescent depression, non-suicidal self-injury, and suicidal thoughts and behaviors to shine a spotlight on Dr Cicchetti's contributions. In addition, we review recent developments, ongoing challenges, and promising future directions within developmental psychopathology as we endeavor to carry on the tradition of growth in the field.
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Affiliation(s)
| | | | - Zeynep Başgöze
- Psychiatry and Behavioral Sciences, University of Minnesota Medical School Twin Cities, Minneapolis, MN, USA
| | - Kathryn R Cullen
- Psychiatry and Behavioral Sciences, University of Minnesota Medical School Twin Cities, Minneapolis, MN, USA
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2
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Lee HJ, Park YM, Shim M. Differences in Functional Connectivity between Patients with Depression with and without Nonsuicidal Self-injury. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:451-457. [PMID: 39069684 PMCID: PMC11289610 DOI: 10.9758/cpn.23.1133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 07/30/2024]
Abstract
Objective : Nonsuicidal self-injury (NSSI), which involves deliberate harm to body tissues without suicidal intent, represents an escalating clinical concern. We used electroencephalography (EEG) to investigate the differences in functional connectivity (FC) patterns in patients with depression with and without a history of NSSI. Methods : Seventy-seven patients with mood disorders experiencing major depressive episodes were categorized into NSSI (Group A; n = 31) and non-NSSI (Group B; n = 46) groups on the basis of their NSSI history. EEG data were collected and FC was analyzed using coherence (Coh), imaginary coherence (iCoh), and phase-locking value (PLV) metrics. Network indices based on graph theory were calculated. Demographic and clinical characteristics and scale scores were compared between groups A and B. Results : While the two groups showed no significant differences in demographic characteristics such as age and diagnosis, the Beck Depression Inventory and Suicidal Ideation Questionnaire (SIQ) scores were higher in Group A. Binary logistic regression analyses revealed associations of NSSI with sex and the SIQ score. We examined the connectivity of 1,326 pairs of signals across six frequency bands, yielding 7,956 signal pairs. The two groups showed no significant differences in the Coh, iCoh, corrected PLV, or network indices but showed significant differences in all the frequency bands when an uncorrected t test was used. Conclusion : In this study, FC differences in depression with and without NSSI were not observed. Further well-controlled research is expected to clarify neurobiological underpinnings and guide future interventions.
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Affiliation(s)
- Hye-Jin Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Miseon Shim
- Department of Artificial Intelligence, Tech University of Korea, Siheung, Korea
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Miller AB, Jenness JL, Elton AL, Pelletier-Baldelli A, Patel K, Bonar A, Martin S, Dichter G, Giletta M, Slavich GM, Rudolph KD, Hastings P, Nock M, Prinstein MJ, Sheridan MA. Neural Markers of Emotion Reactivity and Regulation Before and After a Targeted Social Rejection: Differences Among Girls With and Without Suicidal Ideation and Behavior Histories. Biol Psychiatry 2024; 95:1100-1109. [PMID: 37918460 PMCID: PMC11063123 DOI: 10.1016/j.biopsych.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Suicidal thoughts and behaviors (STBs) are common among adolescent girls and increase risk for suicide death. Emotion regulation difficulties are linked with STBs, particularly in response to targeted social rejection. However, neural correlates of this link have not been investigated and may identify novel targets for interventions. Here, we examined neural correlates of emotion regulation before and after an experimentally delivered targeted social rejection in adolescent girls with STBs and girls without STBs (i.e., control participants). METHODS Girls (N = 138; age range, 9-15 years; mean [SD] age = 11.6 [1.79] years) completed a functional neuroimaging emotion regulation task. In the middle of the task, participants were socially rejected by an unfamiliar confederate whom the participants had elected to meet. Participants also completed a multimethod STB assessment. RESULTS Before rejection, girls with a history of STBs, compared with control participants, showed greater activation in the right superior frontal gyrus when passively viewing negative stimuli, and girls with suicidal behavior (SB) versus those without SB showed less activation in the right frontal pole during emotion regulation attempts. Following the rejection, girls with STBs, compared with control participants, showed greater activation in the right inferior frontal gyrus during emotion regulation. CONCLUSIONS Before social rejection, girls with SB versus without SB may not activate brain regions implicated in emotion regulation, suggesting a vulnerability to poor regulation at their baseline emotional state. After social rejection, girls with any history of STBs showed altered activation in a brain region strongly associated with inhibition and emotion regulation success, possibly reflecting increased effort at inhibiting emotional responses during regulation following stress exposure.
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Affiliation(s)
- Adam Bryant Miller
- Mental Health Risk and Resilience Research Program, RTI International, Research Triangle Park, North Carolina; Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Jessica L Jenness
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Amanda L Elton
- Department of Psychiatry, University of Florida, Gainesville, Florida
| | | | - Kinjal Patel
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Adrienne Bonar
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sophia Martin
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gabriel Dichter
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Matteo Giletta
- Department of Developmental, Personality, and Social Psychology, Gent University, Gent, Belgium
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Science, University of California Los Angeles, Los Angeles, California
| | - Karen D Rudolph
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, Illinois
| | - Paul Hastings
- Department of Psychology, University of California Davis, Davis, California
| | - Matthew Nock
- Department of Psychology, Harvard University, Boston, Massachusetts
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Margaret A Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Noor L, Hoffmann J, Meller T, Gaser C, Nenadić I. Amygdala functional connectivity in borderline personality disorder. Psychiatry Res Neuroimaging 2024; 340:111808. [PMID: 38492542 DOI: 10.1016/j.pscychresns.2024.111808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/08/2024] [Accepted: 03/09/2024] [Indexed: 03/18/2024]
Abstract
Borderline personality disorder (BPD) is characterised by structural and functional brain alterations. Yet, there is little data on functional connectivity (FC) across different levels of brain networks and parameters. In this study, we applied a multi-level approach to analyse abnormal functional connectivity. We analysed resting-state functional magnetic resonance imaging (fMRI) data sets of 69 subjects: 17 female BPD patients and 51 age-matched psychiatrically healthy female controls. fMRI was analysed using CONN toolbox including: a) seed-based FC analysis of amygdala connectivity, b) independent component analysis (ICA) based network analysis of intra- and inter-network FC of selected resting-state networks (DMN, SN, FPN), as well as c) graph-theory based measures of network-level characteristics. We show group-level seed FC differences with higher amygdala to contralateral (superior) occipital cortex connectivity in BPD, which correlated with schema-therapy derived measures of symptoms/traits across the entire cohort. While there was no significant group effect on DMN, SN, or FPN intra-network or inter-network FC, we show a significant group difference for local efficiency and cluster coefficient for a DMN-linked cerebellum cluster. Our findings demonstrate BPD-linked changes in FC across multiple levels of observation, which supports a multi-level analysis for future studies to consider different aspects of functional connectome alterations.
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Affiliation(s)
- Laila Noor
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Jonas Hoffmann
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Neurology, Jena University Hospital, Jena, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain and Behavior (CMBB), Marburg, Germany.
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Foster SL, Breukelaar IA, Ekanayake K, Lewis S, Korgaonkar MS. Functional Magnetic Resonance Imaging of the Amygdala and Subregions at 3 Tesla: A Scoping Review. J Magn Reson Imaging 2024; 59:361-375. [PMID: 37352130 DOI: 10.1002/jmri.28836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 06/25/2023] Open
Abstract
The amygdalae are a pair of small brain structures, each of which is composed of three main subregions and whose function is implicated in neuropsychiatric conditions. Functional Magnetic Resonance Imaging (fMRI) has been utilized extensively in investigation of amygdala activation and functional connectivity (FC) with most clinical research sites now utilizing 3 Tesla (3T) MR systems. However, accurate imaging and analysis remains challenging not just due to the small size of the amygdala, but also its location deep in the temporal lobe. Selection of imaging parameters can significantly impact data quality with implications for the accuracy of study results and validity of conclusions. Wide variation exists in acquisition protocols with spatial resolution of some protocols suboptimal for accurate assessment of the amygdala as a whole, and for measuring activation and FC of the three main subregions, each of which contains multiple nuclei with specialized roles. The primary objective of this scoping review is to provide a broad overview of 3T fMRI protocols in use to image the activation and FC of the amygdala with particular reference to spatial resolution. The secondary objective is to provide context for a discussion culminating in recommendations for a standardized protocol for imaging activation of the amygdala and its subregions. As the advantages of big data and protocol harmonization in imaging become more apparent so, too, do the disadvantages of data heterogeneity. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Sheryl L Foster
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Radiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Isabella A Breukelaar
- Brain Dynamics Centre, The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
| | - Kanchana Ekanayake
- University Library, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Lewis
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mayuresh S Korgaonkar
- Brain Dynamics Centre, The Westmead Institute for Medical Research, Westmead, New South Wales, Australia
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Huang Y, Yan R, Zhang Y, Wang X, Sun H, Zhou H, Zou H, Xia Y, Yao Z, Shi J, Lu Q. Abnormal fractional amplitude of low-frequency fluctuations and regional homogeneity in major depressive disorder with non-suicidal self-injury. Clin Neurophysiol 2024; 157:120-129. [PMID: 38101296 DOI: 10.1016/j.clinph.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/18/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE We conducted this resting-state functional magnetic resonance imaging (rsfMRI) study to characterize changes in regional homogeneity (ReHo) or fractional amplitude of low-frequency fluctuations (fALFF) in young adult patients with major depressive disorder (MDD), with or without non-suicidal self-injury (NSSI). METHODS We recruited 54 MDD patients with NSSI (MDD/NSSI), 68 MDD patients without NSSI, which is referred to as simple MDD (sMDD), and 66 matched healthy controls (HCs). A combination of fALFF and ReHo analyses was conducted. The effects of NSSI on the brain and their relationship to clinical variables were examined in this study. RESULTS MDD/NSSI patients have decreased fALFF in the right superior frontal gyrus (SFG) and the right inferior parietal lobe (IPL), decreased ReHo in the right SFG and the right middle temporal gyrus (MTG) and the left middle occipital gyrus (MOG). fALFF and ReHo values of the right SFG are positively correlated. The ReHo values of the right SFG and the number of recent self-injuries are positively correlated; the fALFF values of the right SFG are negatively correlated with NSSI severity. CONCLUSIONS There is a difference in brain activity between MDD/NSSI and sMDD, which may serve as an important physiological marker to determine the risk of self-injury and suicide. SIGNIFICANCE Abnormal brain activity in patients with NSSI may provide new perspectives and significant implications on the severity of MDD patients and the prevention of self-injury and suicide.
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Affiliation(s)
- Yinghong Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China
| | - Rui Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yu Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Department of Clinical Psychology, The Affiliated Hangzhou First People's Hospital of Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Xiaoqin Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hao Sun
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China
| | - Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Haowen Zou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, China; School of Biological Sciences and Medical Engineering, Southeast University, 2 Sipailou, Nanjing 210096, China.
| | - Jiabo Shi
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, 2 Sipailou, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing 210096, China.
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Patel KK, Sheridan MA, Bonar AS, Giletta M, Hastings PD, Nock MK, Rudolph KD, Slavich GM, Prinstein MJ, Miller AB. A preliminary investigation into cortical structural alterations in adolescents with nonsuicidal self-injury. Psychiatry Res Neuroimaging 2023; 336:111725. [PMID: 38456014 PMCID: PMC10917139 DOI: 10.1016/j.pscychresns.2023.111725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
The structural neural correlates underlying youth nonsuicidal self-injury (NSSI) warrant further exploration. Few studies have explored the association between NSSI and brain structure in adolescence, and no studies have investigated differences in the relation between age and brain structure in youth with NSSI. This preliminary investigation examined associations between NSSI history, age, and cortical structure using magnetic resonance imaging in adolescent girls (N=100, Mage=13.4 years) at increased risk for psychopathology. We conducted whole-brain analyses to investigate the associations between age and cortical structure, NSSI history and cortical structure, and NSSI history as a moderator of the association between age and cortical structure. Results suggested that age was associated with less cortical thickness and surface area in the left and right prefrontal, temporal, and parietal cortex. NSSI history was associated with less left insula and left inferior parietal cortex cortical surface area. Among adolescents with NSSI history, older age predicted greater left inferior parietal cortex surface area and was not associated with left precentral cortex surface area. Among adolescents without NSSI history, older age predicted smaller surface areas as expected with the typical trajectory of neurodevelopment. Overall, our results suggest differences in cortical surface area development in adolescents with NSSI history.
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Affiliation(s)
- Kinjal K Patel
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Margaret A Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adrienne S Bonar
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matteo Giletta
- Department of Developmental, Personality, and Social Psychology, Ghent University, Ghent, Belgium
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Paul D Hastings
- Department of Psychology, University of California, Davis, Davis, CA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Karen D Rudolph
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adam Bryant Miller
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- RTI International, Research Triangle Park, NC, USA
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Otto A, Jarvers I, Kandsperger S, Reichl C, Ando A, Koenig J, Kaess M, Brunner R. Stress-induced alterations in resting-state functional connectivity among adolescents with non-suicidal self-injury. J Affect Disord 2023; 339:162-171. [PMID: 37437722 DOI: 10.1016/j.jad.2023.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/12/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a major mental health problem among youth worldwide. Dysfunction in emotion regulation contributes to NSSI, but research on the underlying neurobiological mechanisms of NSSI is limited. Adolescents with emotion regulation difficulties are vulnerable to stress, making them susceptible to maladaptive coping mechanisms such as NSSI. METHODS This study examined the functional neurocircuitry relevant to emotion regulation and stress coping in individuals with NSSI compared with healthy controls. This case-control study included 34 adolescents with NSSI (15.91 years) and 28 (16.0 years) unaffected controls. Participants underwent a functional magnetic resonance imaging scan before and after completing a laboratory stress-induction paradigm (the Montreal Imaging Stress Test). The effects of stress induction were quantified by both physiological measures and self-reports. RESULTS Participants with NSSI showed distinctive alterations in functional resting-state following stress induction, which differentiated them from unaffected controls. Results show a reduction in functional connectivity between frontoparietal regions and the angular gyrus within the patient group compared to controls, as well as an increase in functional connectivity between visual regions, the insular cortex, the planum polare, and the central opercular cortex. After conditions of acute stress, adolescents with NSSI show changes in functional connectivity of regions associated with sensorimotor alertness, attention, and effortful emotion regulation. LIMITATIONS The patient group showed both NSSI and suicidal behavior, therefore results might be partly due to suicidality. CONCLUSION The findings emphasize the importance of targeting emotion regulation within therapeutic approaches to enhance stress coping capacity, which in turn may contribute to counteracting self-injurious behavior.
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Affiliation(s)
- Alexandra Otto
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Irina Jarvers
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Stephanie Kandsperger
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ayaka Ando
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Romuald Brunner
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany.
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Başgöze Z, Demers L, Thai M, Falke CA, Mueller BA, Fiecas MB, Roediger DJ, Thomas KM, Klimes-Dougan B, Cullen KR. A Multilevel Examination of Cognitive Control in Adolescents With Nonsuicidal Self-injury. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:855-866. [PMID: 37881532 PMCID: PMC10593942 DOI: 10.1016/j.bpsgos.2023.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 10/27/2023] Open
Abstract
Background Nonsuicidal self-injury (NSSI), a transdiagnostic behavior, often emerges during adolescence. This study used the Research Domain Criteria approach to examine cognitive control (CC) with a focus on response inhibition and urgency relative to NSSI severity in adolescents. Methods One hundred thirty-eight adolescents, assigned female sex at birth, with a continuum of NSSI severity completed negative and positive urgency measurements (self-report), an emotional Go/NoGo task within negative and positive contexts (behavioral), and structural and functional imaging during resting state and task (brain metrics). Cortical thickness, subcortical volume, resting-state functional connectivity, and task activation focused on an a priori-defined CC network. Eighty-four participants had all these main measures. Correlations and stepwise model selection followed by multiple regression were used to examine the association between NSSI severity and multiunit CC measurements. Results Higher NSSI severity correlated with higher negative urgency and lower accuracy during positive no-inhibition (Go). Brain NSSI severity correlates varied across modalities and valence. For right medial prefrontal cortex and right caudate, higher NSSI severity correlated with greater negative but lower positive inhibition (NoGo) activation. The opposite pattern was observed for the right dorsolateral prefrontal cortex. Higher NSSI severity correlated with lower left dorsal anterior cingulate cortex (ACC) negative inhibition activation and thicker left dorsal ACC, yet it was correlated with higher right rostral ACC positive inhibition activation and thinner right rostral ACC, as well as lower CC network resting-state functional connectivity. Conclusions Findings revealed multifaceted signatures of NSSI severity across CC units of analysis, confirming the relevance of this domain in adolescent NSSI and illustrating how multimodal approaches can shed light on psychopathology.
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Affiliation(s)
- Zeynep Başgöze
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Lauren Demers
- Child Development & Rehabilitation Center, Oregon Health & Science University, Portland, Oregon
| | - Michelle Thai
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Chloe A. Falke
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Bryon A. Mueller
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Mark B. Fiecas
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Donovan J. Roediger
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Kathleen M. Thomas
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | | | - Kathryn R. Cullen
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
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10
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Mürner-Lavanchy I, Koenig J, Güzel N, van der Venne P, Höper S, Cavelti M, Kaess M. Prefrontal oxygenation varies as a function of response inhibition performance in healthy participants but not in youth with non-suicidal self-injury. Psychiatry Res Neuroimaging 2023; 334:111697. [PMID: 37562206 DOI: 10.1016/j.pscychresns.2023.111697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/24/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
Non-suicidal self-injury (NSSI), a highly prevalent symptom in adolescence, has been associated with impulsivity. Behavioral measures of response inhibition in combination with the recording of brain activity potentially improve the understanding of the etiology of the behavior. We therefore investigated prefrontal cortex (PFC) oxygenation during a response inhibition task using functional near-infrared spectroscopy (fNIRS) in n = 152 adolescents with NSSI and n = 47 healthy controls. We compared groups regarding behavioral performance and PFC oxygenation and tested whether the association between task performance and PFC oxygenation differed between groups. PFC oxygenation was slightly higher in adolescents with NSSI than in controls. Further, there was evidence for a group by performance interaction: In healthy controls, higher oxygenated hemoglobin was associated with better task performance, which was not the case in the NSSI group. We did not find evidence of associations between PFC oxygenation and clinical measures. Our study provides preliminary evidence of altered brain functional correlates of response inhibition in adolescents with NSSI potentially reflecting deficient top-down regulation of limbic regions through prefrontal regions. Due to methodological limitations of the current study, findings must be interpreted with caution and future studies should optimize task designs for fNIRS processing.
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Affiliation(s)
- Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany; Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Nebile Güzel
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Patrice van der Venne
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Saskia Höper
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Marialuisa Cavelti
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany.
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Pollak OH, Kwon SJ, Jorgensen NA, Lindquist KA, Telzer EH, Prinstein MJ. Neural Reactivity to Social Punishment Predicts Future Engagement in Nonsuicidal Self-injury Among Peer-Rejected Adolescents. Biol Psychiatry 2023; 94:40-49. [PMID: 36411092 DOI: 10.1016/j.biopsych.2022.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Rates of nonsuicidal self-injury (NSSI) increase dramatically in adolescence. Affective reactivity and adverse social experiences have been linked to NSSI, but less is known about whether these factors may separately or interactively predict NSSI, especially longitudinally. This study combined functional magnetic resonance imaging and a sociometric measure to test whether a combination of neural (e.g., amygdala) reactivity to social punishment and peer-nominated peer acceptance/rejection predicts NSSI longitudinally in adolescence. Amygdala reactivity was examined as a potential neural marker of affective reactivity to social punishment, which may heighten NSSI risk in contexts of social adversity. METHODS One hundred twenty-five adolescents (63 female) completed a social incentive delay task during neuroimaging and school-based peer nominations to measure peer acceptance/rejection. NSSI engagement was assessed at baseline and 1-year follow-up. RESULTS Greater amygdala reactivity to social punishment predicted greater NSSI engagement 1 year later among adolescents with high peer rejection. This effect for the amygdala was specific to social punishment (vs. reward) and held when controlling for biological sex and pubertal development. Exploratory analyses found that ventral striatum reactivity to social reward and punishment similarly interacted with peer rejection to predict NSSI but that amygdala connectivity with salience network regions did not. CONCLUSIONS Amygdala reactivity to social punishment, in combination with high peer rejection, may increase NSSI risk in adolescence, possibly via heightened affective reactivity to adverse social experiences. Objective measures of neurobiological and social risk factors may improve prediction of NSSI, while therapeutic approaches that target affective reactivity and increase prosocial skills may protect against NSSI in adolescence.
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Affiliation(s)
- Olivia H Pollak
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Seh-Joo Kwon
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nathan A Jorgensen
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kristen A Lindquist
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eva H Telzer
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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12
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Deng W, Yan S, Xu Y, Lu Z, Liu L, Zhou Y, Chen M. Effects of BPD tendencies and subjective well-being on NSSI in adolescents with PTSD. Front Psychiatry 2023; 14:1152352. [PMID: 37398590 PMCID: PMC10308082 DOI: 10.3389/fpsyt.2023.1152352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/04/2023] [Indexed: 07/04/2023] Open
Abstract
Background Severe posttraumatic stress disorder (PTSD) may lead to non-suicidal self-injury (NSSI), and borderline personality disorder (BPD) tendencies may play a role in this process. Secondary vocational students experience more social, familial and other pressures and are more vulnerable to psychological problems. Thus, we explored the effect of BPD tendencies and subjective well-being (SWB) on NSSI in secondary vocational students with PTSD. Methods A total of 2,160 Chinese secondary vocational students in Wuhan participated in our cross-sectional investigation. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), criteria for PTSD, NSSI Questionnaire, Personality Diagnostic Questionnaire-4+, subjective well-being scale, and family adaptation, partnership, growth, affection, and resolve (APGAR) Index were used. We conducted a binary logistic regression model and linear regression analysis. Results Sex (odds ratio [OR] = 0.354, 95% confidence interval [CI] = 0.171-0.733), BPD tendencies (OR = 1.192, 95% CI = 1.066-1.333) and SWB (OR = 0.652, 95% CI = 0.516-0.824) were independent factors that predicted NSSI in secondary vocational students with PTSD. Spearman's correlation analysis showed that BPD tendencies were positively correlated with NSSI frequency (r = 0.282, P < 0.01). SWB was negatively correlated with NSSI frequency (r = -0.301, P < 0.01). The linear regression showed that BPD tendencies (β = 0.137, P < 0.05 and β = -0.230, P < 0.001) were significantly correlated with NSSI frequency. Spearman's correlation analysis showed that family functioning was positively correlated with SWB (r = 0.486, P < 0.01) and negatively correlated with BPD tendencies (r = -0.296, P < 0.01). Conclusion In adolescents, PTSD in response to stressful events could lead to NSSI, and BPD tendencies promote the intensity of NSSI, while SWB diminishes its intensity. Improvement in family functioning may actively guide the development of mental health and improve SWB; such steps may constitute interventions to prevent or treat NSSI.
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Affiliation(s)
- Weixi Deng
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong, University of Science and Technology, Wuhan, China
| | - Shu Yan
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yongjun Xu
- Wuhan Dongfang Bode Psychiatric Hospital, Wuhan, China
| | - Zhaoyuan Lu
- School of Medicine, Jianghan University, Wuhan, China
| | - Lianzhong Liu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong, University of Science and Technology, Wuhan, China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yang Zhou
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Mo Chen
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
- Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan, China
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13
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Nawaz H, Shah I, Ali S. The amygdala connectivity with depression and suicide ideation with suicide behavior: A meta-analysis of structural MRI, resting-state fMRI and task fMRI. Prog Neuropsychopharmacol Biol Psychiatry 2023; 124:110736. [PMID: 36842608 DOI: 10.1016/j.pnpbp.2023.110736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/11/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023]
Abstract
In recent decades, the primary intention of neuroscientists and psychiatrics is to evaluate the connectivity between brain regions and psychiatric disorders. The amygdala has central immersion in memory alliance, stress response, emotional perception, and automatic responses to emotional stimuli. This paper uses a meta-analysis approach to establish the relationship between structural resting state and functional amygdala connectivity with depression and suicide ideation with suicide behavior. In addition, this study explores the moderating effect of patients' demographic characteristics (gender and age) based on 30 studies. The results show that structural amygdala connectivity is positively related to the instability of depression, while for resting and task functional connectivity amygdala shows a significant negative connection with depression. Furthermore, the amygdala showed a partial activation for non-suicide self-injuries and suicide ideation. From structural and functional magnetic imaging, the current findings also support the moderating effect of the age of the participants on the amygdala connectivity with psychiatric conditions. Generally, amygdala connectivity with psychiatric disorders was not significantly moderate with the role of gender, however, this study enhances the existing hypothetical review articles and confirms the connectivity of the psychological condition with the amygdala region. It concludes that the amygdala plays a vital role in regulating and responding to emotions.
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Affiliation(s)
- Humma Nawaz
- Department of Statistics, Quaid-i-Azam University, 45320 Islamabad, Pakistan
| | - Ismail Shah
- Department of Statistics, Quaid-i-Azam University, 45320 Islamabad, Pakistan.
| | - Sajid Ali
- Department of Statistics, Quaid-i-Azam University, 45320 Islamabad, Pakistan.
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14
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Won GH, Bae S, Kim HK, Choi TY. Subcortical volume analysis in non-suicidal self-injury adolescents: A pilot study. Psychiatry Res Neuroimaging 2023; 331:111617. [PMID: 36907098 DOI: 10.1016/j.pscychresns.2023.111617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/23/2023] [Accepted: 02/19/2023] [Indexed: 02/25/2023]
Abstract
Given the high prevalence of non-suicidal self-injury (NSSI) among teenagers worldwide, the underlying mechanisms promoting such behavior must be urgently investigated. This study aimed to investigate neurobiological changes in the regional brain in adolescents with NSSI by comparing the volumes of the subcortical structures of 23 female adolescents with NSSI and 23 healthy controls with no history of psychiatric diagnosis or treatment. The NSSI group comprised those who underwent inpatient treatment for non-suicidal self-harm behavior at the Department of Psychiatry at Daegu Catholic University Hospital from July 1, 2018, to December 31, 2018. The control group comprised healthy adolescents from the community. We compared differences in the volume of the bilateral thalamus, caudate, putamen, hippocampus, and amygdala. All statistical analyses were conducted using SPSS Statistics Version 25. The NSSI group exhibited decreased subcortical volume in the left amygdala and marginally decreased subcortical volume in the left thalamus. Our results provide important clues about adolescent NSSI's underlying biology. Analysis of subcortical volumes between the NSSI and normal groups revealed subcortical volume differences in the left amygdala and thalamus, part of the core cerebral regions responsible for emotional processing and regulation, which may help explain the neurobiological mechanism of NSSI.
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Affiliation(s)
- Geun Hui Won
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Sujin Bae
- Office of Research, Chung-Ang University, Seoul, Republic of Korea
| | - Ho Kyun Kim
- Department of Radiology, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Tae Young Choi
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea.
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15
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Westlund Schreiner M, Roberts H, Dillahunt AK, Farstead B, Feldman D, Thomas L, Jacobs RH, Bessette KL, Welsh RC, Watkins ER, Langenecker SA, Crowell SE. Negative association between non-suicidal self-injury in adolescents and default mode network activation during the distraction blocks of a rumination task. Suicide Life Threat Behav 2023; 53:510-521. [PMID: 36942887 PMCID: PMC10441767 DOI: 10.1111/sltb.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/17/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Rumination, or repetitive and habitual negative thinking, is associated with psychopathology and related behaviors in adolescents, including non-suicidal self-injury (NSSI). Despite the link between self-reported rumination and NSSI, there is limited understanding of how rumination is represented at the neurobiological level among youth with NSSI. METHOD We collected neuroimaging and rumination data from 39 adolescents with current or past NSSI and remitted major depression. Participants completed a rumination induction fMRI task, consisting of both rumination and distraction blocks. We examined brain activation associated with total lifetime NSSI in the context of the rumination versus distraction contrast. RESULTS Lifetime NSSI was associated with a greater discrepancy in activation during rumination relative to distraction conditions in clusters including the precuneus, posterior cingulate, superior, and middle frontal gyrus, and cerebellum. CONCLUSION Difficulties associated with rumination in adolescents with NSSI may be related to requiring greater cognitive effort to distract from ruminative content in addition to increased attention in the context of ruminative content. Increasing knowledge of neurobiological circuits and nodes associated with rumination and their relationship with NSSI may enable us to better tailor interventions that can facilitate lasting well-being and neurobiological change.
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Affiliation(s)
- Mindy Westlund Schreiner
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | | | - Alina K Dillahunt
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Brian Farstead
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Daniel Feldman
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Leah Thomas
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Rachel H Jacobs
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Katie L Bessette
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | - Robert C Welsh
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | | | - Scott A Langenecker
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
| | - Sheila E Crowell
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
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16
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Carosella KA, Mirza S, Başgöze Z, Cullen KR, Klimes-Dougan B. Adolescent non-suicidal self-injury during the COVID-19 pandemic: A prospective longitudinal study of biological predictors of maladaptive emotion regulation. Psychoneuroendocrinology 2023; 151:106056. [PMID: 36822129 PMCID: PMC9922437 DOI: 10.1016/j.psyneuen.2023.106056] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) in adolescence is thought to stem from interactions between vulnerability in developing biological systems and experience of stressors. The current study assesses whether multiple levels of the stress system's response to threat could prospectively predict NSSI engagement during the COVID-19 pandemic, a shared, time-locked stressor. METHODS Participants were 64 female adolescents (ages 12-16) from community and clinical settings who were oversampled for NSSI histories. Prior to the onset of the COVID-19 pandemic, adolescents completed a protocol that measured hypothalamic-pituitary-adrenal axis response to a social stressor (via salivary cortisol), amygdala volume, amygdala emotion-evoked activation, and frontolimbic resting-state functional connectivity. During early months of the pandemic (Summer 2020), measures of NSSI behavior (Inventory of Statements About Self-Injury), emotion regulation difficulties (Difficulties in Emotion Regulation Scale), perceived stress (Perceived Stress Scale), and pandemic-related stressors (Epidemic Pandemic Impacts Inventory) were collected. Multinomial logistic regression was used to assess if pre-pandemic biomarkers predicted mid-pandemic NSSI engagement: persistence of NSSI (Persist; N = 21), cessation of NSSI (Desist; N = 26), and no history of NSSI (Never; N = 17). Linear regressions explored if pre-pandemic biomarkers predicted mid-pandemic difficulties in emotion regulation and perceived stress. RESULTS Higher pre-pandemic overall cortisol response to stress and amygdala emotion-evoked activation characterized adolescents who persisted in NSSI, compared to those who desisted. These findings remained significant when controlling for pandemic related stressors. Lower prepandemic cortisol reactivity predicted more difficulties in emotion regulation during the pandemic. This finding did not remain significant after controlling for pandemic related stressors. CONCLUSIONS Findings suggest that patterns in key biological threat response systems may confer vulnerability for risk outcomes including NSSI engagement in adolescent females in the context of a shared, novel, naturally-occurring stressor. The results point to the importance of multi-level, longitudinal approaches for understanding the interface between developing neurobiological systems and experiential stress in at-risk adolescents. Identified patterns give insight into potential risk assessment strategies based on an understanding of the multi-level threat response.
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Affiliation(s)
| | | | - Zeynep Başgöze
- Psychiatry and Behavioral Sciences, University of Minnesota Medical School, USA
| | - Kathryn R Cullen
- Psychiatry and Behavioral Sciences, University of Minnesota Medical School, USA
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17
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Yan H, Yue W. Risk factors, theoretical models, and biological mechanisms of nonsuicidal self-injury: a brief review. INTERDISCIPLINARY NURSING RESEARCH 2023; 2:112-120. [PMID: 37645376 PMCID: PMC10461723 DOI: 10.1097/nr9.0000000000000023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/07/2023] [Indexed: 08/31/2023]
Abstract
Nonsuicidal self-injury (NSSI) refers to the direct, deliberate infliction of harm to one's body tissue without the intention to die. The prevalence of NSSI has increased significantly globally in recent years and has become an important public health problem affecting the health of people, especially adolescents. The occurrence of NSSI in adolescents is the result of the interaction of different factors. Many scholars have proposed various theoretical models to explain the mechanism of NSSI behavior based on previous research on the influencing factors of NSSI. Moreover, advances have been made in genetic and neuroimaging mechanisms related to NSSI. Understanding the genetic and neuroimaging mechanisms of NSSI is important for both describing and treating the disorder. This literature review discusses the progress made on the risk factors, theoretical models, and biological mechanisms of NSSI.
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Affiliation(s)
- Huiru Yan
- School of Nursing and Sixth Hospital, Peking University, Beijing, China
- Institute of Mental Health, Peking University Sixth Hospital and Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder of Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health and (Peking University Sixth Hospital), Beijing, China
| | - Weihua Yue
- Institute of Mental Health, Peking University Sixth Hospital and Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder of Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health and (Peking University Sixth Hospital), Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
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18
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Mürner-Lavanchy I, Josi J, Koenig J, Reichl C, Brunner R, Kaess M. Resting-state functional connectivity predicting clinical improvement following treatment in female adolescents with non-suicidal self-injury. J Affect Disord 2023; 327:79-86. [PMID: 36739001 DOI: 10.1016/j.jad.2023.01.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is highly prevalent among adolescents and predicts future psychopathology including suicide. To improve therapeutic decisions and clinical outcome of patients engaging in NSSI, it seems beneficial to determine neurobiological markers associated with treatment response. The present study investigated whether resting-state functional brain connectivity (RSFC) served to predict clinical improvements following treatment in adolescents engaging in NSSI. METHODS N = 27 female adolescents with NSSI took part in a baseline MRI exam and clinical outcome was assessed at follow-ups one, two and three years after baseline. During the follow-up period, patients received in- and/or outpatient treatment. Mixed-effects linear regression models were calculated to examine whether RSFC was associated with clinical improvement. RESULTS Patients' clinical outcome improved across time. Lower baseline RSFC between left paracentral gyrus and right anterior cingulate gyrus was associated with clinical improvement from baseline to one-year and from two-year to three-year follow-up. Lower and higher baseline RSFC in several inter- and intrahemispheric cortico-cortical and cortico-subcortical connections of interest were associated with clinical symptomatology and its severity, independent from time. LIMITATIONS A relatively small sample size constrains the generalizability of our findings. Further, no control group not receiving treatment was recruited, therefore clinical changes across time cannot solely be attributed to treatment. CONCLUSIONS While there was some evidence that RSFC was associated with clinical improvement following treatment, our findings suggest that functional connectivity is more predictive of severity of psychopathology and global functioning independent of time and treatment. We thereby add to the limited research on neurobiological markers as predictors of clinical outcome after treatment.
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Affiliation(s)
- Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Johannes Josi
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Romuald Brunner
- Clinic and Policlinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany.
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Grove JL, Carlson SE, Parkhurst KA, O’Neill JC, Smith TW. Nonsuicidal self-injury, sleep quality, and shame response to a laboratory stress task. J Clin Psychol 2023; 79:871-885. [PMID: 36223526 PMCID: PMC9925399 DOI: 10.1002/jclp.23450] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/26/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Nonsuicidal self-injury (NSSI) frequently functions to regulate shame-based emotions and cognitions in the context of interpersonal stress. The present study sought to examine how sleep quality (SQ) may influence this process in a laboratory setting. METHODS Participants included 72 adults (Mage = 24.28; 36 with a lifetime history of NSSI) who completed a self-report measure of prior month SQ and engaged in a modified Trier social stress task (TSST). State shame ratings were collected immediately before and following the TSST, as well as 5 min post-TSST, to allow for the measurement of shame reactivity and recovery. RESULTS No significant results emerged for NSSI history and SQ as statistical predictors of shame reactivity. However, NSSI history was significantly associated with heightened shame intensity during the recovery period of the task, and this was moderated by SQ. Simple slopes analyses revealed a conditional effect whereby poorer SQ (1SD above the mean) was associated with greater intensity of shame during recovery, but only for those with a history of NSSI. CONCLUSION Poor SQ may contribute to worrisome emotional responses to daytime stressors in those at risk for NSSI.
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Lee SM, Cha J, Hong M. Increased Right Dorsolateral Prefrontal Cortex Connectivity During Emotion Recognition Task in Adolescents With Self-Injurious Behavior: A Functional Near-Infrared Spectroscopy Study. Psychiatry Investig 2023; 20:137-143. [PMID: 36891598 PMCID: PMC9996148 DOI: 10.30773/pi.2022.0152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/24/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE Research on neural correlates in the prefrontal cortex (PFC) associated with self-injurious behavior has mainly been performed in adults. However, studies on adolescents are scarce. We aimed to investigate the activation and connectivity of the PFC between adolescents with self-injurious behavior (ASI) and psychiatric controls (PC) using functional near-infrared spectroscopy (fNIRS). METHODS We used an emotion recognition task during fNIRS to assess 37 adolescents (23 with self-injurious behavior and 14 PC) between June 2020 and October 2021 and compared connectivity and activation between the two groups. We also measured adverse childhood events (ACE, Adverse Childhood Experiences) and performed a correlation analysis of channel activation according to ACE total scores. RESULTS The difference in activation between the groups was not statistically significant. The connectivity of channel 6 was statistically significant. The interaction between channel 6 and the ACE total score showed statistical significance between the two groups(t[33] -2.61; p=0.014). The ASI group showed a negative correlation with the total ACE score. CONCLUSION This is the first study to investigate PFC connectivity using fNIRS in ASI. It has the implication of a novel attempt with a practically useful tool to uncover neurobiological differences among Korean adolescents.
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Affiliation(s)
- Sang Min Lee
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | | | - Minha Hong
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea.,UNC Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
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Malejko K, Hafner S, Brown RC, Plener PL, Grön G, Graf H, Abler B. Neural Signatures of Error Processing in Depressed Adolescents with Comorbid Non-Suicidal Self-Injury (NSSI). Biomedicines 2022; 10:3188. [PMID: 36551944 PMCID: PMC9775576 DOI: 10.3390/biomedicines10123188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/24/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Non-suicidal self-injury (NSSI), as a highly prevalent psychiatric symptom in adolescents and young adults, is defined as the deliberate destruction of body tissue without suicidal intent. Impulsivity and dysfunctional response inhibition have been suggested to play a central role in adolescents' vulnerability to self-harm. To investigate the potentially distinct neurobiology of NSSI, we used a well-established Go/No Go task in which activation of the inferior frontal gyrus (IFG) and dorsal anterior cingulate cortex (dACC) is interpreted as a neural correlate of processing failed response inhibition. Task-based functional magnetic resonance imaging data were obtained from 14 adolescents with a diagnosis of major depression and a history of NSSI (MD-NSSI), 13 depressed adolescents without NSSI (MD-only), and 14 healthy controls (HC). In line with hypotheses of dysfunctional response inhibition, we observed increased rates of commission errors in MD-NSSI along with significantly reduced error-related activations of the dACC and IFG. Intact response inhibition, as reflected by low commission error rates not different from HC, was observed in MD-only, along with increased activation of the error-processing network. Our findings support the hypothesis of a distinct neurobiological signature of NSSI. Further research on biomarkers of NSSI could focus on behavioral and neural correlates of failed response inhibition.
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Affiliation(s)
- Kathrin Malejko
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
| | - Stefan Hafner
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
| | - Rebecca C. Brown
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, 89075 Ulm, Germany
| | - Paul L. Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, 89075 Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria
| | - Georg Grön
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
| | - Heiko Graf
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
| | - Birgit Abler
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
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22
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Kang L, Wang W, Zhang N, Nie Z, Gong Q, Yao L, Tu N, Feng H, Zong X, Bai H, Wang G, Bu L, Wang F, Liu Z. Superior temporal gyrus and cerebellar loops predict nonsuicidal self-injury in major depressive disorder patients by multimodal neuroimaging. Transl Psychiatry 2022; 12:474. [PMID: 36357369 PMCID: PMC9649804 DOI: 10.1038/s41398-022-02235-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
In major depressive disorder (MDD) patients, nonsuicidal self-injury (NSSI) is a common comorbidity, and it is important to clarify the underlying neurobiology. Here, we investigated the association of NSSI with brain function and structure in MDD patients. A total of 260 MDD patients and 132 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging and three-dimensional T1-weighted structural scans. NSSI behaviour was assessed through interviews. Voxel-based morphometry analysis (VBM), regional homogeneity analysis (ReHo), functional connectome topology properties and network-based statistics were used to detect the differences in neuroimaging characteristics. Finally, the random forest method was used to evaluate whether these factors could predict NSSI in MDD. Compared with HCs, MDD patients with a history of NSSI showed significant right putamen grey matter volume (GMV), right superior orbital frontal cortex ReHo, left pallidum degree centrality, and putamen-centre function network differences. Compared to MDD subjects without NSSI, those with past NSSI showed significant right superior temporal gyrus (STG) GMV, right lingual gyrus ReHo, sigma and global efficiency, and cerebellum-centre function network differences. The right STG GMV and cerebellum-centre function network were more important than other factors in predicting NSSI behaviour in MDD. MDD patients with a history of NSSI have dysregulated spontaneous brain activity and structure in regions related to emotions, pain regulation, and the somatosensory system. Importantly, right STG GMV and cerebellar loops may play important roles in NSSI in MDD patients.
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Affiliation(s)
- Lijun Kang
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Wang
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Nan Zhang
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhaowen Nie
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qian Gong
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lihua Yao
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ning Tu
- grid.412632.00000 0004 1758 2270PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongyan Feng
- grid.412632.00000 0004 1758 2270PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaofen Zong
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hanping Bai
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gaohua Wang
- grid.412632.00000 0004 1758 2270Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lihong Bu
- PET/CT/MRI and Molecular Imaging Center, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Fei Wang
- Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China. .,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China.
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China. .,Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, China.
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23
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Wang K, He Q, Zhu X, Hu Y, Yao Y, Hommel B, Beste C, Liu J, Yang Y, Zhang W. Smaller putamen volumes are associated with greater problems in external emotional regulation in depressed adolescents with nonsuicidal self-injury. J Psychiatr Res 2022; 155:338-346. [PMID: 36179414 DOI: 10.1016/j.jpsychires.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/17/2022] [Accepted: 09/16/2022] [Indexed: 10/31/2022]
Abstract
The functions of nonsuicidal self-injury (NSSI) consist of social and emotional aspects (Social influence, Sensation seeking, Internal and External emotion regulation). Previous studies have indicated that dysfunction in reward-related brain structures especially the striatum might drive this habitual behavior. However, no studies to date have investigated the associations between striatum and different functions for adolescents engaging in NSSI behaviors. Here, we recruited 35 depressed adolescents with recent NSSI behaviors and 36 healthy controls and acquired structural brain images, depressive symptoms, social, academic and family environments assessments, in addition to NSSI functions in patients only. Subcortical volumes and cortical thickness were estimated with FreeSurfer. Mixed linear regressions were performed to examine associations between striatal structures (caudate, putamen, nucleus accumbens, pallidum) and NSSI functions, with age, sex, total intracranial volume, hemisphere and depression severity included as covariates. Effect of environmental factors and potential associations with cortical thickness and other subcortical volumes were also tested. We found that, among the four functions, external emotional regulation represented the main function for NSSI engagement. Increased external emotion regulation was significantly associated with smaller putamen volume. No environmental factors biased the association with putamen. No associations with other cortical or subcortical regions were observed. Our findings suggested that smaller putamen might be a biomarker of NSSI engagement for depressed adolescents when they regulated frustrated or angry emotions. The results have potentially clinical implications in early identification and brain intervention of NSSI in youth.
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Affiliation(s)
- Kangcheng Wang
- School of Psychology, Shandong Normal University, Jinan, 250358, China
| | - Qiang He
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Xingxing Zhu
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Yufei Hu
- School of Psychology, Shandong Normal University, Jinan, 250358, China
| | - Yuan Yao
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, China
| | - Bernhard Hommel
- School of Psychology, Shandong Normal University, Jinan, 250358, China; Cognitive Psychology Unit, & Leiden Institute for Brain & Cognition, Institute of Psychology, Leiden University, Netherlands; Department of Child and Adolescent Psychiatry, TU Dresden, Germany
| | - Christian Beste
- School of Psychology, Shandong Normal University, Jinan, 250358, China; Department of Child and Adolescent Psychiatry, TU Dresden, Germany; University Neuropsychology Center, TU Dresden, Germany
| | - Jintong Liu
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; Childhood Psychiatry Unit, Shandong Mental Health Center, Jinan, 250014, China
| | - Ying Yang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; Childhood Psychiatry Unit, Shandong Mental Health Center, Jinan, 250014, China.
| | - Wenxin Zhang
- School of Psychology, Shandong Normal University, Jinan, 250358, China.
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24
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Catalogna M, Sasson E, Hadanny A, Parag Y, Zilberman-Itskovich S, Efrati S. Effects of hyperbaric oxygen therapy on functional and structural connectivity in post-COVID-19 condition patients: A randomized, sham-controlled trial. Neuroimage Clin 2022; 36:103218. [PMID: 36208548 PMCID: PMC9528018 DOI: 10.1016/j.nicl.2022.103218] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Post-COVID-19 condition refers to a range of persisting physical, neurocognitive, and neuropsychological symptoms after SARS-CoV-2 infection. Abnormalities in brain connectivity were found in recovered patients compared to non-infected controls. This study aims to evaluate the effect of hyperbaric oxygen therapy (HBOT) on brain connectivity in post-COVID-19 patients. METHODS In this randomized, sham-controlled, double-blind trial, 73 patients were randomized to receive 40 daily sessions of HBOT (n = 37) or sham treatment (n = 36). We examined pre- and post-treatment resting-state brain functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) scans to evaluate functional and structural connectivity changes, which were correlated to cognitive and psychological distress measures. RESULTS The ROI-to-ROI analysis revealed decreased internetwork connectivity in the HBOT group which was negatively correlated to improvements in attention and executive function scores (p < 0.001). Significant group-by-time interactions were demonstrated in the right hippocampal resting state function connectivity (rsFC) in the medial prefrontal cortex (PFWE = 0.002). Seed-to-voxel analysis also revealed a negative correlation in the brief symptom inventory (BSI-18) score and in the rsFC between the amygdala seed, the angular gyrus, and the primary sensory motor area (PFWE = 0.012, 0.002). Positive correlations were found between the BSI-18 score and the left insular cortex seed and FPN (angular gyrus) (PFWE < 0.0001). Tractography based structural connectivity analysis showed a significant group-by-time interaction in the fractional anisotropy (FA) of left amygdala tracts (F = 7.81, P = 0.007). The efficacy measure had significant group-by-time interactions (F = 5.98, p = 0.017) in the amygdala circuit. CONCLUSIONS This study indicates that HBOT improves disruptions in white matter tracts and alters the functional connectivity organization of neural pathways attributed to cognitive and emotional recovery in post-COVID-19 patients. This study also highlights the potential of structural and functional connectivity analysis as a promising treatment response monitoring tool.
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Affiliation(s)
- Merav Catalogna
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Efrat Sasson
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Amir Hadanny
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel- Aviv University, Tel-Aviv, Israel
| | - Yoav Parag
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Shani Zilberman-Itskovich
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel- Aviv University, Tel-Aviv, Israel
| | - Shai Efrati
- Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel- Aviv University, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
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25
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Zhang F, Wang C, Lan X, Li W, Fu L, Ye Y, Liu H, Wu K, Zhou Y, Ning Y. The functional connectivity of the middle frontal cortex predicts ketamine’s outcome in major depressive disorder. Front Neurosci 2022; 16:956056. [PMID: 36188452 PMCID: PMC9521309 DOI: 10.3389/fnins.2022.956056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background Ketamine, a robust antidepressant, has promising potential in the treatment of major depressive disorder (MDD). However, it does not work for all MDD patients, and the mechanism underlying its anti-depressive effects is unclear. Researchers have explored the mechanisms of ketamine action in MDD patients through MRI, a technique that measures brain activity intuitively. Notably, many MRI results were inconsistent because they selected different brain regions as seeds, particularly with respect to functional connectivity (FC) analysis. To eliminate the influence of prior seeds as much as possible, we used the significantly different results in degree centrality (DC) analysis as seeds to explore the FC changes in MDD patients to identify an imaging biomarker of ketamine’s effect. Methods Forty-four MDD patients and 45 healthy controls (HCs) were included in the study. Patients, aged 18–65, received six intravenous ketamine injections over 12 days. Depressive symptoms were estimated and MRI scans were performed at baseline and the day after the sixth infusion. We estimated FC differences between responders, non-responders and HCs using the region that showed significant differences between responders and non-responders in DC analysis as the seed. The correlation between the MADRS changes and zFC values was performed, and the potential of zFC values to be a neuroimaging biomarker was explored using the receiver operating characteristic curve. Result Compared with non-responders, responders had significantly decreased DC values in the right middle frontal gyrus (MFG). In the analysis of FC using the region that showed significant differences in DC as a seed, there was a significant difference in the region of the right supplementary motor area (SMA) among responders, non-responders, and HCs. This region also overlapped with the bilateral median cingulate gyrus. In post hoc analysis, responders had higher FC than non-responders and HCs, and non-responders had lower FC than HCs. Importantly, the FC between the MFG and SMA (overlapping bilateral median cingulate gyrus) was correlated with the improvement of symptoms, which was estimated by the Mongomery-Asberg Depression Scale (MADRS). FC has the potential to be an imaging biomarker that can predict the ketamine effect in MDD patients according to the receiver operating characteristic curve analysis. Conclusion Our results revealed that FC between the SMG and SMA and mACC was highly correlated with depressive symptoms and has the potential to be a neuroimaging biomarker to predict the effect of ketamine in MDD.
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Affiliation(s)
- Fan Zhang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Weicheng Li
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Ling Fu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Yanxiang Ye
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Haiyan Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzho, China
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Yuping Ning
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
- *Correspondence: Yuping Ning,
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26
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Westlund Schreiner M, Dillahunt AK, Frandsen SB, DelDonno SR, Schubert BL, Pocius SL, Jenkins LM, Kassel MT, Bessette KL, Thomas L, Stange JP, Crowell SE, Langenecker SA. Increased sensitivity of insula to supraliminal faces in adults with histories of mood disorders and self-injury. J Psychiatr Res 2022; 152:167-174. [PMID: 35738159 DOI: 10.1016/j.jpsychires.2022.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/23/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mood disorders are associated with neurobiological disruptions in subliminal and supraliminal emotion processing. There may be additional variation based on sex and the presence of self-injurious thoughts and behaviors (SITBs). Examining individuals in remission allows us to understand trait-like emotion processing characteristics that persist in the absence of symptoms. This study investigates neural processing in response to supraliminal and subliminal emotional stimuli based upon mood disorder diagnosis, sex, and SITBs. METHODS Seventy-five participants with a history of any mood disorder (AMD; 52 female) and 27 healthy controls (HC; 14 female) completed a fMRI task presenting subliminal and supraliminal facial stimuli. Within the AMD group, 20 had no history of SITBs, 26 had histories of suicidal ideation only, and 27 had histories of both SI and self-injurious behavior. We examined activation of salience network regions of interest including the amygdala, insula, and subgenual anterior cingulate cortex (sgACC) during the task. RESULTS AMD showed greater insula activation in response to happy faces relative to sad faces, which was not seen in the HC group. Males exhibited lower insula activation in response to sad faces relative happy faces, a pattern not seen in females. Individuals with SITBs demonstrated a lack of sgACC blunting during supraliminal versus subliminal trials. CONCLUSIONS We found different patterns of neural responses related to mood disorder status, sex, and SITBs. Findings highlight the importance of considering heterogeneity within diagnoses and examining neurobiological features in the context of remission.
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Affiliation(s)
| | - Alina K Dillahunt
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, USA
| | - Summer B Frandsen
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, USA; Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Department of Neurology, Harvard Medical School, USA
| | | | | | | | - Lisanne M Jenkins
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Michelle T Kassel
- San Francisco VA Medical Center, University of California, San Francisco, USA
| | - Katie L Bessette
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, USA; Department of Psychiatry, University of Illinois at Chicago, USA; Department of Psychiatry & Biobehavioral Sciences, University of California at Los Angeles, USA
| | - Leah Thomas
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, USA
| | | | | | - Scott A Langenecker
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, USA
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27
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Guo X, Jia J, Zhang Z, Miao Y, Wu P, Bai Y, Ren Y. Metabolomic biomarkers related to non-suicidal self-injury in patients with bipolar disorder. BMC Psychiatry 2022; 22:491. [PMID: 35869468 PMCID: PMC9306041 DOI: 10.1186/s12888-022-04079-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is an important symptom of bipolar disorder (BD) and other mental disorders and has attracted the attention of researchers lately. It is of great significance to study the characteristic markers of NSSI. Metabolomics is a relatively new field that can provide complementary insights into data obtained from genomic, transcriptomic, and proteomic analyses of psychiatric disorders. The aim of this study was to identify the metabolic pathways associated with BD with NSSI and assess important diagnostic and predictive indices of NSSI in BD. METHOD Nuclear magnetic resonance spectrometry was performed to evaluate the serum metabolic profiles of patients with BD with NSSI (n = 31), patients with BD without NSSI (n = 46), and healthy controls (n = 10). Data were analyzed using an Orthogonal Partial Least Square Discriminant Analysis and a t-test. Differential metabolites were identified (VIP > 1 and p < 0.05), and further analyzed using Metabo Analyst 3.0 to identify associated metabolic pathways. RESULTS Eight metabolites in the serum and two important metabolic pathways, the urea and glutamate metabolism cycles, were found to distinguish patients with BD with NSSI from healthy controls. Eight metabolites in the serum, glycine and serine metabolism pathway, and the glucose-alanine cycle were found to distinguish patients with BD without NSSI from healthy controls. Five metabolites in the serum and the purine metabolism pathway were found to distinguish patients with BD with NSSI from those with BD without NSSI. CONCLUSIONS Abnormalities in the urea cycle, glutamate metabolism, and purine metabolism played important roles in the pathogenesis of BD with NSSI.
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Affiliation(s)
- Xiangjie Guo
- grid.263452.40000 0004 1798 4018Department of Forensic Medicine, Shanxi Medical University, Taiyuan, China
| | - Jiao Jia
- grid.470966.aDepartment of Psychiatry, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, 99 Longcheng street, Taiyuan, 030032 Shanxi China ,grid.412793.a0000 0004 1799 5032Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430030 China
| | - Zhiyong Zhang
- grid.263452.40000 0004 1798 4018Department of Psychology, School of Humanities and Social Sciences, Shanxi Medical University, Taiyuan, China
| | - Yuting Miao
- grid.263452.40000 0004 1798 4018Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Peng Wu
- grid.263452.40000 0004 1798 4018Department of Forensic Medicine, Shanxi Medical University, Taiyuan, China
| | - Yaqin Bai
- grid.263452.40000 0004 1798 4018Department of Forensic Medicine, Shanxi Medical University, Taiyuan, China
| | - Yan Ren
- Department of Psychiatry, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, 99 Longcheng street, Taiyuan, 030032, Shanxi, China. .,Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430030, China. .,Shanxi Provincial Key Laboratory of Brain Science and Neuropsychiatric Diseases, Taiyuan, China.
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28
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Yan R, Huang Y, Shi J, Zou H, Wang X, Xia Y, Zhao S, Zhou H, Chen Y, Li X, Wu X, Yao Z, Lu Q. Alterations of regional spontaneous neuronal activity and corresponding brain circuits related to non-suicidal self-injury in young adults with major depressive disorder. J Affect Disord 2022; 305:8-18. [PMID: 35181386 DOI: 10.1016/j.jad.2022.02.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/24/2021] [Accepted: 02/13/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) with non-suicidal self-injury (NSSI)(MDD/NSSI) has been found to differ from simple MDD without NSSI (sMDD). This study analyzes the amplitude of low-frequency fluctuations (ALFF) to explore the NSSI-relevant local neural activity, and uses functional connectivity (FC) analysis to explore the NSSI-relevant circuits corresponding to alterations in local regions in young adult patients with MDD/NSSI. METHODS A total of 54 patients with MDD/NSSI, 68 patients with sMDD, and 66 matched healthy controls (HCs) were recruited. ALFF and seed-based FC analyses were employed. The NSSI-relevant brain alteration and its associations with clinical variables were examined. RESULTS Compared with the sMDD group, the MDD/NSSI group showed higher ALFF in the right lingual gyrus and right middle occipital gyrus; lower ALFF in the right superior frontal gyrus; higher FC values between the right lingual gyrus and left precentral gyrus; and lower FC values between the right middle occipital gyrus and right paracentral gyrus. Within the MDD/NSSI group, ALFF values of the right superior frontal gyrus and right lingual gyrus were positively correlated with the frequency and severity of NSSI. LIMITATIONS The sample size was small, and the potential influence of medicine on brain activity was not excluded. CONCLUSIONS Our preliminary findings indicate that NSSI-relevant ALFF in the right lingual gyrus, right middle occipital gyrus, and right superior frontal gyrus, as well as the alteration FCs in corresponding brain circuits, may play an important role in the neural basis of MDD/NSSI.
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Affiliation(s)
- Rui Yan
- Nanjing Brain Hospital, Medical School, Nanjing University, 22 Hankou Road, Nanjing 210093, China; Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - YingHong Huang
- Nanjing Brain Hospital, Medical School, Nanjing University, 22 Hankou Road, Nanjing 210093, China; Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - JiaBo Shi
- Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - HaoWen Zou
- Nanjing Brain Hospital, Medical School, Nanjing University, 22 Hankou Road, Nanjing 210093, China; Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - XuMiao Wang
- Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Yi Xia
- Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Shuai Zhao
- Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - HongLiang Zhou
- Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Yu Chen
- Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - XueSong Li
- School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing 210096, China
| | - XiaoXiao Wu
- School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing 210096, China
| | - ZhiJian Yao
- Nanjing Brain Hospital, Medical School, Nanjing University, 22 Hankou Road, Nanjing 210093, China; Department of psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing 210096, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing 210096, China.
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29
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Zhang Y, Lai S, Wu W, Wang Y, Zhao H, He J, Zhu Y, Chen G, Qi Z, Chen P, Lv S, Song Z, Hu Y, Miao H, Yan S, Luo Y, Ran H, Huang X, Lu X, Zhong S, Jia Y. Associations between executive function impairment and biochemical abnormalities in depressed adolescents with non-suicidal self-injury. J Affect Disord 2022; 298:492-499. [PMID: 34737017 DOI: 10.1016/j.jad.2021.10.132] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND H protons magnetic resonance spectroscopy (1H-MRS) has been used to detect the biochemical metabolism changes and the mechanism of executive dysfunction in major depressive disorder (MDD). While, finding information associated with non-suicidal self-injury (NSSI) among adolescents with MDD is challenging. The present study aimed to examine the executive function and biochemical metabolism alterations, as well as to elucidate their associations in depressed adolescents with NSSI. METHODS A total of 86 adolescents with MDD (40 with NSSI, and 46 without NSSI) and 28 healthy controls were recruited in the current study. The executive function was assessed by Digital symbol test (DST), Wisconsin Card Sorting Test (WCST), Trail Making Test, part B (TMT-B), and Verbal fluency (VF). Bilateral metabolite levels of the prefrontal cortex (PFC), anterior cingulated cortex (ACC), lenticular nucleus (LN) of basal ganglia and thalamus were obtained by 1H-MRS at 3.0 T, and then the ratios of N-acetyl aspartate (NAA) and choline-containing compounds (Cho) to creatine (Cr) were determined, respectively. Finally, association analysis was conducted to investigate their relationships. RESULTS The depressed adolescents with NSSI showed significantly lower VF scores than those without NSSI and healthy controls. We also found significantly higher NAA/Cr ratios in the right thalamus, while significantly lower Cho/Cr ratios in the right thalamus of NSSI group than the MDD without NSSI group and healthy controls. And NSSI group also showed lower NAA/Cr ratio in the right LN than the MDD without NSSI group. For MDD with NSSI, the NAA/Cr ratios of the left thalamus were positively correlated with the time of TMTB and the Cho/Cr ratios of the left ACC were positively correlated with the VF scores. CONCLUSIONS Depressed adolescents with NSSI may have executive dysfunction and NAA and Cho metabolism abnormalities in the thalamus. And the NAA/Cr ratios of the right LN could distinguish NSSI from depressed adolescents. Further, the executive dysfunction may be associated with the abnormal NAA metabolism in the left thalamus and ACC.
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Affiliation(s)
- Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Weige Wu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; The Department of Child and Adolescent Psychology Xiamen Xianyue hospital, Fujian 361012, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yunxia Zhu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Guangmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- School of Management, Jinan University, Guangzhou 510316, China
| | - Zijin Song
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yilei Hu
- School of Management, Jinan University, Guangzhou 510316, China
| | - Haofei Miao
- School of Management, Jinan University, Guangzhou 510316, China
| | - Shuya Yan
- School of Management, Jinan University, Guangzhou 510316, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou 510316, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou 510316, China
| | - Xiaosi Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Xiaodan Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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Mürner-Lavanchy I, Koenig J, Reichl C, Brunner R, Kaess M. Altered Resting-State Networks in Adolescent Non-Suicidal Self-Injury - A Graph Theory Analysis. Soc Cogn Affect Neurosci 2022; 17:819-827. [PMID: 35086140 PMCID: PMC9433841 DOI: 10.1093/scan/nsac007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 11/21/2021] [Accepted: 01/27/2022] [Indexed: 11/14/2022] Open
Abstract
Non-suicidal self-injury (NSSI) is a highly prevalent transdiagnostic symptom and risk marker for mental health problems among adolescents. Research on the neurobiological mechanisms underlying NSSI is needed to clarify the neural correlates associated with the behavior. We examined resting-state functional connectivity in n = 33 female adolescents aged 12–17 years engaging in NSSI, and in n = 29 age-matched healthy controls using graph theory. Mixed linear models were evaluated with the Bayes Factor to determine group differences on global and regional network measures and associations between network measures and clinical characteristics in patients. Adolescents engaging in NSSI demonstrated longer average characteristic path lengths and a smaller number of weighted hubs globally. Regional measures indicated lower efficiency and worse integration in (orbito)frontal regions and higher weighted coreness in the pericalcarine gyrus. In patients, higher orbitofrontal weighted local efficiency was associated with NSSI during the past month while lower pericalcarine nodal efficiency was associated with suicidal thoughts in the past year. Higher right but lower left pericalcarine weighted hubness was associated with more suicide attempts during the past year. Using a graph-based technique to identify functional connectivity networks, this study adds to the growing understanding of the neurobiology of NSSI.
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Affiliation(s)
- Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 60 3000, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 60 3000, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg 69115, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50931, Germany
| | - Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 60 3000, Switzerland
| | - Romuald Brunner
- Clinic and Policlinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg 93053, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 60 3000, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg 69115, Germany
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31
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Zhu J, Qian R, Zhong H, Li Y, Liu X, Ma J. Factors influencing the addiction characteristics of non-suicidal self-injurious behaviors in adolescents: A case-control study. Front Psychiatry 2022; 13:1033242. [PMID: 36532167 PMCID: PMC9751054 DOI: 10.3389/fpsyt.2022.1033242] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Many studies have shown that in the context of public health emergencies, the incidence rate of adolescent non-suicidal self-injury (NSSI) patients increased dramatically. This paper aims to characterize the behavioral characteristics of adolescent NSSI and analyze the influencing factors of NSSI behavior addiction characteristics. METHODS Our research was a case-control study which included 84 adolescents with NSSI (female vs. male: 59 vs. 25) and 84 healthy controls (female vs. male: 53 vs. 31). All the participants enrolled were aged 12-18 years. The differences in the scores of the following five scales were compared between the case and control groups: Egna Minnen Barndoms Uppfostran (EMBU), Perceived Social Support Scale (PSSS), Perceived Stress Scale (PSS); Bergen Social Media Addiction Scale (BSMAS) and Video Game Dependence Scale (VDG-S). The characteristics of NSSI behavior of the study group were evaluated using the Ottawa Self Inventory Chinese Revised Edition (OSIC). And a binary logistic regression model was developed to analyze the factors that influence adolescent NSSI behavioral addiction characteristics. RESULTS In the study group, the emotional warmth scores in the father's and mother's rearing style scores in the EMBU were significantly lower than the controls. The BSMAS and VDG-S scores were significantly higher than those in the control group. 38 cases of NSSI with addiction characteristics accounted for 45.24% in the study group. The risk factors for NSSI addiction traits were as follows: female, single-child, high level of VDG-S scores, high scores of excessive interferences in father's rearing style, and high scores of punishments and excessive interferences in mother's rearing style score. CONCLUSION Female, only child, internet addiction, and negative parenting styles were predictors of NSSI behavioral addiction characteristics in adolescents. Targeted coping strategies should be developed to reduce the occurrence and development of self-injurious behavior, especially for female adolescents with Internet dependence in one-child families with negative parenting styles.
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Affiliation(s)
- Junhong Zhu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Rui Qian
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Hao Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yi Li
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Xuebing Liu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Jun Ma
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Wuhan Hospital for Psychotherapy, Wuhan, China
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32
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Abstract
Nonsuicidal self-injury (NSSI) is a common but poorly understood phenomenon in adolescents. This study examined the Sustained Threat domain in female adolescents with a continuum of NSSI severity (N = 142). Across NSSI lifetime frequency and NSSI severity groups (No + Mild NSSI, Moderate NSSI, Severe NSSI), we examined physiological, self-reported and observed stress during the Trier Social Stress Test; amygdala volume; amygdala responses to threat stimuli; and resting-state functional connectivity (RSFC) between amygdala and medial prefrontal cortex (mPFC). Severe NSSI showed a blunted pattern of cortisol response, despite elevated reported and observed stress during TSST. Severe NSSI showed lower amygdala-mPFC RSFC; follow-up analyses suggested that this was more pronounced in those with a history of suicide attempt for both moderate and severe NSSI. Moderate NSSI showed elevated right amygdala activation to threat; multiple regressions showed that, when considered together with low amygdala-mPFC RSFC, higher right but lower left amygdala activation predicted NSSI severity. Patterns of interrelationships among Sustained Threat measures varied substantially across NSSI severity groups, and further by suicide attempt history. Study limitations include the cross-sectional design, missing data, and sampling biases. Our findings highlight the value of multilevel approaches in understanding the complexity of neurobiological mechanisms in adolescent NSSI.
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Cruciani G, Boccia M, Lingiardi V, Giovanardi G, Zingaretti P, Spitoni GF. An Exploratory Study on Resting-State Functional Connectivity in Individuals with Disorganized Attachment: Evidence for Key Regions in Amygdala and Hippocampus. Brain Sci 2021; 11:brainsci11111539. [PMID: 34827538 PMCID: PMC8615787 DOI: 10.3390/brainsci11111539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/08/2021] [Accepted: 11/17/2021] [Indexed: 02/02/2023] Open
Abstract
Studies comparing organized (O) and unresolved/disorganized (UD) attachment have consistently shown structural and functional brain abnormalities, although whether and how attachment patterns may affect resting state functional connectivity (RSFC) is still little characterized. Here, we investigated RSFC of temporal and limbic regions of interest for UD attachment. Participants’ attachment was classified via the Adult Attachment Interview, and all participants underwent clinical assessment. Functional magnetic resonance imaging data were collected from 11 UD individuals and seven matched O participants during rest. A seed-to-voxel analysis was performed, including the anterior and the posterior cingulate cortex, the bilateral insula, amygdala and hippocampus as seed regions. No group differences in the clinical scales emerged. Compared to O, the UD group showed lower RSFC between the left amygdala and the left cerebellum (lobules VIII), and lower functional coupling between the right hippocampus and the posterior portion of the right middle temporal gyrus. Moreover, UD participants showed higher RSFC between the right amygdala and the anterior cingulate cortex. Our findings suggest RSFC alterations in regions associated with encoding of salient events, emotion processing, memories retrieval and self-referential processing in UD participants, highlighting the potential role of attachment experiences in shaping brain abnormalities also in non-clinical UD individuals.
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Affiliation(s)
- Gianluca Cruciani
- Department of Psychology, Ph.D. Program in Behavioral Neuroscience, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-(0)6-49917711
| | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy;
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), 00179 Rome, Italy;
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (V.L.); (G.G.)
| | - Guido Giovanardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (V.L.); (G.G.)
| | - Pietro Zingaretti
- Villa von Siebenthal Neuropsychiatric Clinic and Hospital, Genzano di Roma, 00045 Rome, Italy;
| | - Grazia Fernanda Spitoni
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), 00179 Rome, Italy;
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (V.L.); (G.G.)
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Kaess M, Hooley JM, Klimes-Dougan B, Koenig J, Plener PL, Reichl C, Robinson K, Schmahl C, Sicorello M, Westlund Schreiner M, Cullen KR. Advancing a temporal framework for understanding the biology of nonsuicidal self- injury: An expert review. Neurosci Biobehav Rev 2021; 130:228-239. [PMID: 34450182 PMCID: PMC8783544 DOI: 10.1016/j.neubiorev.2021.08.022] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 07/17/2021] [Accepted: 08/21/2021] [Indexed: 11/04/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a serious clinical problem, particularly for adolescents and young adults. NSSI is a complex behavior that emerges through the intersecting effects of social, psychological, and biological mechanisms. Although the social and psychological contributions to risk for developing NSSI are relatively well understood and have guided the development of effective psychosocial treatments for self-injury, the biological mechanisms underlying NSSI have just begun to come to light. To evaluate and categorize the biological research conducted on the topic of NSSI, we propose a model that distinguishes between trait and state markers. According to this model, risk factors and mechanisms involved in NSSI can be distinguished into both trait and state factors. We review the existing evidence on distal biological traits (predictors) of NSSI, proximal biological traits (correlates) of NSSI, and biological states directly preceding or following NSSI. We conclude by providing recommendations for future research on the neurobiology of NSSI.
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Affiliation(s)
- Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
| | - Jill M Hooley
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, MN, USA
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria; Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kealagh Robinson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Maurizio Sicorello
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | | | - Kathryn R Cullen
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN, USA
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35
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Başgöze Z, Wiglesworth A, Carosella KA, Klimes-Dougan B, Cullen KR. Depression, Non-Suicidal Self-Injury, and Suicidality in Adolescents: Common and Distinct Precursors, Correlates, and Outcomes. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6:e210018. [PMID: 34734122 PMCID: PMC8562706 DOI: 10.20900/jpbs.20210018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Depression, non-suicidal self-injury (NSSI), and suicidal thoughts and behaviors (STB) often emerge during adolescence. Despite considerable overlap in clinical presentation, risk factors, and implicated neurobiology, there is also evidence for divergence in terms of precursors, correlates, and outcomes. The complex interrelationships amongst these three clinical domains require considering both shared and divergent patterns of risk for depression, NSSI, and STB; a clearer understanding of these developmental trajectories will be needed to guide optimization and tailoring of early interventions.
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Affiliation(s)
- Zeynep Başgöze
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Minnesota, Minneapolis, MN 55454, USA
| | - Andrea Wiglesworth
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, USA
| | | | | | - Kathryn R. Cullen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Minnesota, Minneapolis, MN 55454, USA
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36
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Ma J, Ding J, Hu J, Wang K, Xiao S, Luo T, Yu S, Liu C, Xu Y, Liu Y, Wang C, Guo S, Yang X, Song H, Geng Y, Jin Y, Chen H, Liu C. Children and Adolescents' Psychological Well-Being Became Worse in Heavily Hit Chinese Provinces during the COVID-19 Epidemic. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6:e210020. [PMID: 34888418 PMCID: PMC8653505 DOI: 10.20900/jpbs.20210020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In light of the novel coronavirus's (COVID-19's) threat to public health worldwide, we sought to elucidate COVID-19's impacts on the mental health of children and adolescents in China. Through online self-report questionnaires, we aimed to discover the psychological effects of the pandemic and its associated risk factors for developing mental health symptoms in young people. We disseminated a mental health survey through online social media, WeChat, and QQ in the five Chinese provinces with the most confirmed cases of COVID-19 during the late stage of the country-wide lockdown. We used a self-made questionnaire that queried children and adolescents aged 6 to 18 on demographic information, psychological status, and other lifestyle and COVID-related variables. A total of 17,740 children and adolescents with valid survey data participated in the study. 10,022 (56.5%), 11,611 (65.5%), 10,697 (60.3%), 6868 (38.7%), and 6225 (35.1%) participants presented, respectively, more depressive, anxious, compulsive, inattentive, and sleep-related problems compared to before the outbreak of COVID-19. High school students reported a greater change in depression and anxiety than did middle school and primary school students. Despite the fact that very few children (0.1%) or their family members (0.1%) contracted the virus in this study, the psychological impact of the pandemic was clearly profound. Fathers' anxiety appeared to have the strongest influence on a children's psychological symptoms, explaining about 33% of variation in the child's overall symptoms. Other factors only explained less than 2% of the variance in symptoms once parents' anxiety was accounted for. The spread of COVID-19 significantly influenced the psychological state of children and adolescents in participants' view. It is clear that children and adolescents, particularly older adolescents, need mental health support during the pandemic. The risk factors we uncovered suggest that reducing fathers' anxiety is particularly critical to addressing young people's mental health disorders in this time.
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Affiliation(s)
- Jing Ma
- Department of Child and Adolescent Psychiatry, Brain Hospital of Hunan Province (School of Clinical Medicine, Hunan University of Chinese Medicine), Changsha 410007, Hunan, China
| | - Jun Ding
- Department of Social Work, Shenzhen Mental Health Center, Shenzhen 518046, Guangdong, China
| | - Jiawen Hu
- Department of Child and Adolescent Psychiatry, Brain Hospital of Hunan Province (School of Clinical Medicine, Hunan University of Chinese Medicine), Changsha 410007, Hunan, China
| | - Kai Wang
- Futian hospital for prevention and treatment of chronic disease, Shenzhen 518017, Guangdong, China
| | - Shuaijun Xiao
- Department of Child and Adolescent Psychiatry, Brain Hospital of Hunan Province (School of Clinical Medicine, Hunan University of Chinese Medicine), Changsha 410007, Hunan, China
| | - Ting Luo
- Department of Child and Adolescent Psychiatry, Brain Hospital of Hunan Province (School of Clinical Medicine, Hunan University of Chinese Medicine), Changsha 410007, Hunan, China
| | - Shuxiang Yu
- Department of Child and Adolescent Psychiatry, Brain Hospital of Hunan Province (School of Clinical Medicine, Hunan University of Chinese Medicine), Changsha 410007, Hunan, China
| | - Chuntao Liu
- Department of Child and Adolescent Psychiatry, Brain Hospital of Hunan Province (School of Clinical Medicine, Hunan University of Chinese Medicine), Changsha 410007, Hunan, China
| | - Yunxuan Xu
- Department of Child and Adolescent Psychiatry, Brain Hospital of Hunan Province (School of Clinical Medicine, Hunan University of Chinese Medicine), Changsha 410007, Hunan, China
| | - Yingxian Liu
- Xiangyifurong Middle School of Changsha, Changsha 410011, Hunan, China
| | - Changhong Wang
- The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453099, Henan, China
| | - Suqin Guo
- The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453099, Henan, China
| | - Xiaohua Yang
- Changsha Changjun Bilingual Experimental Middle School, Changsha 410002, Hunan, China
| | - Haidong Song
- Mental Health Center, Zhejiang University school of Medicine (Hangzhou Seventh People’s Hospital), Hangzhou 310013, Zhejiang, China
| | - Yaoguo Geng
- School of Education, Zhengzhou University, Zhengzhou 45001, Henan, China
| | - Yu Jin
- School of Public Health, Sun Yat-sen University, Guangzhou 510970, Guangdong, China
| | - Huayun Chen
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Chunyu Liu
- Department of Psychiatry, SUNY Upstate Medical University, New York, NY 13210, USA
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Tozzi L, Tuzhilina E, Glasser MF, Hastie TJ, Williams LM. Relating whole-brain functional connectivity to self-reported negative emotion in a large sample of young adults using group regularized canonical correlation analysis. Neuroimage 2021; 237:118137. [PMID: 33951512 PMCID: PMC8536403 DOI: 10.1016/j.neuroimage.2021.118137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/15/2022] Open
Abstract
The goal of our study was to use functional connectivity to map brain function to self-reports of negative emotion. In a large dataset of healthy individuals derived from the Human Connectome Project (N = 652), first we quantified functional connectivity during a negative face-matching task to isolate patterns induced by emotional stimuli. Then, we did the same in a complementary task-free resting state condition. To identify the relationship between functional connectivity in these two conditions and self-reports of negative emotion, we introduce group regularized canonical correlation analysis (GRCCA), a novel algorithm extending canonical correlations analysis to model the shared common properties of functional connectivity within established brain networks. To minimize overfitting, we optimized the regularization parameters of GRCCA using cross-validation and tested the significance of our results in a held-out portion of the data set using permutations. GRCCA consistently outperformed plain regularized canonical correlation analysis. The only canonical correlation that generalized to the held-out test set was based on resting state data (r = 0.175, permutation test p = 0.021). This canonical correlation loaded primarily on Anger-aggression. It showed high loadings in the cingulate, orbitofrontal, superior parietal, auditory and visual cortices, as well as in the insula. Subcortically, we observed high loadings in the globus pallidus. Regarding brain networks, it loaded primarily on the primary visual, orbito-affective and ventral multimodal networks. Here, we present the first neuroimaging application of GRCCA, a novel algorithm for regularized canonical correlation analyses that takes into account grouping of the variables during the regularization scheme. Using GRCCA, we demonstrate that functional connections involving the visual, orbito-affective and multimodal networks are promising targets for investigating functional correlates of subjective anger and aggression. Crucially, our approach and findings also highlight the need of cross-validation, regularization and testing on held out data for correlational neuroimaging studies to avoid inflated effects.
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Affiliation(s)
- Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Elena Tuzhilina
- Department of Statistics, Stanford University, Stanford, USA
| | - Matthew F Glasser
- Departments of Radiology and Neuroscience, Washington University, St. Louis, USA
| | - Trevor J Hastie
- Department of Statistics, Stanford University, Stanford, USA
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA; Sierra-Pacific Mental Illness Research, Education and Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
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38
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Matera E, Margari M, Serra M, Petruzzelli MG, Gabellone A, Piarulli FM, Pugliese A, Tassiello AR, Croce F, Renna C, Margari A. Non-Suicidal Self-Injury: An Observational Study in a Sample of Adolescents and Young Adults. Brain Sci 2021; 11:brainsci11080974. [PMID: 34439593 PMCID: PMC8391479 DOI: 10.3390/brainsci11080974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
Non-Suicidal Self-Injury (NSSI) is the self-inflicted destruction of body tissues without suicidal intent with a prevalence of 1.5% to 6.7% in the youth population. At present, it is not clear which emotional and behavioral components are specifically associated with it. Therefore, we studied NSSI in a clinical sample of youth using the Ottawa Self-injury Inventory and the Barratt Impulsiveness Scale 11. The Mann-Whitney test was used to compare the numerical responses provided to the tests. We found 54 patients with NSSI, with a mean age of 17 years. Scores were analyzed in the total sample and in four subgroups. In the total sample, Internal Emotion and External Emotion Regulation, Craving, Non-Planning and Total Impulsivity were significantly associated with NSSI. There were statistically significant differences in Craving between patients with multiple NSSI episodes, suicide attempts and multiple injury modes and patients of other corresponding subgroups, in Internal Emotion Regulation, Sensation Seeking and Motor Impulsivity between NSSI patients with suicide attempts and no suicide attempts, and in Cognitive Impulsivity between NSSI patients with multiple injury modes and one injury mode. It is necessary to carefully evaluate the components underlying NSSI in order to activate personalized treatment options.
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Affiliation(s)
- Emilia Matera
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
- Correspondence:
| | - Mariella Margari
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Maria Serra
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Maria Giuseppina Petruzzelli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Alessandra Gabellone
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
| | - Francesco Maria Piarulli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Assunta Pugliese
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Anna Rita Tassiello
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Federica Croce
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Caterina Renna
- Center for Treatment and Research on Eating Disorders Mental Health Department AL, Via Miglietta 5, 73100 Lecce, Italy;
| | - Anna Margari
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
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Neuroimaging Studies of Nonsuicidal Self-Injury in Youth: A Systematic Review. Life (Basel) 2021; 11:life11080729. [PMID: 34440473 PMCID: PMC8399885 DOI: 10.3390/life11080729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 01/14/2023] Open
Abstract
Nonsuicidal self-injury (NSSI) is prevalent and affects mainly the youth population. It is prospectively associated with suicide attempts, making it a target for suicide prevention. Recently, several studies have investigated neural pathways of NSSI using neuroimaging. However, there is a lack of systematized appraisal of these findings. This systematic review aims to identify and summarize the main neuroimaging findings of NSSI in youth. We followed PRISMA statement guidelines and searched MEDLINE, APA PsycInfo, and Google Scholar databases for neuroimaging studies, irrespective of imaging modality, specifically investigating NSSI in samples with a mean age of up to 25 years old. Quality assessment was made using the Newcastle–Ottawa and Joanna Briggs Institute scales. The initial search retrieved 3030 articles; 21 met inclusion criteria, with a total of 938 subjects. Eighteen studies employed functional neuroimaging techniques such as resting-state and task-based fMRI (emotional, interpersonal exposure/social exclusion, pain, reward, and cognitive processing paradigms). Three studies reported on structural MRI. An association of NSSI behavior and altered emotional processing in cortico-limbic neurocircuitry was commonly reported. Additionally, alterations in potential circuits involving pain, reward, interpersonal, self-processing, and executive function control processes were identified. NSSI has complex and diverse neural underpinnings. Future longitudinal studies are needed to understand its developmental aspects better.
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Perini I, Zetterqvist M, Mayo LM. Beyond distress: a role for positive affect in nonsuicidal self-injury. Curr Opin Behav Sci 2021. [DOI: 10.1016/j.cobeha.2021.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Resting state prefrontal cortex oxygenation in adolescent non-suicidal self-injury - A near-infrared spectroscopy study. NEUROIMAGE-CLINICAL 2021; 31:102704. [PMID: 34091351 PMCID: PMC8182302 DOI: 10.1016/j.nicl.2021.102704] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/07/2021] [Accepted: 05/18/2021] [Indexed: 12/02/2022]
Abstract
Resting prefrontal cortex (PFC) oxygenation is decreased in adolescents with non-suicidal self-injury (NSSI) compared to healthy controls. Lower PFC oxygenation (full sample) is associated with greater adverse childhood experiences and less health-related quality of life (HRQoL). On the group-level, patients show no alterations of resting state functional connectivity within the PFC. Among other clinical variables, increased PFC connectivity (full sample) is associated with greater borderline personality pathology.
Introduction Neural alterations in limbic and prefrontal circuits in association with self-injurious behavior have been studied primarily in adult borderline personality disorder (BPD). In adolescent patients, research is still sparse. Here, we used resting functional near-infrared spectroscopy (NIRS) to examine oxygenation of the prefrontal cortex (PFC) and its association with symptom severity in adolescents engaging in non-suicidal self-injury (NSSI) and matched healthy controls (HC). Methods Adolescents (12–17 years) with recurrent episodes of NSSI (n = 170) and healthy controls (n = 43) performed a low-demanding resting-state vanilla baseline task. Mean oxygenation of the PFC and functional connectivity within the PFC, were measured using an 8-channel functional NIRS system (Octamon, Artinis, The Netherlands). Various clinical variables derived from diagnostic interviews and self-reports were included in statistical analyses to explore potential associations with PFC oxygenation and connectivity. Results Adolescents with NSSI showed significantly decreased PFC oxygenation compared to HC, as indexed by oxygenated hemoglobin. Lower PFC oxygenation was associated with greater adverse childhood experiences and less health-related quality of life (HRQoL). While there was no evidence for alterations in PFC connectivity in adolescents engaging in NSSI compared to HC, increased PFC connectivity in the full sample was associated with greater adverse childhood experience, greater BPD pathology, greater depression severity and psychological burden in general, as well as lower HRQoL. Conclusion This study is the first to examine PFC oxygenation using NIRS technology in adolescents engaging in NSSI. Overall, results indicate small effects not specific to NSSI. Clinical implications of these findings and recommendations for further research are discussed.
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Sahasrabudhe SA, Silamongkol T, Park YW, Colette A, Eberly LE, Klimes-Dougan B, Coles LD, Cloyd JC, Öz G, Mueller BA, Kartha RV, Cullen KR. Identifying Biological Signatures of N-Acetylcysteine for Non-Suicidal Self-Injury in Adolescents and Young Adults. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6:e210007. [PMID: 34036177 PMCID: PMC8143039 DOI: 10.20900/jpbs.20210007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The prevalence of non-suicidal self-injury (NSSI) is high in adolescents and young adults. However, there is a paucity of evidence-based treatments to address this clinical problem. An open-label, pilot study in the target population showed that treatment with oral N-acetylcysteine (NAC), a widely available dietary supplement, was associated with reduction in NSSI frequency. In preparation for a biologically informed design of an efficacy trial, a critical preliminary step is to clarify NAC's biological signatures, or measures of the mechanisms underlying its clinical effects. Toward that end, we propose a 2-stage project to investigate NAC's biological signatures (changes in glutathione (GSH) and/or glutamate (Glu)) in women with NSSI. The first stage; a double-blind randomized placebo-controlled study will focus on identifying the optimal dose to achieve meaningful change in GSH and Glu during short-term (4 weeks) NAC treatment in 36 women aged 16-24 years with NSSI. Go/No-go criteria to determine if the study will progress to the second stage include pre-specified changes in brain and blood measures of GSH. Changes in the brain GSH are measured through magnetic resonance spectroscopy (MRS). The dose for the stage 2 will be selected based on the biological changes and the tolerability observed in the stage 1. The stage 2 will seek to replicate the biological signature findings in an 8-week trial in a new patient cohort, and examine the relationships among biological signatures, NAC pharmacokinetics and clinical response. This 2-stage project is unique as it unifies clinical psychiatric measurements, quantitative MRS and pharmacological approaches in the first placebo-controlled clinical trial of NAC in young women with NSSI. TRIAL REGISTRATION The stage 1 trial protocol has been registered on https://clinicaltrials.gov/ with ClinicalTrials.gov ID "NCT04005053" (Registered on 02 July 2019. Available from: https://clinicaltrials.gov/ct2/show/NCT04005053).
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Affiliation(s)
- Siddhee A. Sahasrabudhe
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Thanharat Silamongkol
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
| | - Young Woo Park
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alanna Colette
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
| | - Lynn E. Eberly
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA
- School of Public Health, Division of Biostatistics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, MN 55455, USA
| | - Lisa D. Coles
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - James C. Cloyd
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bryon A. Mueller
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
| | - Reena V. Kartha
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kathryn R. Cullen
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
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Zinchuk MS, Avedisova AS, Voinova NI, Kustov GV, Pashnin EV, Gulyaeva NV, Guekht AB. [Pain perception and nonsuicidal self-injurious behavior]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 120:144-152. [PMID: 33459555 DOI: 10.17116/jnevro2020120121144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review focuses on studies of pain threshold and tolerance in individuals with nonsuicidal self-injurious (NSSI) behavior. The data on methods of pain sensitivity studies are presented, with issues in animal modeling of NSSI discussed separately. The results of neuroimaging studies on pain sensitivity in individuals with NSSI are described, along with contribution of genetic factors, psychological variables, and disturbances in opioid and hypothalamic-pituitary-adrenal systems. A critical methodological analysis of the studies on pain sensitivity in individuals with NSSI was performed.
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Affiliation(s)
- M S Zinchuk
- Scientific and Practical Psychoneurological Center, Moscow, Russia
| | - A S Avedisova
- Scientific and Practical Psychoneurological Center, Moscow, Russia.,Serbsky National Medical Research Center for Psychiatry and Narcology, Moscow, Russia
| | - N I Voinova
- Scientific and Practical Psychoneurological Center, Moscow, Russia
| | - G V Kustov
- Scientific and Practical Psychoneurological Center, Moscow, Russia
| | - E V Pashnin
- Scientific and Practical Psychoneurological Center, Moscow, Russia
| | - N V Gulyaeva
- Scientific and Practical Psychoneurological Center, Moscow, Russia.,Institute of Higher Nervous Activity and Neurophysiology of RAS, Moscow, Russia
| | - A B Guekht
- Scientific and Practical Psychoneurological Center, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
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Auerbach RP, Pagliaccio D, Allison GO, Alqueza KL, Alonso MF. Neural Correlates Associated With Suicide and Nonsuicidal Self-injury in Youth. Biol Psychiatry 2021; 89:119-133. [PMID: 32782140 PMCID: PMC7726029 DOI: 10.1016/j.biopsych.2020.06.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/23/2022]
Abstract
There is no definitive neural marker of suicidal thoughts and behaviors (STBs) or nonsuicidal self-injury (NSSI), and relative to adults, research in youth is more limited. This comprehensive review focuses on magnetic resonance imaging studies reporting structural and functional neural correlates of STBs and NSSI in youth to 1) elucidate shared and independent neural alternations, 2) clarify how developmental processes may interact with neural alterations to confer risk, and 3) provide recommendations based on convergence across studies. Forty-seven articles were reviewed (STBs = 27; NSSI = 20), and notably, 63% of STB articles and 45% of NSSI articles were published in the previous 3 years. Structural magnetic resonance imaging research suggests reduced volume in the ventral prefrontal and orbitofrontal cortices among youth reporting STBs, and there is reduced anterior cingulate cortex volume related to STBs and NSSI. With regard to functional alterations, blunted striatal activation may characterize STB and NSSI youth, and there is reduced frontolimbic task-based connectivity in suicide ideators and attempters. Resting-state functional connectivity findings highlight reduced positive connectivity between the default mode network and salience network in attempters and show that self-injurers exhibit frontolimbic alterations. Together, suicidal and nonsuicidal behaviors are related to top-down and bottom-up neural alterations, which may compromise approach, avoidance, and regulatory systems. Future longitudinal research with larger and well-characterized samples, especially those integrating ambulatory stress assessments, will be well positioned to identify novel targets that may improve early identification and treatment for youth with STBs and NSSI.
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Affiliation(s)
- Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA,Division of Clinical Developmental Neuroscience, Sackler Institute, New York, New York, USA, Corresponding author: 1051 Riverside Drive, Pardes 2407, New York, NY 10032;
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Grace O. Allison
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Kira L. Alqueza
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Maria Fernanda Alonso
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
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Ho TC, Walker JC, Teresi GI, Kulla A, Kirshenbaum JS, Gifuni AJ, Singh MK, Gotlib IH. Default mode and salience network alterations in suicidal and non-suicidal self-injurious thoughts and behaviors in adolescents with depression. Transl Psychiatry 2021; 11:38. [PMID: 33436537 PMCID: PMC7804956 DOI: 10.1038/s41398-020-01103-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/23/2020] [Accepted: 11/10/2020] [Indexed: 12/27/2022] Open
Abstract
Suicidal ideation (SI) and non-suicidal self-injury (NSSI) are two distinct yet often co-occurring risk factors for suicide deaths in adolescents. Elucidating the neurobiological patterns that specifically characterize SI and NSSI in adolescents is needed to inform the use of these markers in intervention studies and to develop brain-based treatment targets. Here, we clinically assessed 70 adolescents-49 adolescents with depression and 21 healthy controls-to determine SI and NSSI history. Twenty-eight of the depressed adolescents had a history of SI and 29 had a history of NSSI (20 overlapping). All participants underwent a resting-state fMRI scan. We compared groups in network coherence of subdivisions of the central executive network (CEN), default mode network (DMN), and salience network (SN). We also examined group differences in between-network connectivity and explored brain-behavior correlations. Depressed adolescents with SI and with NSSI had lower coherence in the ventral DMN compared to those without SI or NSSI, respectively, and healthy controls (all ps < 0.043, uncorrected). Depressed adolescents with NSSI had lower coherence in the anterior DMN and in insula-SN (all ps < 0.030, uncorrected), and higher CEN-DMN connectivity compared to those without NSSI and healthy controls (all ps < 0.030, uncorrected). Lower network coherence in all DMN subnetworks and insula-SN were associated with higher past-month SI and NSSI (all ps < 0.001, uncorrected). Thus, in our sample, both SI and NSSI are related to brain networks associated with difficulties in self-referential processing and future planning, while NSSI specifically is related to brain networks associated with disruptions in interoceptive awareness.
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Affiliation(s)
- Tiffany C Ho
- Department of Psychiatry and Behavioral Sciences; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Johanna C Walker
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Giana I Teresi
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Artenisa Kulla
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | - Anthony J Gifuni
- Department of Psychology, Stanford University, Stanford, CA, USA
- Department of Psychiatry and Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
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Lai CH. Task MRI-Based Functional Brain Network of Major Depression. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:19-33. [PMID: 33834392 DOI: 10.1007/978-981-33-6044-0_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This chapter will focus on task magnetic resonance imaging (MRI) to understand the biological mechanisms and pathophysiology of brain in major depressive disorder (MDD), which would have minor alterations in the brain function. Therefore, the functional study, such as task MRI functional connectivity, would play a crucial role to explore the brain function in MDD. Different kinds of tasks would determine the alterations in functional connectivity in task MRI studies of MDD. The emotion-related tasks are linked with alterations in anterior cingulate cortex, insula, and default mode network. The emotional memory task is linked with amygdala-hippocampus alterations. The reward-related task would be related to the reward circuit alterations, such as fronto-straital. The cognitive-related tasks would be associated with frontal-related functional connectivity alterations, such as the dorsolateral prefrontal cortex, anterior cingulate cortex, and other frontal regions. The visuo-sensory characteristics of tasks might be associated with the parieto-occipital alterations. The frontolimbic regions might be major components of task MRI-based functional connectivity in MDD. However, different scenarios and tasks would influence the representations of results.
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Affiliation(s)
- Chien-Han Lai
- Psychiatry & Neuroscience Clinic, Taoyuan, Taiwan. .,Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.
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Psychophysiological and Neural Support for Enhanced Emotional Reactivity in Female Adolescents With Nonsuicidal Self-injury. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:682-691. [PMID: 33541848 DOI: 10.1016/j.bpsc.2020.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/26/2020] [Accepted: 11/11/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is prevalent in adolescent populations worldwide. Emotion dysregulation is believed to contribute to NSSI, but underlying mechanisms are less known. We combined psychophysiological and neural data with subjective self-report in close temporal proximity to examine the mechanisms underlying emotion processing in adolescents with NSSI relative to control adolescents without a psychiatric diagnosis. METHODS Thirty female adolescents with NSSI and 30 age-matched female control subjects were included in this case-control study. Participants were presented with negative affective pictures during a functional magnetic resonance imaging scan. In a separate facial electromyography session, the same participants were shown positive and negative affective images and also provided ratings of valence and arousal. RESULTS Participants with NSSI responded to affective images with greater positive (e.g., zygomatic) and greater negative (e.g., corrugator) reactivity. We found no differences in self-reported affect in response to the images. Analyses of the negative picture-viewing functional magnetic resonance imaging data showed a significant positive correlation between anterior insula response and the averaged electromyography magnitude in NSSI, but not in control subjects. CONCLUSIONS Adolescents with NSSI show enhanced emotional reactivity that is associated with anterior insula responding, but no abnormalities in self-reported affect. This discrepancy between self-report and objective measures of emotional reactivity potentially indicates a suppression of the emotional reaction in adolescents with NSSI. Moreover, the current data suggest potential targets for novel therapeutic approaches that can be combined with existing clinical treatment, such as real-time electromyography-based biofeedback focusing on emotional awareness, labeling, and expressing emotional experiences.
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48
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Cullen KR, Schreiner MW, Klimes-Dougan B, Eberly LE, LaRiviere L, Lim KO, Camchong J, Mueller BA. Neural correlates of clinical improvement in response to N-acetylcysteine in adolescents with non-suicidal self-injury. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109778. [PMID: 31682891 PMCID: PMC7058485 DOI: 10.1016/j.pnpbp.2019.109778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 01/05/2023]
Abstract
Non-suicidal self-injury (NSSI) is a serious clinical problem that is common in adolescents. Novel, biologically-informed approaches for treating NSSI in adolescents are needed to prevent negative outcomes such as chronic NSSI and future suicide attempts. N-acetylcysteine (NAC) has been used successfully to address other conditions that involve repetitive maladaptive behaviors and may have utility in addressing NSSI. This study explored neural circuit changes following an open-label, 8-week trial of NAC in female adolescents with NSSI. We measured whole-brain resting-state functional connectivity (RSFC) of the amygdala and the nucleus accumbens before and after treatment using resting-state functional neuroimaging. Usable neuroimaging data from both pre- and post-treatment were available for 18 participants. Reduction in NSSI frequency was associated with a decrease in left amygdala RSFC with right supplementary motor area (SMA), but with an increase in right amygdala RSFC with right inferior frontal cortex. For nucleus accumbens, a reduction in NSSI frequency was associated with a decrease in connectivity between right nucleus accumbens and left superior medial frontal cortex. We also report change in similar circuits accompanying clinical improvement in depression and global psychopathology measures. These preliminary findings suggest amygdala and nucleus accumbens-based circuits as potential treatment targets, and set the stage for future research designed to confirm these neural targets using randomized, placebo-controlled designs to confirm clinical efficacy and mechanisms of effect.
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Affiliation(s)
- Kathryn R. Cullen
- University of Minnesota, Medical School, Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry
| | | | | | - Lynn E. Eberly
- University of Minnesota, School of Public Health, Division of Biostatistics
| | | | - Kelvin O. Lim
- University of Minnesota, Medical School, Department of Psychiatry and Behavioral Sciences
| | - Jazmin Camchong
- University of Minnesota, Medical School, Department of Psychiatry and Behavioral Sciences
| | - Bryon A. Mueller
- University of Minnesota, Medical School, Department of Psychiatry and Behavioral Sciences
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Hooley JM, Dahlgren MK, Best SG, Gonenc A, Gruber SA. Decreased Amygdalar Activation to NSSI-Stimuli in People Who Engage in NSSI: A Neuroimaging Pilot Study. Front Psychiatry 2020; 11:238. [PMID: 32300315 PMCID: PMC7143895 DOI: 10.3389/fpsyt.2020.00238] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 03/11/2020] [Indexed: 01/29/2023] Open
Abstract
In healthy individuals, stimuli associated with injury (such as those depicting blood or wounds) tend to evoke negative responses on both self-report and psychophysiological measures. Such an instinctive aversion makes sense from an evolutionary perspective. However, to engage in nonsuicidal self-injury (NSSI), this natural barrier must be overcome. The Benefits and Barriers model of NSSI predicts that people who engage in NSSI will show diminished aversion to NSSI-related stimuli compared to controls who do not engage in NSSI. We tested this hypothesis in a pilot study assessing 30 adults, 15 of whom reported current skin cutting and 15 of whom had no history of NSSI. Functional magnetic resonance imaging (fMRI) data were collected while participants viewed neutral, positive, and negative images selected from the International Affective Picture System. Participants also viewed NSSI images depicting razors, scalpels, or wounds caused by cutting. Compared to healthy control (HC) participants, the NSSI group showed decreased amygdala and increased cingulate cortex (CC) and orbitofrontal cortex (OFC) activation to NSSI and negative images. They also showed increased amygdalar and OFC activation to positive images. Neither the control group nor the NSSI group demonstrated significant activation within regions more typically associated with reward during any of the conditions; however, positive and negative affect ratings collected throughout the course of the task suggested that none of the affective conditions were viewed as rewarding. Although preliminary, these findings are suggestive of reduced limbic and greater cortical processing of NSSI stimuli in those with a history of this behavior. This has potentially important implications for current models of NSSI as well as for its treatment.
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Affiliation(s)
- Jill M Hooley
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Mary Kathryn Dahlgren
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Stephanie G Best
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States.,McLean Hospital, Boston, MA, United States
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Staci A Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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Westlund Schreiner M, Klimes-Dougan B, Parenteau A, Hill D, Cullen KR. A Framework for Identifying Neurobiologically Based Intervention Targets for NSSI. Curr Behav Neurosci Rep 2019. [DOI: 10.1007/s40473-019-00188-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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