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Mirabella G, Mancini C, Pacifici S, Guerrini D, Terrinoni A. Enhanced reactive inhibition in adolescents with non-suicidal self-injury disorder. Dev Med Child Neurol 2024; 66:654-666. [PMID: 37899708 DOI: 10.1111/dmcn.15794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 08/08/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023]
Abstract
AIM To investigate whether the core of the pathophysiology underlying non-suicidal self-injury (NSSI) relates to poor impulse control due to impaired motor inhibition (i.e. the ability to inhibit a preplanned motor response). METHOD We conducted a case-control study to compare the proficiency of two domains of motor inhibition, that is, reactive and proactive inhibition, by giving the reaching arm version of the stop-signal task and a go-only task to 28 drug-naive adolescents with NSSI disorder (NSSID) (mean age [SD] 15 years 8 months [1 year 4 months]; three males and 25 females) and 28 typically developing adolescents (mean age 15 years 8 months [1 year 5 months]; three males and 25 females). RESULTS Reactive inhibition, as determined by the duration of the stop-signal reaction time, was enhanced in adolescents with NSSID compared to typically developing controls (194.2 [22.5 ms] vs 217.5 [17.3 ms], p < 0.001). By contrast, proactive inhibition was similar in both groups. Lastly, the level of impulsivity, assessed using the Barratt Impulsiveness Scale Version 11, did not differ between typically developing adolescents and adolescents with NSSID. However, adolescents with NSSID were more impulsive than controls in a subscale of the UPPS-P Impulsive Behavior Scale. INTERPRETATION NSSID is not driven by heightened motor impulsivity. Instead, adolescents with NSSID exhibited greater proficiency in reactive inhibition, a proxy for motor impulsivity. We suggest that the enhancement of reactive inhibition strengthens action control, allowing adolescents to suppress their self-protection instinct and perform NSSI behaviours.
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Affiliation(s)
- Giovanni Mirabella
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Neuromed, Pozzilli, Italy
| | - Christian Mancini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Susanna Pacifici
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Daiana Guerrini
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Arianna Terrinoni
- Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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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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Burke TA, Allen KJ, Carpenter RW, Siegel DM, Kautz MM, Liu RT, Alloy LB. Emotional response inhibition to self-harm stimuli interacts with momentary negative affect to predict nonsuicidal self-injury urges. Behav Res Ther 2021; 142:103865. [PMID: 33940222 PMCID: PMC8523023 DOI: 10.1016/j.brat.2021.103865] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 03/29/2021] [Accepted: 04/06/2021] [Indexed: 01/31/2023]
Abstract
The current study investigated whether impaired emotional response inhibition to self-harm stimuli is a risk factor for real-time nonsuicidal self-injury (NSSI) urges. Participants were 60 university students with a history of repetitive NSSI. At baseline, participants completed an emotional stop-signal task assessing response inhibition to self-harm stimuli. Participants subsequently completed an ecological momentary assessment protocol in which they reported negative affect, urgency, and NSSI urge intensity three times daily over a ten-day period. Impaired emotional response inhibition to self-harm stimuli did not evidence a main effect on the strength of momentary NSSI urges. However, emotional response inhibition to self-harm images interacted with momentary negative affect to predict the strength of real-time NSSI urges, after adjusting for emotional response inhibition to neutral images. Our findings suggest that emotional response inhibition deficits specifically to self-harm stimuli may pose vulnerability for increased NSSI urge intensity during real-time, state-level negative affect.
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Affiliation(s)
- Taylor A. Burke
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior
| | | | | | - David M. Siegel
- Rutgers University, Graduate School of Applied and Professional Psychology
| | | | - Richard T. Liu
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior
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Allen KJD, Sammon MM, Fox KR, Stewart JG. Emotional Response Inhibition: A Shared Neurocognitive Deficit in Eating Disorder Symptoms and Nonsuicidal Self-Injury. Brain Sci 2020; 10:E104. [PMID: 32075254 PMCID: PMC7071419 DOI: 10.3390/brainsci10020104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 01/18/2023] Open
Abstract
Eating disorder (ED) symptoms often co-occur with non-suicidal self-injury (NSSI). This comorbidity is consistent with evidence that trait negative urgency increases risk for both of these phenomena. We previously found that impaired late-stage negative emotional response inhibition (i.e., negative emotional action termination or NEAT) might represent a neurocognitive mechanism for heightened negative urgency among people with NSSI history. The current study evaluated whether relations between negative urgency and ED symptoms similarly reflect deficits in this neurocognitive process. A total of 105 community adults completed an assessment of ED symptoms, negative urgency, and an emotional response inhibition task. Results indicated that, contrary to predictions, negative urgency and NEAT contributed independent variance to the prediction of ED symptoms, while controlling for demographic covariates and NSSI history. Worse NEAT was also uniquely associated with restrictive eating, after accounting for negative urgency. Our findings suggest that difficulty inhibiting ongoing motor responses triggered by negative emotional reactions (i.e., NEAT) may be a shared neurocognitive characteristic of ED symptoms and NSSI. However, negative urgency and NEAT dysfunction capture separate variance in the prediction of ED-related cognitions and behaviors, distinct from the pattern of results we previously observed in NSSI.
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Affiliation(s)
| | - M. McLean Sammon
- Department of Psychology, Oberlin College, Oberlin, OH 44074-1024, USA;
| | - Kathryn R. Fox
- Department of Psychology, University of Denver, Denver, CO 80210-4638, USA;
| | - Jeremy G. Stewart
- Department of Psychology, Queen’s University, Kingston, ON K7L 3N6, Canada
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Allen KJD, Hooley JM. Negative Emotional Action Termination (NEAT): Support for a Cognitive Mechanism Underlying Negative Urgency in Nonsuicidal Self-Injury. Behav Ther 2019; 50:924-937. [PMID: 31422848 DOI: 10.1016/j.beth.2019.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/29/2019] [Accepted: 02/01/2019] [Indexed: 11/27/2022]
Abstract
Negative urgency, the self-reported tendency to act impulsively when distressed, increases risk for nonsuicidal self-injury (NSSI). NSSI is also associated with impaired negative emotional response inhibition (NERI), specifically negative emotional action termination (NEAT), a cognitive process theoretically related to negative urgency. We previously found that adults with NSSI history had difficulty inhibiting behavioral responses to affective images depicting negative content (but not positive or neutral images) in an Emotional Stop-Signal Task. We sought to replicate this finding, determine whether this deficit extends to negative emotional action suppression (NEAS; an earlier stage of NERI), and explore whether impairment in these two stages of emotional response inhibition helps explain the relationship between negative urgency and NSSI. Eighty-eight adults with NSSI history (n = 45) and healthy control participants (n = 43) without NSSI history or psychopathology completed a clinical interview, symptom inventories, an impulsivity questionnaire, and behavioral assays of early and late NERI (NEAS and NEAT, respectively). The NSSI group had worse NEAT than the control group in the Emotional Stop-Signal Task, but no group differences in NEAS were observed in an Emotional Go/No-go task. However, both early and late stages of NERI accounted for independent variance in negative urgency. We additionally found that NEAT explained variance in the association between negative urgency and NSSI. These results suggest that impulsive behavior in NSSI may involve specifically impaired inhibitory control over initiated negative emotional impulses. This deficit in late response inhibition to negative emotional stimuli might reflect a cognitive mechanism or pathway to elevated negative urgency among people who self-injure.
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Mo J, Wang C, Niu X, Jia X, Liu T, Lin L. The relationship between impulsivity and self-injury in Chinese undergraduates: The chain mediating role of stressful life events and negative affect. J Affect Disord 2019; 256:259-266. [PMID: 31200164 DOI: 10.1016/j.jad.2019.05.074] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 05/26/2019] [Accepted: 05/30/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Self-injury is one of the strongest predictors of suicide. Undergraduates have been recognized as one of the populations with the highest incidence of self-injury. A substantial body of literature has documented the important influence of impulsivity on self-injury. However, few studies have focused on the mediating mechanisms underlying this relationship. Based on the stress generation hypothesis and the affect-regulation model of self-injury, this study constructed a chain mediating model to examine whether stressful life events and negative affect mediated the relationship between impulsivity and self-injury among Chinese undergraduates. METHODS A total of 2270 undergraduates (69.8% female, mean age = 19 years) were recruited to participate in this study and completed self-report measures of impulsivity, self-injury, stressful life events and negative affect. RESULTS (1) There were significant positive correlations among impulsivity, stressful life events, negative affect and self-injury. (2) After controlling for the effect of gender, impulsivity still had a significant positive effect on self-injury. (3) Undergraduates' self-injury was affected by impulsivity partly through 3 different pathways: the mediating role of stressful life events, the mediating role of negative affect, and the chain mediating role of both stressful life events and negative affect. CONCLUSIONS These findings contribute to a more comprehensive understanding of the risk factors for self-injury. Impulsivity, stressful life events, and negative affect might increase the occurrence of self-injury. In addition, the chain mediating effect of stressful life events and negative affect plays an important role in the occurrence of self-injury.
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Affiliation(s)
- Juanchan Mo
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Chenxu Wang
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Xiaoxiao Niu
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Xuji Jia
- Faculty of Psychology, Tianjin Normal University, Tianjin, China; Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Tuo Liu
- Faculty of Psychology, Tianjin Normal University, Tianjin, China; Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Lin Lin
- Faculty of Psychology, Tianjin Normal University, Tianjin, China; Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.
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Mullins-Sweatt SN, DeShong HL, Lengel GJ, Helle AC, Krueger RF. Disinhibition as a unifying construct in understanding how personality dispositions undergird psychopathology. JOURNAL OF RESEARCH IN PERSONALITY 2019; 80:55-61. [PMID: 31537951 DOI: 10.1016/j.jrp.2019.04.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Disinhibition has been a construct of interest for decades, as evidenced by its inclusion in most prominent models of general personality functioning and its link to personality pathology, other psychopathology, health behaviors, and public health concerns. Disinhibition is manifest in behavioral, task based, and physiological measures, and common etiologies are a major reason for the coherence of the domain across a variety of assessment modalities. The current review will provide a summary of the conceptualization of the construct across prominent models, its link to psychopathology and maladaptive behaviors, and its etiology. Finally, we provide discussion on its clinical application utilizing disinhibition to aid in understanding comorbid psychopathology and through a description of its potential use in treatment.
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Affiliation(s)
| | - Hilary L DeShong
- Mississippi State University, Department of Psychology, Starkville, MS
| | - Gregory J Lengel
- Drake University, Department of Psychology & Neuroscience, Des Moines, IA
| | - Ashley C Helle
- University of Missouri, Department of Psychological Sciences, Columbia, MO
| | - Robert F Krueger
- University of Minnesota, Department of Psychology, Minneapolis, MN
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Kolbeck K, Moritz S, Bierbrodt J, Andreou C. Borderline Personality Disorder: Associations Between Dimensional Personality Profiles and Self-Destructive Behaviors. J Pers Disord 2019; 33:249-261. [PMID: 29505390 DOI: 10.1521/pedi_2018_32_346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ongoing research is shifting towards a dimensional understanding of borderline personality disorder (BPD). Aim of this study was to identify personality profiles in BPD that are predictive of self-destructive behaviors. Personality traits were assessed (n = 130) according to the five-factor model of personality (i.e., Neuroticism, Extraversion, Openness to Experience, Agreeableness, Conscientiousness) and an additional factor called Risk Preference. Self-destructive behavior parameters such as non-suicidal self-injury (NSSI) and other borderline typical dyscontrolled behaviors (e.g., drug abuse) were assessed by self-report measures. Canonical correlation analyses demonstrated that Neuroticism, Extraversion, and Conscientiousness are predictors of NSSI. Further, Neuroticism, Agreeableness, and Risk Preference were associated with dyscontrolled behaviors. Our results add further support on personality-relevant self-destructive behaviors in BPD. A combined diagnostic assessment could offer clinically meaningful insights about the causes of self-destruction in BPD to expand current therapeutic repertoires.
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Affiliation(s)
- Katharina Kolbeck
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Julia Bierbrodt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany.,Center for Psychotic Disorders, University Psychiatric Clinics, University of Basel, Switzerland
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Allen KJD, Fox KR, Schatten HT, Hooley JM. Frequency of nonsuicidal self-injury is associated with impulsive decision-making during criticism. Psychiatry Res 2019; 271:68-75. [PMID: 30469091 PMCID: PMC6382530 DOI: 10.1016/j.psychres.2018.11.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/22/2018] [Accepted: 11/11/2018] [Indexed: 01/23/2023]
Abstract
Research indicates that nonsuicidal self-injury (NSSI) is associated with impulsive traits, but not impulsive behavior on laboratory tasks, even in the context of negative mood. However, previous studies may not have induced forms of negative affect most relevant to NSSI. For example, evidence implicates both self-criticism and feeling criticized by others in NSSI engagement. We conducted two studies examining whether negative mood related to criticism increases impulsive decision-making among individuals with NSSI histories, using a gambling task embedded with auditory critical comments; participants imagined loved ones saying these comments to them. Study 1 evaluated community adults with (n = 33) and without (n = 31) NSSI histories. Despite no group differences in task performance, we found an association between past-year NSSI frequency and more impulsive choices during criticism. This was confirmed in Study 2 using a separate sample of adults (n = 69) with more frequent and recent NSSI. In regression models including self-criticism and depressive symptoms, only task performance (i.e., decision-making while receiving critical feedback) predicted NSSI frequency across multiple measurement periods. These studies suggest that more frequent and recent NSSI is associated with neurocognitive impulsivity, specifically in negative emotional contexts involving actual or imagined criticism in close relationships.
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Affiliation(s)
- Kenneth J D Allen
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Psychosocial Research Program, Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA.
| | - Kathryn R Fox
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, 02138 MA, USA
| | - Heather T Schatten
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Psychosocial Research Program, Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA
| | - Jill M Hooley
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, 02138 MA, USA
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