Behavioral measures of impulsivity and compulsivity in adolescents with nonsuicidal self-injury.

Nina M Lutz,Samuel R Chamberlain,Barbara J Sahakian,Paul O Wilkinson,Peter B Jones,Ian M Goodyer,Anupam Bhardwaj

doi:10.1017/s1092852921000274

Abstract

BackgroundNonsuicidal self-injury (NSSI) is prevalent among adolescents and research is needed to clarify the mechanisms which contribute to the behavior. Here, the authors relate behavioral neurocognitive measures of impulsivity and compulsivity to repetitive and sporadic NSSI in a community sample of adolescents.MethodsComputerized laboratory tasks (Affective Go/No-Go, Cambridge Gambling Task, and Probabilistic Reversal Task) were used to evaluate cognitive performance. Participants were adolescents aged 15 to 17 with (n = 50) and without (n = 190) NSSI history, sampled from the ROOTS project which recruited adolescents from secondary schools in Cambridgeshire, UK. NSSI was categorized as sporadic (1-3 instances per year) or repetitive (4 or more instances per year). Analyses were carried out in a series of linear and negative binomial regressions, controlling for age, gender, intelligence, and recent depressive symptoms.ResultsAdolescents with lifetime NSSI, and repetitive NSSI specifically, made significantly more perseverative errors on the Probabilistic Reversal Task and exhibited significantly lower quality of decision making on the Cambridge Gambling Task compared to no-NSSI controls. Those with sporadic NSSI did not significantly differ from no-NSSI controls on task performance. NSSI was not associated with behavioral measures of impulsivity.ConclusionsRepetitive NSSI is associated with increased behavioral compulsivity and disadvantageous decision making, but not with behavioral impulsivity. Future research should continue to investigate how neurocognitive phenotypes contribute to the onset and maintenance of NSSI, and determine whether compulsivity and addictive features of NSSI are potential targets for treatment.

Highlights

One in five adolescents (22%) engage in nonsuicidal self-injury (NSSI), the direct and deliberate damage of body tissue without suicidal intent.[1]
Neither sporadic nor repetitive Nonsuicidal self-injury (NSSI) was associated with increased commission errors (Table 2), whether across the task or response pattern across valences
While we reduced the effects of this potential confound by controlling for recent depressive symptoms at the time of neurocognitive testing, additional research is needed to elucidate the relationship between NSSI, psychopathology, and cognitive impairments

Summary

Introduction

One in five adolescents (22%) engage in nonsuicidal self-injury (NSSI), the direct and deliberate damage of body tissue without suicidal intent.[1]. The overlapping neurocognitive phenotypes “impulsivity” and “compulsivity” have become a focus of this emerging literature Both constructs are implicated in difficulty controlling behavioral responses.[11] Impulsivity broadly describes a pattern of rash reactions without due consideration for consequences.[15] Many people report NSSI which fits this. Adolescents with lifetime NSSI, and repetitive NSSI made significantly more perseverative errors on the Probabilistic Reversal Task and exhibited significantly lower quality of decision making on the Cambridge Gambling Task compared to no-NSSI controls. Those with sporadic NSSI did not significantly differ from no-NSSI controls on task performance. Future research should continue to investigate how neurocognitive phenotypes contribute to the onset and maintenance of NSSI, and determine whether compulsivity and addictive features of NSSI are potential targets for treatment

Results

Discussion

Conclusion