Dysfunction of goal-directed control in patients with depression and nonsuicidal self-injury.

Abstract

BackgroundNon‐suicidal self‐injury (NSSI) is a common problem associated with dangerous outcomes. Dysfunction of goal‐directed behavioral control may contribute to NSSI. To test this, we used a novel experimental paradigm (Pavlovian‐to‐Instrumental Transfer, PIT) to test whether patients with NSSI utilize Pavlovian conditioned stimuli (CSs) during goal‐directed control of ongoing behavior.MethodsThirty‐five depressed patients with NSSI (D‐NSSI) and thirty‐four healthy controls performed a PIT task. We measured the influence of positive and negative background CSs on instrumental responses for rewards.ResultsThe results showed that D‐NSSI performed significantly lower PIT than controls, and PIT measures were negatively correlated with NSSI frequency. Furthermore, in a subset of patients exhibiting high levels of compulsivity, PIT positively moderated the relationship between compulsivity and NSSI frequency.ConclusionsThese results indicate that D‐NSSI patients have difficulties in using different CSs to control ongoing behavior in a goal‐directed manner, and the dysfunction of goal‐directed control may contribute to NSSI.