Neural correlates of affective theory of mind in medication-free nonsuicidal self-injury: An fMRI study

Abstract

Emerging evidence indicates that emotion processing deficits are associated with nonsuicidal self-injury (NSSI). However, limited attention has been paid to the socio-affective functions of NSSI. In this study, we aimed to investigate the affective theory of mind (ToM) in medication-free individuals engaging in NSSI at both behavioral and neural levels. Twenty-eight individuals (mean age = 22.96 years) who engaged in NSSI and 38 age-, sex-, and IQ-matched controls (mean age = 22.79 years) underwent functional magnetic resonance imaging while performing the “Reading the Mind in the Eyes Test” (RMET). All participants also completed the Difficulties in Emotion Regulation Scale (DERS), Toronto Alexithymia Scale (TAS-20), and Beck Scale for Suicide Ideation (BSI). Although we did not find significant group differences in the RMET performance, the NSSI group, relative to the controls, exhibited significantly greater left medial superior frontal lobe activation and decreased right angular gyrus activation than did the control group. Reduced right angular gyrus activity was related to higher DERS and TAS scores across all participants. Our findings provide new evidence for aberrant neural processing of affective ToM in self-injurers. Future studies in developing intervention protocols for NSSI should focus on the multifaceted phases of socio-affective processing.

Negative association between non‐suicidal self‐injury in adolescents and default mode network activation during the distraction blocks of a rumination task

“…The middle frontal gyrus overlaps with both the dorsal and ventral attention regions (Fox et al, 2006), suggesting that with higher lifetime NSSI episodes, individuals tend to have more attentional engagement in the context of repetitive negative thinking. Previous work has also demonstrated greater middle frontal gyrus activation in response to NSSI photographs among adolescent females with NSSI and increased superior frontal gyrus activity during an affective theory of mind task in adults with NSSI (Moon et al, 2022; Plener et al, 2012).…”

The effect of increased reward sensitivity on risk decision making in adolescents with non-suicidal self-injury

“…In addition, recent studies have found that NSSI behavior is on the rise [7,8]. Neuropsychological alterations in adolescents with NSSI involve emotion dysregulation, reduced impulse control, and impaired problem solving [9][10][11][12][13]. D'Zurilla and Goldfried [14] de ned decision making (DM) as a component of problem-solving skills, which are advanced cognitive processes.…”

Altered structural brain connectivity and reorganization of hubs are associated with emotional processing in nonsuicidal self-injury

“…A great deal of empirical evidence has shown that individuals with NSSI, relative to controls, exhibit higher emotion dysregulation, such as limited access to regulation strategies, nonacceptance of emotional responses, and difficulties in impulse control [2,34]. More recently, along with emotion regulation problems, dysfunctions in socio-affective processing, such as emotional contagion, emotional mimicry, and affective theory of mind, have also been highlighted in those engaging in NSSI [35][36][37][38][39]. In particular, emotional contagion is closely tied to an individual's well-being and mental health [40], as the successful contagion of emotions has adaptive advantages in social species, such as humans, in allowing individuals to bond and communicate among close relationships [41][42][43].…”