Social Feedback and Dysfunctional Risk Taking in NSSI Adolescents

Study Overview
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Brief Summary
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Nonsuicidal self-injury (NSSI) is defined as direct, intentional physical injury without suicidal intention. Problematic interpersonal relationships and decision-making have been demonstrated to play crucial roles in this maladaptive behavior, especially for adolescents. Accumulating evidence suggests that decision processes and risk-taking are strongly influenced by the affective state of the individual. However, whether these interactions are disrupted in NSSI adolescents has not been systematically examined. In the current study, the investigators modified one of the most widely used paradigms for measuring an individual's risk decision-making, the Balloon Analogue Risk Task (BART). The investigators combine social reward (green balloon), punishment (red balloon), and control feedback (yellow balloon), to investigate whether the NSSI adolescents have dysfunctional risk-taking behavior while facing different social outcomes. The investigators recruit one group of NSSI adolescents (n = 40) and one health control (HC) group (n = 40), to compare their risk-related decisions during the emotional BART. The investigators hypothesize that compared to HC, NSSI adolescents will show altered effects of social reward and punishment on risk-related decision-making, in particular higher risk avoidance in the context of social punishment.

Official Title
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Risk and Social Feedback in Adolescents With Nonsuicidal Self-Injury

Conditions
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Nonsuicidal Self Injury, Risk-Taking

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 15-18 years right-handed normal or corrected normal visual acuity meet the proposed DSM-5 frequency criteria (e.g., ≥5 days of NSSI behaviors in the past year) Exclusion Criteria: diagnosis of borderline personality disorder, major depressive disorder, other psychiatric disorders, etc. high suicidal risk recent use of medications that can affect neural activity have received or are receiving Dialectical Behavior Therapy (DBT) other treatment for emotional problems within the past 6 months have a contraindication to MRI scanning (e.g., metal implants, claustrophobia or other conditions that make them inappropriate for MRI scanning)

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| NSSI<br> | |
| HC<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risky avoidance measured by BART | Adjusted number of pumps (average number of pumps excluding balloons that exploded) as the index of risk avoidance. Alterations in the patients will be determined by using ANOVA models with the group (NSSI vs. HC) as a between-subject factor and emotional feedback (social reward, social punishment, and control) as a within-subject factor. | About 20 minutes | 
| Decision-making measured by BART | Earned money (total amount of money earned in the task) as the index of decision-making. Alterations in the patients will be determined by using ANOVA models with the group (NSSI vs. HC) as a between-subject factor and emotional feedback (social reward, social punishment, and control) as a within-subject factor. | About 20 minutes |