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The Neural Basis of Social Evaluation in Adolescents with Non-Suicidal Self-Injury

Non-suicidal self-injurious behavior (NSSI) is common in adolesitives, an issue that has become increasingly important in the field [8]. In addition to these noteworthy contributions, several limitations of cents, with… Click to show full abstract

Non-suicidal self-injurious behavior (NSSI) is common in adolesitives, an issue that has become increasingly important in the field [8]. In addition to these noteworthy contributions, several limitations of cents, with rising prevalence in recent decades. NSSI is associated with future suicide attempts [1], underscoring the need to develop new interventions. NSSI episodes are often triggered by interpersonal stress; individuals with NSSI have enhanced rejection sensitivity [2], often feeling they do not belong, even when they are included [3]. Therefore, investigation of the neural systems underlying self/other perceptions is a promising area for NSSI research. In the current issue, Perini et al. examined behavioral and neural correlates of self/other evaluation using a within-scanner rejection sensitivity paradigm in 30 adolescents with NSSI and 30 healthy controls [4]. Participants judged others, were informed how others judged them, and reported their perceptions and feelings during the procedure. Compared to controls, the NSSI group felt rejected more frequently, felt more upset during perceived rejection, disliked seeing their own face more, and (at a trend) disliked others more frequently. Both groups enjoyed being liked by others. Replicating this team's prior work using this paradigm in healthy adolescents [5], both groups demonstrated activation in the anterior cingulate cortex and insula during social evaluation (no group differences). However, a multivariate machine learning analysis was capable of classifying groupswith 68% accuracy, 74% sensitivity and 59% specificity. Post-hoc analysis of the classification results showed thatwhile awaiting peer evaluation, activation in the subgenual cingulate cortex, dorsomedial prefrontal cortex, and posterior cingulate cortex was lower in the NSSI group than controls. Validating the construct, classification scores correlated with rejection sensitivity scores. A key strength of this study is the application of a novel, ecologicallyvalid behavioral paradigm to assess social rejection in adolescents with NSSI. In social media, which is nearly ubiquitous in adolescents [6], young people frequently judge themselves and others. Therefore, the electronic, interactive format represents an accessible platform for assessing perceived interpersonal judgments that is similar to adoles-

Keywords: suicidal self; rejection; sensitivity; evaluation; social evaluation; non suicidal

Journal Title: EClinicalMedicine
Year Published: 2019

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