Self-injuring adolescent girls exhibit insular cortex volumetric abnormalities that are similar to those seen in adults with borderline personality disorder
Open accessAbstract
Self-inflicted injury (SII) in adolescence is a serious public health concern that portends prospective vulnerability to internalizing and externalizing psychopathology, borderline personality development, suicide attempts, and suicide. To date, however, our understanding of neurobiological vulnerabilities to SII is limited. Behaviorally, affect dysregulation is common among those who self-injure. This suggests ineffective cortical modulation of emotion, as observed among adults with borderline personality disorder. In borderline samples, structural and functional abnormalities are observed in several frontal regions that subserve emotion regulation (e.g., anterior cingulate, insula, dorsolateral prefrontal cortex). However, no volumetric analyses of cortical brain regions have been conducted among self-injuring adolescents. We used voxel-based morphometry to compare cortical gray matter volumes between self-injuring adolescent girls, ages 13-19 years (n = 20), and controls (n = 20). Whole-brain analyses revealed reduced gray matter volumes among self-injurers in the insular cortex bilaterally, and in the right inferior frontal gyrus, an adjacent neural structure also implicated in emotion and self-regulation. Insular and inferior frontal gyrus gray matter volumes correlated inversely with self-reported emotion dysregulation, over-and-above effects of psychopathology. Findings are consistent with an emotion dysregulation construal of SII, and indicate structural abnormalities in some but not all cortical brain regions implicated in borderline personality disorder among adults.
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Compared with healthy controls, self-injurers show reduced insula gray matter volume, but this is not substantiated in BPD youth reporting parasuicidal behaviors.
“In comparison to healthy controls, self-injurers show reduced insula GMV (62, 64), but this is not substantiated in BPD youth reporting parasuicidal behaviors (65).”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [62]
One study reports reduced right inferior frontal gyrus gray matter volume in NSSI adolescents compared to non-depressed individuals.
“One study reports reduced GMV in the right IFG among NSSI adolescents compared to non-depressed individuals (62).”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [62]
Youth STB research is characterized by alterations within prefrontal and limbic systems, where a compromised regulatory system may potentiate suicidal thinking, and perturbations in top-down and bottom-up connections may lead to suicidal behaviors.
“Consistent with Schmaal and colleagues (32), youth STB research is characterized by alterations within prefrontal (53–55) and limbic (62, 75, 102, 103) systems whereby a compromised regulatory system may potentiate suicidal thinking, and perturbations in top-down and bottom-up connections may lead to suicidal behaviors.”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [62]
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Takahashi, T., Chanen, A. M., Wood, S. J., Yücel, M., Tanino, R., Suzuki, M., Velakoulis, D., Pantelis, C., & McGorry, P. D. (2009) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2009.07.017 · Cited by 36 · see citing works
Bodfish, J. W., & Lewis, M. H. (2002) · American Psychological Association eBooks · doi:10.1037/10457-002 · Cited by 35 · see citing works
Adolescents’ Willingness to Access School-Based Support for Nonsuicidal Self-Injury
Heath, N. L., Baxter, A. L., Toste, J. R., & McLouth, R. (2010) · Canadian Journal of School Psychology · doi:10.1177/0829573510377979 · Cited by 31 · see citing works
Urgesi, C., Mattiassi, A. D. A., Buiatti, T., & Marini, A. (2016) · NeuroImage · doi:10.1016/j.neuroimage.2016.05.039 · Cited by 25 · see citing works
Anxiety Regulation: A Developmental Psychopathology Perspective
Tone, E. B., Garn, C. L., & Pine, D. S. (2016) · Wiley eBooks · doi:10.1002/9781119125556.devpsy214 · Cited by 14 · see citing works
A Developmental Model of Self-Inflicted Injury, Borderline Personality, and Suicide Risk
Derbidge, C. M., & Beauchaine, T. P. (2014) · Springer eBooks · doi:10.1007/978-1-4614-9608-3_26 · Cited by 12 · see citing works
Self-citationSelf-Injury, Borderline Personality Development, and the Externalizing Spectrum
Beauchaine, T. P., Hinshaw, S. P., Kaufman, E. A., Crowell, S. E., & Stepp, S. D. (2014) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199324675.013.19 · Cited by 3 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- First MB Gibbon M Spitzer RL Williams JB Benjamin LS 1997 User’s guide for the Structured Clinical Interview for DSM-IV Axis II personality disorders Washington DC American Psychiatric Press
Cited by
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Neural correlates associated with suicide and nonsuicidal self-injury in youth
Auerbach, R. P., Pagliaccio, D., Allison, G. O., Alqueza, K. L., & Alonso, M. F. (2021) · Biological Psychiatry · doi:10.1016/j.biopsych.2020.06.002 · Cited by 204 · see citing works
Beauchaine, T. P., Hinshaw, S. P., & Bridge, J. A. (2019) · Clinical Psychological Science · doi:10.1177/2167702618818474 · Cited by 80 · see citing works
Self-citationZheng, Q., Liu, J., Ji, Y., Zhang, Y., Chen, X., & Liu, B. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04260-z · Cited by 26 · see citing works
- Authors
- Beauchaine, T. P., Sauder, C. L., Derbidge, C. M., & Uyeji, L. L.
- Affiliations
- The Ohio State University (US)
- The University of Texas at San Antonio (US)
- University of Utah (US)
- Temple University (US)
- Corresponding author
- Beauchaine, Theodore P.
- Venue
- Development and Psychopathology
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018-11-05
- Volume
- 31
- Issue
- 04
- Pages
- 1203-1212
- ISSN
- 0954-5794 (ISSN-L)
- 1469-2198
- PMC
- PMC6500772
- OpenAlex
- W2899698906
- Cited by
- 49
- References
- 104
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 7 · 2020: 4 · 2019: 4
- FWCI
- 4.40
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Development and Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (F31MH086198)
- National Institute of Dental and Craniofacial Research (UH2DE025980)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- self-harm, adolescent girls, insula, gray matter volume, inferior frontal gyrus, emotional dysregulation, borderline personality disorder, affective self-regulation, suicide risk
- MeSH terms
- Adolescent, Borderline Personality Disorder, Brain, Cerebral Cortex, Emotions, Female, Frontal Lobe, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Organ Size, Personality Development, Prospective Studies, Self-Injurious Behavior, Prefrontal Cortex, Young Adult, Gray Matter
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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