Fronto-limbic connectivity as a predictor of improvement in nonsuicidal self-injury in adolescents following psychotherapy
Abstract
Objectives: Key neurobiological factors contribute to vulnerability to nonsuicidal self-injury (NSSI) among adolescents and how they respond to treatment targeted to reduce such behaviors. This study aims to examine differences in intrinsic functional connectivity between adolescents with NSSI and healthy controls (HCs) and to identify baseline connectivity markers that predict improvements in NSSI after psychotherapy. Methods: Adolescents aged 12–17 (n = 24) with repetitive NSSI along with demographically similar HCs (n = 16) underwent resting-state functional MRI scanning after which patients received up to 4 months of psychological treatment. A seed-based approach was used to examine baseline between-group differences in intrinsic functional connectivity of the amygdala and the medial prefrontal cortex (mPFC). Further analyses examined the associations between intrinsic functional connectivity at baseline and improvement in NSSI after psychological treatment. Results: Compared with HCs, adolescents with NSSI showed significantly reduced connectivity between the amygdala and the anterior cingulate cortex, subcallosal cortex, and paracingulate gyrus, as well as between the amygdala and a cluster encompassing the right planum temporale and right insula. Adolescents with NSSI, compared with HCs, also showed reduced connectivity between the mPFC and two clusters: one located in the precentral and postcentral gyri and another in the left insula. After treatment, 50% of patients reported fewer NSSI episodes compared to baseline, which was considered as improvement. Stronger negative amygdala-prefrontal connectivity was associated with greater posttreatment improvement in NSSI. Conclusions: Adolescents with NSSI may have aberrant amygdala and mPFC connectivity compared with HCs. Furthermore, stronger baseline negative amygdala-prefrontal connectivity may predict greater improvement in NSSI after psychological intervention. Given that no prior study has used resting-state functional connectivity to predict response to psychological treatment in adolescents with NSSI, replication of these findings is needed.
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Medial PFC-amygdala connectivity correlates with change in suicidal ideation but not suicidal behavior following treatment.
“Medial PFC-amygdala connectivity also correlates with change in suicidal ideation but not suicidal behavior following treatment (109).”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [109]
Findings suggest amygdala-seed connectivity is altered in adolescents with NSSI history, particularly with ACC.
“Although limited, findings suggest that amygdala-seed connectivity is altered in adolescents with an NSSI history, particularly with the ACC (96, 109).”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [109]
Relative to healthy adolescents, youth with NSSI history show reduced amygdala-seed connectivity with ACC and a cluster spanning right planum temporale and right insula, and reduced medial PFC connectivity with precentral/postcentral gyri and left insula.
“relative to healthy adolescents, youth with an NSSI history show reduced amygdala-seed connectivity with the ACC and a cluster spanning right planum temporale and right insula, as well as reduced medial PFC connectivity with the precentral/postcentral gyri and left insula.”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [109]
Reductions in NSSI frequency post-treatment associate with greater negative amygdala-ACC, greater amygdala-brainstem/parahippocampal gyrus, reduced positive medial PFC-amygdala/striatum, and more negative medial PFC-intracalcarine cortex RSFC.
“Reductions in NSSI frequency post-treatment associate with greater negative amygdala-ACC, greater amygdala-brainstem/parahippocampal gyrus, reduced positive medial PFC-amygdala/striatum, and more negative medial PFC-intracalcarine cortex RSFC.”
From Neural correlates associated with suicide and nonsuicidal self-injury in youth (2021) · cites this paper as [109]
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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
- Authors
- Santamarina-Perez, P., Romero, S., Mendez, I., Leslie, S. M., Packer, M. M., Sugranyes, G., Picado, M., Font, E., Moreno, E., Martinez, E., Morer, A., Romero, M., & Singh, M. K.
- Affiliations
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Stanford Medicine (US)
- Hospital Clínic de Barcelona (ES)
- Venue
- Journal of Child and Adolescent Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2019-08
- Volume
- 29
- Issue
- 6
- Pages
- 456-465
- ISSN
- 1044-5463 (ISSN-L)
- 1557-8992
- OpenAlex
- W2950487112
- Cited by
- 64
- References
- 57
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 6 · 2023: 12 · 2022: 11 · 2021: 8 · 2020: 2 · 2019: 1
- FWCI
- 6.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child and Adolescent Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- non-suicidal self-injury, adolescents, resting-state functional connectivity, amygdala, medial prefrontal cortex, amygdala-prefrontal connectivity, treatment response prediction, psychotherapy, anterior cingulate cortex, subcallosal cortex, paracingulate gyrus, insula, planum temporale
- MeSH terms
- Adolescent, Brain, Child, Female, Frontal Lobe, Humans, Limbic System, Magnetic Resonance Imaging, Male, Psychotherapy, Self-Injurious Behavior
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