About this trial
Nonsuicidal self-injury (NSSI) is defined as direct, deliberate bodily harm without suicidal intention. Recent studies indicate that prevalence rates are increasing worldwide, in particular under adolescents, indicating a growing public health issue. An impaired ability to regulate negative emotion has been suggested to play a potential role in NSSI behavior. Some recent interventions aim at improving dysfunctional emotion regulation via 'acceptance'. Acceptance represents an objective, nonreactive, nonjudgmental, and calming emotion regulation strategy, partly based on the philosophy of dialectical behavior therapy (DBT) that has been widely used in the clinical treatment of NSSI behaviors. The aim of the present functional magnetic resonance imaging (fMRI) study is to examine whether adolescents with NSSI can implement the acceptance strategy in naturalistic emotional contexts (immersive video clips) and whether they differ from healthy controls in terms of behavioral and neural effects. To this end, the investigators recruit one group of NSSI adolescents (n=40) and one healthy control group (n=40), to compare the subjective emotional experience as well as underlying neural activity as measured by blood oxygenation level-dependent (BOLD) fMRI. The investigators hypothesize that compared to HC, NSSI adolescents will experience stronger negative emotions and show dysregulated neural recruitment of brain systems engaged in emotional reactivity and regulations (e.g. limbic regions, default mode network, and frontal regions).
Eligibility criteria
This trial accepts healthy volunteersQualifiers
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)
Disqualifiers
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
Trial population
Treatment-seeking NSSI individuals will be recruited from local hospitals and HC from the community.
Trial design
Case-control
Cross-sectional
Treatments tested in this trial
Acceptance mindset
BehavioralBrief training of acceptance versus emotional reactivity as emotion regulation strategy.
Treatment groups
Trial outcomes
Primary outcomes
Negative subjective emotional experience as indexed by self-report
Subjects will rate their negative affect on a scale ranging from 1-9 in response to neutral and negative emotional stimuli during normal experience or acceptance. Alterations in the patients will be determined by using ANOVA models with the group (NSSI vs. HC) as a between-subject factor and emotion regulation condition as a within-subject factor.
Neural activity as indexed by BOLD fMRI
Brain activity will be monitored by task-based fMRI. Alterations in the patients will be determined by the experimental groups (NSSI vs. HC) with respect to the emotion regulation conditions.
Sponsors and contacts
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