A Longitudinal Study Examining Three RDoC Constructs in Adolescents with Non-Suicidal Self-Injury

摘要 非自杀性自我伤害（NSSI）是一种常见的临床问题，可导致严重的负面后果， 有限的治疗选择。由于缺乏知识，国家社会保障机构新干预措施的推进受到阻碍 关于它的神经机制关于NSSI的神经生物学研究应该理想地结合方法 由NIMH研究领域标准（RDoC）倡议推动，即检查大脑行为 传统精神病诊断范围之外的关系。由于个人主要使用NSSI 调节负面情绪，并以人际关系障碍和负面自我概念为特征， 进一步研究的候选RDoC域包括负价和社会过程。NSI通常 在青春期出现，这是一个以大脑的显著发育变化而闻名的时期， 行为本研究的主要目的是描述神经发育异常的特征， 青少年NSSI的潜在系统。我们小组的新数据揭示了大脑行为的线索 与青少年NSSI有关的关系两名飞行员的神经影像学、自我报告和内分泌数据 研究表明，两个RDoC结构最相关的青少年NSSI：持续的威胁（负 效价;由于长时间暴露于危险信号的刺激而引起的一种厌恶的情绪状态， 杏仁核-额叶回路和神经内分泌对压力的反应）和自我认识（社会过程; 判断一个人的状态、特征和能力的能力，涉及内侧皮层网络[MCN]，包括吻侧 前扣带和后扣带/楔前叶）。我们发现（a）NSSI相关的多模态异常 （B）它们的测量之间的结构内和结构间的联系，以及 (c)提示NSSI青少年神经发育轨迹异常。我们现建议 更全面地研究了152名12-14岁月经后青春期女孩的持续威胁和自我认识 老年人代表连续的NSSI [无NSSI（N=38）;瞬时NSSI实验（N=38）; 中度/慢性NSSI（N=38）;和重度/慢性NSSI（N=38）]，使用多个分析单位（自 报告、电路、生理学）和纵向设计（间隔18年进行两次随访评估）， 测量青春期中期的发展轨迹。我们的第一个目标是检查基线的一致性 在持续威胁和自我认知的测量中。我们的第二个目标是研究发展性的 持续威胁和自我知识在青春期中期的变化，以及发展轨迹如何 受NSSI的影响。我们的第三个目标是研究持续威胁和自我认知的神经机制。 系统随着时间的推移而相互作用。这些结果将指导创建有针对性的早期所需的基础知识 对NSSI青少年进行干预，促进健康的神经发育。此外，这项研究将 提供了一种方法，询问负价和社会过程系统的发展， 典型的和非典型的条件，这将可能对更广泛的精神病理学的影响。

Abstract Non-Suicidal Self Injury (NSSI) is a common clinical problem can lead to severe negative outcomes and has limited treatment options. Advancement of new interventions for NSSI is hindered by a lack of knowledge about its neural mechanisms. Neurobiological research on NSSI should ideally incorporate approaches promoted by the NIMH Research Domains Criteria (RDoC) initiative, i.e. examination of brain-behavior relationships outside of the confines of traditional psychiatric diagnoses. Since individuals primarily use NSSI to regulate negative affect and are characterized by interpersonal disturbances and negative self-conceptions, candidate RDoC domains for further study include Negative Valence and Social Processes. NSSI usually emerges during adolescence, a time period notable for significant developmental changes in brain and behavior. The over-arching goal of this research is to characterize the abnormal development of neural systems underlying NSSI in adolescence. New data from our group has revealed clues about brain-behavior relationships implicated in adolescent NSSI. Neuroimaging, self-report and endocrine data from two pilot studies suggest two RDoC constructs most relevant to adolescent NSSI: Sustained Threat (Negative Valence; an aversive emotional state caused by prolonged exposure to stimuli that signal danger that involves amygdala-frontal circuitry and neuroendocrine response to stress) and Self-Knowledge (Social Processes; the ability to judge one's states, traits, and abilities that involves the medial cortical network [MCN] including rostral anterior cingulate and posterior cingulate/precuneus). We found (a) NSSI-related abnormalities in multi-modal measures of these constructs, (b) within-construct and across-construct links among their measurements, and (c) a suggestion of aberrant neurodevelopmental trajectories in adolescents with NSSI. We now propose to more fully examine Sustained Threat and Self-Knowledge in 152 post-menarchal adolescent girls 12-14 years old who represent a continuum of NSSI [no NSSI (N=38); transient NSSI experimentation (N=38); moderate/chronic NSSI (N=38); and severe/chronic NSSI (N=38)], utilizing multiple units of analysis (self- reports, circuits, physiology) and a longitudinal design (with two follow-up assessments at 18 year intervals) to measure developmental trajectories across mid-adolescence. Our first aim is to examine baseline coherence across measurements of Sustained Threat and Self Knowledge. Our second aim will examine developmental change in Sustained Threat and Self-Knowledge across mid-adolescence, and how developmental trajectories are influenced by NSSI. Our third aim is to examine how Sustained Threat and Self Knowledge neural systems interact over time. These results will guide foundational knowledge needed to create targeted early interventions for adolescents with NSSI that promote healthy neurodevelopment. Additionally, this research will provide a method of interrogating the development of Negative Valence and Social Process systems under typical and atypical conditions, which will likely have implications for a broader array of psychopathology.