Exploring the Neural Circuitry of Deliberate Self Harm in Adolescents

描述(申请人提供)：这项脑成像研究的目标是检查患有非自杀性自我损伤(NSSI)的青春期女孩的大脑连接性。迄今为止，人们对NSSI的神经生物学基础知之甚少。这种行为发生在各种情况下，包括严重抑郁障碍(MDD)、边缘人格障碍(BPD)、焦虑症、药物滥用障碍、适应障碍和饮食障碍。相反，许多患有NSSI的青少年不符合任何精神障碍的标准。因此，该领域已经开始将NSSI视为一种特定障碍的症状，而是作为一个实体本身。我们的实验室一直在开发使用扩散张量成像(DTI)和功能磁共振成像(FMRI)来检查大脑网络(连通性)中的联系的方法。这些工具允许应用基于系统的方法来检查精神病理学的神经基础，这是该领域最近的一个优先事项。因此，最近的研究没有检查特定的大脑区域，而是专注于表征神经回路中的连通性。对大脑连通性的检查尤其与 研究青春期出现的问题，因为在这段时间内，相关大脑系统内的连接正在成熟。目前这项研究的假设是，异常的神经回路是青少年参与NSSI的倾向的基础。当我们研究这组人的大脑连接时，我们将探索关键的心理维度，如情绪调节(和其他)，这些因素可能调节回路异常和NSSI之间的联系。为了与NIH的RDoC倡议保持一致，我们关注的不是诊断，而是特定的行为(即NSSI)；为了增加NSSI群体的同质性，我们将包括几个限制：药物使用不成熟，仅限女孩，年龄和青春期发育范围窄，没有SA病史。这个项目可能是第一次研究NSSI的神经回路。 因此，这将是在揭示NSSI背后的神经生物学机制方面向前迈出的重要一步。在青春期，阐明NSSI的神经相关性尤其重要；在神经可塑性增加的时期进行早期干预，可以防止异常行为的根深蒂固，促进神经健康发育。该项目将为未来的纵向研究提供基础，这些研究将检验(A)精神病理过程和治疗反应的预测因素，以及(2)治疗对患有NSSI的青少年异常连接模式的影响(即，成功治疗的机制)。

DESCRIPTION (provided by applicant): The goal of this brain imaging study is to examine brain connectivity in adolescent girls with non-suicidal self- injury (NSSI). To date, little is knwn about the neurobiological underpinnings of NSSI. This behavior occurs in a wide range of conditions including major depressive disorder (MDD), borderline personality disorder (BPD), anxiety disorders, substance abuse disorders, adjustment disorders and eating disorders. Conversely, many adolescents with NSSI do not meet criteria for any psychiatric disorders. Thus, the field has begun to consider NSSI not as a symptom of a specific disorder, but as an entity in its own right. Our laboratory has been developing methods to examine the connections within brain networks (connectivity) using diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI). These tools allow for the application of systems-based approaches to examining the neural underpinnings of psychopathology, a recent priority in the field. Thus, instead of examining specific brain regions, recent research has been focused on characterizing connectivity within neural circuitry. Examination of brain connectivity is particularly relevant to studying problems that emerge in adolescence given the ongoing maturation of connections within relevant brain systems during this time period. The hypothesis of the current study is that aberrant neural circuitry underlies the tendency to engage in NSSI in adolescents. As we examine brain connectivity in this group, we will explore key psychological dimensions such as emotion regulation (and others) that could mediate the link between circuitry abnormalities and NSSI. In keeping with the NIH initiative RDoC, we focus not on diagnosis but on a specific behavior (i.e., NSSI); to increase homogeneity of the NSSI group we will include several constraints: medication-naive, girls only, a narrow range of age and pubertal development, and no history of SA. This project may represent the first study to examine neural circuitry of NSSI in adolescents, and thus will be a major step forward in uncovering neurobiological mechanisms that underlie NSSI. Elucidating the neural correlates of NSSI is especially important during adolescence; early intervention during a time of increased neuroplasticity could prevent entrenchment of aberrant behavior and promote healthy neurodevelopment. This project will provide the foundation for future longitudinal studies that will examine (a) predictors for course of psychopathology and treatment response, and (2) the impact of treatment on aberrant connectivity patterns in adolescents with NSSI (i.e., mechanisms of successful treatment.)