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 治疗选择有限。NSSI新干预措施的推进因缺乏知识而受阻 关于它的神经机制。NSSI的神经生物学研究应该理想地结合各种方法 由NIMH研究领域标准(RDoC)倡议推动，即大脑行为检查 超越传统精神病学诊断范围的关系。由于个人主要使用NSSI 调节负面情绪，以人际关系障碍和消极自我概念为特征， 需要进一步研究的候选RDoC领域包括负价和社会过程。NSSI通常 出现在青春期，这段时间是大脑和大脑显著发育变化的时期 行为。本研究的总体目标是刻画神经发育的异常。 青春期NSSI的基本系统。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。两名飞行员的神经成像、自我报告和内分泌数据 研究提出了两个与青少年NSSI最相关的RDoC结构：持续威胁(负面 价态；由于长期暴露在发出危险信号的刺激中而引起的一种令人厌恶的情绪状态 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，涉及包括喙在内的内侧皮质网络[MCN] 前扣带和后扣带/楔前叶)。我们发现(A)NSSI相关的异常在多模式 这些构造的度量；(B)其度量之间的构造内和构造间的联系；以及 (C)提示患有NSSI的青少年神经发育轨迹异常。我们现在建议 对152名12-14岁月经后青春期女孩的持续威胁和自我认识进行更全面的调查 代表NSSI连续体的老年人[无NSSI(N=38)；一过性NSSI实验(N=38)； 中度/慢性NSSI(N=38)；和重度/慢性NSSI(N=38)]，利用多个分析单元(自 报告、电路、生理学)和纵向设计(每隔18年进行两次跟踪评估) 测量青春期中期的发展轨迹。我们的首要目标是检查基线一致性 所有持续威胁和自我认识的衡量标准。我们的第二个目标是检查发展 青春期中期持续威胁和自我认识的变化，以及发展轨迹 都受到NSSI的影响。我们的第三个目标是检查持续威胁和自我认知神经 随着时间的推移，系统会相互作用。这些结果将指导早期创建目标所需的基础知识 对患有NSSI的青少年进行干预，促进健康的神经发育。此外，这项研究将 提供了一种质疑负价和社会过程系统发展的方法 典型和非典型情况，这可能会对更广泛的精神病理学产生影响。

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.