Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Wenzhou Seventh People's Hospital, Wenzhou, 325000, China.
Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, 213000, China.
J Psychiatr Res. 2024 Nov;179:306-313. doi: 10.1016/j.jpsychires.2024.09.029. Epub 2024 Sep 24.
Non-suicidal self-injury (NSSI) is an increasingly concerning issue that is linked to a range of mental health problems. However, little is known about the potential neurophysiological mechanisms underlying risk decision-making in Major depressive disorder (MDD) patients with NSSI-the present study aimed to fill this important literature gap.
A total of 81 MDD patients (with NSSI: n = 40, without NSSI: n = 41) and 44 matched healthy controls (HC) underwent a modified version of the Iowa Gambling Task (IGT) while an electroencephalogram was recorded. Feedback-related negativity (FRN) and P300 were examined during the feedback stage of the risky decision-making process.
Behavioural findings revealed that individuals diagnosed with MDD displayed a greater tendency to make risky decisions compared to the control group. Furthermore, MDD patients with NSSI demonstrated a significantly more negative ΔFN (i.e., the difference in neural response to losses compared to gains) than those without NSSI. Further, NSSI patients showed a larger difference ΔFN (loss minus gain), which was associated with enhanced impulsivity.
Collectively, the findings suggest that there is an altered processing of risky decision-making in the electrophysiology of patients with MDD who engage in NSSI. The ΔFN may serve as a psychophysiological marker indicating risk for NSSI.
非自杀性自伤(NSSI)是一个日益令人关注的问题,与一系列心理健康问题有关。然而,人们对伴有 NSSI 的重度抑郁症(MDD)患者风险决策的潜在神经生理机制知之甚少——本研究旨在填补这一重要的文献空白。
共有 81 名 MDD 患者(伴有 NSSI:n=40,不伴有 NSSI:n=41)和 44 名匹配的健康对照组(HC)接受了改良版的爱荷华赌博任务(IGT),同时记录脑电图。在风险决策过程的反馈阶段,检查反馈相关负波(FRN)和 P300。
行为学发现表明,与对照组相比,被诊断为 MDD 的个体表现出更大的风险决策倾向。此外,与不伴有 NSSI 的患者相比,伴有 NSSI 的 MDD 患者的 ΔFN(即损失与收益相比的神经反应差异)明显更为负。此外,NSSI 患者的 ΔFN(损失减去收益)差异更大,这与冲动性增强有关。
总的来说,这些发现表明,伴有 NSSI 的 MDD 患者的风险决策的电生理处理存在改变。ΔFN 可能是 NSSI 风险的生理标记。