Psychophysiological and Neural Support for Enhanced Emotional Reactivity in Female Adolescents With Nonsuicidal Self-injury

Leah M Mayo; Irene Perini; Per A Gustafsson; J Paul Hamilton; Robin Kämpe; Markus Heilig; Maria Zetterqvist

doi:10.1016/j.bpsc.2020.11.004

Psychophysiological and Neural Support for Enhanced Emotional Reactivity in Female Adolescents With Nonsuicidal Self-injury

Biol Psychiatry Cogn Neurosci Neuroimaging. 2021 Jul;6(7):682-691. doi: 10.1016/j.bpsc.2020.11.004. Epub 2020 Nov 24.

Authors

Leah M Mayo¹, Irene Perini², Per A Gustafsson³, J Paul Hamilton², Robin Kämpe², Markus Heilig⁴, Maria Zetterqvist²

Affiliations

¹ Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden. Electronic address: leah.mayo@liu.se.
² Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden; Center for Medical Image Visualization, Linköping University, Linköping, Sweden.
³ Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden; Department of Child and Adolescent Psychiatry, Region Östergötland, Linköping, Sweden.
⁴ Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden; Department of Psychiatry, Region Östergötland, Linköping, Sweden.

PMID: 33541848
DOI: 10.1016/j.bpsc.2020.11.004

Abstract

Background: Nonsuicidal self-injury (NSSI) is prevalent in adolescent populations worldwide. Emotion dysregulation is believed to contribute to NSSI, but underlying mechanisms are less known. We combined psychophysiological and neural data with subjective self-report in close temporal proximity to examine the mechanisms underlying emotion processing in adolescents with NSSI relative to control adolescents without a psychiatric diagnosis.

Methods: Thirty female adolescents with NSSI and 30 age-matched female control subjects were included in this case-control study. Participants were presented with negative affective pictures during a functional magnetic resonance imaging scan. In a separate facial electromyography session, the same participants were shown positive and negative affective images and also provided ratings of valence and arousal.

Results: Participants with NSSI responded to affective images with greater positive (e.g., zygomatic) and greater negative (e.g., corrugator) reactivity. We found no differences in self-reported affect in response to the images. Analyses of the negative picture-viewing functional magnetic resonance imaging data showed a significant positive correlation between anterior insula response and the averaged electromyography magnitude in NSSI, but not in control subjects.

Conclusions: Adolescents with NSSI show enhanced emotional reactivity that is associated with anterior insula responding, but no abnormalities in self-reported affect. This discrepancy between self-report and objective measures of emotional reactivity potentially indicates a suppression of the emotional reaction in adolescents with NSSI. Moreover, the current data suggest potential targets for novel therapeutic approaches that can be combined with existing clinical treatment, such as real-time electromyography-based biofeedback focusing on emotional awareness, labeling, and expressing emotional experiences.

Keywords: Anterior insula; Emotion regulation; Emotion suppression; Facial electromyography; NSSI; Self-injury.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Arousal
Case-Control Studies
Emotions
Female
Humans
Self Report
Self-Injurious Behavior*