Research progress on cognitive function and neural mechanisms of non-suicidal self-injury in adolescents

doi:10.3969/j.issn.1674-8115.2026.02.011

Abstract

Abstract:

The prevalence of non-suicidal self-injury (NSSI) among adolescents is on the rise worldwide, and an increasing number of studies indicate that the onset age tends to be younger. Therefore, it has become a public health issue of great concern to all sectors of society.Contrary to previous research perspectives, current studies suggest that NSSI behaviors can be present in various disorders, such as mood disorders, personality disorders, and substance use disorders.Research shows that individuals engaging in NSSI often have impaired social functioning, which is closely related to impaired cognitive function.Impairments in different components also suggest corresponding functional deficits. Cognitive function encompasses numerous components, mainly including attention, executive function, and learning and memory. These components are associated with the occurrence and development of NSSI to some extent.It is worth noting that the identification and assessment of NSSI behaviors have gone beyond the traditional scope of neuropsychology.In neuroimaging and neurophysiology, an increasing number of research results suggest that there are significant differences in brain function and structure between individuals with NSSI and healthy individuals. Therefore, this article systematically reviews the literature on the cognitive functional characteristics and neural mechanisms of adolescents with NSSI behaviors, aiming to provide a basis for a deeper understanding of the neurobiological basis of NSSI.

Key words: adolescent, non-suicidal self-iniury (NSSI), cognitive function, neural mechanism

CLC Number:

R749.4

Jin Feng, Peng Daihui. Research progress on cognitive function and neural mechanisms of non-suicidal self-injury in adolescents[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026, 46(2): 220-226.

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References 53

[1]	Rybak Y E, Lai K S P, Ramasubbu R, et al. Treatment-resistant major depressive disorder: Canadian expert consensus on definition and assessment[J]. Depress Anxiety, 2021, 38(4): 456-467.
[2]	Nixon M K, Levesque C, Preyde M, et al. The Ottawa Self-Injury Inventory: evaluation of an assessment measure of nonsuicidal self-injury in an inpatient sample of adolescents[J]. Child Adolesc Psychiatry Ment Health, 2015, 9: 26.
[3]	Swannell S V, Martin G E, Page A, et al. Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression[J]. Suicide Life Threat Behav, 2014, 44(3): 273-303.
[4]	Qu D Y, Wen X, Liu B W, et al. Non-suicidal self-injury in Chinese population: a scoping review of prevalence, method, risk factors and preventive interventions[J]. Lancet Reg Health West Pac, 2023, 37: 100794.
[5]	Mannekote Thippaiah S, Shankarapura Nanjappa M, Gude J G, et al. Non-suicidal self-injury in developing countries: a review[J]. Int J Soc Psychiatry, 2021, 67(5): 472-482.
[6]	Peng B, Liao J W, Li Y, et al. Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder[J]. Front Psychol, 2023, 14: 989711.
[7]	Moloney F, Amini J, Sinyor M, et al. Sex differences in the global prevalence of nonsuicidal self-injury in adolescents: a meta-analysis[J]. JAMA Netw Open, 2024, 7(6): e2415436.
[8]	Culpepper L, Lam R W, McIntyre R S. Cognitive impairment in patients with depression: awareness, assessment, and management[J]. J Clin Psychiatry, 2017, 78(9): 1383-1394.
[9]	张晶, 徐茜, 杨紫君, 等. 抑郁症患者认知功能评估方法的研究进展[J]. 中国老年学杂志, 2018, 38(15): 3810-3813.
	Zhang J, Xu Q, Yang Z J, et al. Research progress of cognitive function evaluation methods for patients with depression[J]. Chinese Journal of Gerontoloty, 2018, 38(15): 3810-3813.
[10]	邹志礼, 蒙华庆, 胡华, 等. 男性青少年暴力犯罪与认知执行功能的关系[J]. 中华精神科杂志, 2012, 45(6): 335-339.
	Zou Z L, Meng H Q, Hu H, et al. Relationship between executive function and violent crime in male juveniles[J]. Chinese Journal of Psychiatry, 2012, 45(6): 335-339.
[11]	Rock P L, Roiser J P, Riedel W J, et al. Cognitive impairment in depression: a systematic review and meta-analysis[J]. Psychol Med, 2014, 44(10): 2029-2040.
[12]	Hu Z Z, Yuan X, Zhang Y Y, et al. Reasoning, problem solving, attention/vigilance, and working memory are candidate phenotypes of non-suicidal self-injury in Chinese Han nationality[J]. Neurosci Lett, 2021, 753: 135878.
[13]	吴朝毅, 王振. 抑郁症情绪失调的动态特征: 情绪动力学的视角[J]. 心理科学进展, 2024, 32(2): 364-388.
	Wu C Y, Wang Z. The dynamic features of emotion dysregulation in major depressive disorder: an emotion dynamics perspective[J]. Advances in Psychological Science, 2024, 32(2): 364-388.
[14]	龚文玥, 邹浩文, 陈志璐, 等. 童年创伤与抑郁症患者非自杀性自伤行为关联的Meta分析[J]. 中华精神科杂志, 2025, 58(1): 37-46.
	Gong W Y, Zou H W, Chen Z L, et al. Meta-analysis of the association between childhood trauma and non-suicidal self-injury behavior in patients with depression[J]. Chinese Journal of Psychiatry, 2025, 58(1): 37-46.
[15]	张爱国, 胡晓娟, 张许来. 伴非自杀性自伤行为的抑郁障碍患者血清炎性标志物水平与冲动特质的相关性[J]. 安徽医科大学学报, 2023, 58(10): 1769-1772.
	Zhang A G, Hu X J, Zhang X L. The correlation between serum inflammatory marker levels and impulsive traits in depression patients with non-suicidal self-injury behavior[J]. Acta Universitatis Medicinalis Anhui, 2023, 58(10): 1769-1772.
[16]	董晓杰, 王鹏, 马俊华, 等. 青少年抑郁症患者人格特征与非自杀性自伤行为的相关性分析[J]. 实用医学杂志, 2024, 40(20): 2848-2853.
	Dong X J, Wang P, Ma J H, et al. Correlation analysis between personality traits and non-suicidal self-injury behavior in adolescent depression patients[J]. The Journal of Practical Medicine, 2024, 40(20): 2848-2853.
[17]	Sheppes G, Suri G, Gross J J. Emotion regulation and psychopathology[J]. Annu Rev Clin Psychol, 2015, 11: 379-405.
[18]	Cheng F, Shi L W, Xie H B, et al. A study of the interactive mediating effect of ADHD and NSSI caused by co-disease mechanisms in males and females[J]. PeerJ, 2024, 12: e16895.
[19]	Goreis A, Pfeffer B, Hajek Gross C, et al. Attentional biases and nonsuicidal self-injury urges in adolescents[J]. JAMA Netw Open, 2024, 7(7): e2422892.
[20]	James K M, Miskovic V, Woody M L, et al. Attentional capture by angry faces in girls who self-injure: evidence from steady state visual evoked potentials[J]. Suicide Life Threat Behav, 2022, 52(6): 1149-1158.
[21]	Wang Y N, Zhou Y, Li G H, et al. Executive functions in non-suicidal self-injury comorbid first-episode and drug-naïve depression among adolescents[J]. Psychiatry Res, 2023, 328: 115476.
[22]	Hu Z Z, Yu H J, Zou J Z, et al. Relationship among self-injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury[J]. Brain Behav, 2021, 11(12): e2419.
[23]	洪兰. 青少年抑郁发作伴自伤行为的影响因素和认知特征: 基于潜类别分析[D]. 温州: 温州医科大学, 2022.
	Hong L. Influencing factors and cognitive characteristics of NSSI: based on latent class analysis[D].Wenzhou: Wenzhou Medical University, 2022.
[24]	Chen Q, Liu M, Wen R Z, et al. Dysfunction of goal-directed control in patients with depression and nonsuicidal self-injury[J]. Brain Behav, 2022, 12(6): e2607.
[25]	Liu J M, Gao Y M, Wang H, et al. Emotional reactivity and inhibitory control in nonsuicidal self-injury adolescence: divergence between positive and negative emotions[J]. J Youth Adolesc, 2022, 51(9): 1720-1732.
[26]	Wei H F, Xin Q Q, Cheng Y H, et al. Neural responses to social decision-making and their associated factors among nonsuicidal self-injured adolescents: an event-related potentials study[J]. J Psychiatr Res, 2025, 184: 350-358.
[27]	Kim K, Woo S, Kim S H, et al. The prediction model of non-suicidal self-injury in psychiatric patients using decision tree analysis[J]. Yonsei Med J, 2024, 65(3): 137-147.
[28]	Kim S G. Biophysics of BOLD fMRI investigated with animal models[J]. J Magn Reson, 2018, 292: 82-89.
[29]	Nam G, Moon H, Lee J H, et al. Self-referential processing in individuals with nonsuicidal self-injury: an fMRI study[J]. Neuroimage Clin, 2022, 35: 103058.
[30]	Hsu K J, McNamara M E, Shumake J, et al. Neurocognitive predictors of self-reported reward responsivity and approach motivation in depression: a data-driven approach[J]. Depress Anxiety, 2020, 37(7): 682-697.
[31]	Frewen P, Schroeter M L, Riva G, et al. Neuroimaging the consciousness of self: review, and conceptual-methodological framework[J]. Neurosci Biobehav Rev, 2020, 112: 164-212.
[32]	黄倩. 青少年抑郁症自杀自伤行为的额边缘环路多模态磁共振研究[D]. 重庆: 重庆医科大学, 2021.
	Huang Q. A multi-modal MRI study on the frontal-limbic circuitry in adolescent depression with suicidal and self-injury behavior[D]. Chongqing: Chongqing Medical University, 2021.
[33]	Lu X D, Zhang Y L, Zhong S M, et al. Cognitive impairment in major depressive disorder with non-suicidal self-injury: association with the functional connectivity of frontotemporal cortex[J]. J Psychiatr Res, 2024, 177: 219-227.
[34]	马丹丹, 秦雪蓉, 张旺信. 青少年儿童自伤风险评估的事件相关电位研究进展[J]. 国际精神病学杂志, 2022, 49(6): 964-966.
	Ma D D, Qin X R, Zhang W X. Research progress of event-related potentials in self-injury risk assessment of adolescents and children[J]. Journal of International Psychiatry, 2022, 49(6): 964-966.
[35]	Wen Y J, Zhang X M, Xu Y F, et al. Cognitive impairment in adolescent major depressive disorder with nonsuicidal self-injury: evidence based on multi-indicator ERPs[J]. Front Hum Neurosci, 2021, 15: 637407.
[36]	温宇娇. 青少年抑郁障碍患者NSSI行为的社会心理因素及认知功能研究[D]. 太原: 山西医科大学, 2020.
	Wen Y J. Psychosocial factors and cognitive function of NSSI behavior in adolescent patients with depressive disorder[D]. Taiyuan: Shanxi Medical University, 2020.
[37]	Chen H, Hong L, Tong S Y, et al. Cognitive impairment and factors influencing depression in adolescents with suicidal and self-injury behaviors: a cross-sectional study[J]. BMC Psychiatry, 2023, 23(1): 247.
[38]	Wang Y J, Li X, Ng C H, et al. Risk factors for non-suicidal self-injury (NSSI) in adolescents: a meta-analysis[J]. EClinicalMedicine, 2022, 46: 101350.
[39]	王璐, 韩海斌, 刘洁, 等. 伴非自杀性自伤行为的青少年抑郁障碍患者睡眠情况与认知功能的相关性分析[J]. 国际精神病学杂志, 2024, 51(1): 95-99, 107.
	Wang L, Han H B, Liu J, et al. Correlation of cognitive function and sleep in adolescent depressive disorder patients with non-suicidal self-injury behavior[J]. Journal of International Psychiatry, 2024, 51(1): 95-99, 107.
[40]	Lee J S, Kim S, Lee J H, et al. A latent profile analysis on adolescents' non-suicidal self-injury related to intrapersonal and interpersonal factors[J]. Child Adolesc Psychiatry Ment Health, 2024, 18(1): 120.
[41]	郑梦瑶, 何昌九, 刘鑫, 等. 不同干预方式对青少年非自杀性自伤影响Meta分析[J]. 中国学校卫生, 2025, 46(4): 533-538, 543.
	Zheng M Y, He C J, Liu X, et al. Meta-analysis of the effects of different intervention modalities on non-suicidal self-injury in adolescents[J]. Chinese Journal of School Health, 2025, 46(4): 533-538, 543.
[42]	娄凤艳, 郑佳明, 潘乾坤, 等. 认知行为对青少年非自杀性自伤患者负面情绪及行为的影响[J]. 河北医药, 2024, 46(9): 1365-1368.
	Lou F Y, Zheng J M, Pan Q K, et al. Effect of cognitive behavioral intervention on negative emotion and behavior in adolescents with non-suicidal self-injury[J]. Hebei Medical Journal, 2024, 46(9): 1365-1368.
[43]	Fang S H, Chen F Z, Bian J, et al. Interventions for adolescent depression comorbid with non-suicidal self-injury: a scoping review[J]. Front Psychiatry, 2025, 16: 1601073.
[44]	张俊蕾, 赵玉洁, 彭莎栗, 等. 辩证行为疗法对青少年非自杀性自伤行为患者认知情绪调节的影响[J]. 中国学校卫生, 2023, 44(12): 1784-1787.
	Zhang J L, Zhao Y J, Peng S L, et al. Effects of dialectical behavior therapy on cognitive emotion regulation in adolescents with non-suicidal self-injury behavior[J]. Chinese Journal of School Health, 2023, 44(12): 1784-1787.
[45]	Berk M S, Starace N K, Black V P, et al. Implementation of dialectical behavior therapy with suicidal and self-harming adolescents in a community clinic[J]. Arch Suicide Res, 2020, 24(1): 64-81.
[46]	Chen X Y, Dong Y Y, Ye M F, et al. Comparative efficacy and acceptability of psychotherapeutic, pharmacological, and combination treatments for non-suicidal self-injury in children and adolescents: a systematic review and network meta-analysis[J]. BMC Psychiatry, 2025, 25(1): 328.
[47]	邹晓伟. 低频重复经颅磁刺激对青少年抑郁症伴非自杀性自伤患者情绪调节的影响[D]. 南昌: 南昌大学, 2023.
	Zou X W. Effect of low-frequency repetitive transcranial magnetic stimulation on emotional regulation in adolescent patients with depression and non-suicidal self-injury[D]. Nanchang: Nanchang University, 2023.
[48]	沈韵, 李静, 邹可, 等. 重复经颅磁刺激联合双相抑郁三联用药对减少女性青少年非自杀性自伤的疗效评估[J]. 生物医学工程学杂志, 2025, 42(2): 288-292.
	Shen Y, Li J, Zou K, et al. Efficacy evaluation of repeated transcranial magnetic stimulation combined with bipolar depression triple therapy in reducing female adolescents' non-suicidal self-injury[J]. Journal of Biomedical Engineering, 2025, 42(2): 288-292.
[49]	孙茜. 青少年抑郁症非自杀性自伤的行为特征和风险因素分析及低频重复经颅磁刺激干预的疗效评估[D]. 兰州: 兰州大学, 2023.
	Sun Q. Behavioral characteristics and risk factors analysis of non-suicidal self-injury in adolescent depression and evaluation of the efficacy of low-frequency repetitive transcranial magnetic stimulation intervention[D]. Lanzhou: Lanzhou University, 2023.
[50]	Porter R J, Inder M, Douglas K M, et al. Improvement in cognitive function in young people with bipolar disorder: results from participants in an 18-month randomised controlled trial of adjunctive psychotherapy[J]. Aust N Z J Psychiatry, 2020, 54(3): 272-281.
[51]	Bilgi E, Özdemir H H, Bingol A, et al. Evaluation of the effects of group psychotherapy on cognitive function in patients with multiple sclerosis with cognitive dysfunction and depression[J]. Arq Neuropsiquiatr, 2015, 73(2): 90-95.
[52]	Katayama N, Nakagawa A, Umeda S, et al. Cognitive behavioral therapy effects on frontopolar cortex function during future thinking in major depressive disorder: a randomized clinical trial[J]. J Affect Disord, 2022, 298(Pt A): 644-655.
[53]	Liu J, Guan J, Xiong J, et al. Effects of transcranial magnetic stimulation combined with sertraline on cognitive level, inflammatory response and neurological function in depressive disorder patients with non-suicidal self-injury behavior[J]. Actas Esp Psiquiatr, 2024, 52(1): 28-36.