Non-suicidal self-injury (NSSI) in adolescents has gradually become a mental and psychological problem around the world. Globally, the detection rate of NSSI is yearly increasing, and the detection group is also becoming younger. Different from the previous traditional views, NSSI not only exists in the people with affective disorders or psychotic disorders, but may also be present in the people with conduct disorders, substance use disorders, and neurodevelopmental disorders. Its characteristics and neurophysiological mechanisms are also different from pure suicidal behavior and ideation. Adolescents with NSSI often have difficulties and problems in academic performance and social interaction, and these problems are often related to executive dysfunction. There are many components of executive functions, and the impairment of different components indicates that the individual has corresponding dysfunction. Recent research has found that executive dysfunction, including impairments of attention, working memory, and inhibition, is associated with the occurrence of NSSI, and even indicates the occurrence of NSSI in the future. In addition, more and more studies have also confirmed that compared with the normal group, there are differences in brain functions and structures in the NSSI group. In these studies, some researchers have applied executive function-related paradigms and obtained the evidence in task-functional MRI and neuroelectrophysiology. This article reviews the research on executive dysfunction and its neural mechanisms in adolescents with NSSI in recent years.
HE Shan, LÜ Qinyu, YI Zhenghui. Research progress in executive dysfunction among adolescents with non-suicidal self-injury. Journal of Shanghai Jiao Tong University (Medical Science)[J], 2024, 44(4): 518-524 doi:10.3969/j.issn.1674-8115.2024.04.013
非自杀性自伤（non-suicidal self-injury，NSSI）行为表现为个体通过各种手段反复造成躯体浅表且痛苦的损伤，常见的自伤方式包括但不限于切割、伤害性搔抓、刺伤、烫伤、非治疗性服用药物等［1］。NSSI行为的目的不在于结束生命，它通常为个体缓解负面情绪的方式。目前，NSSI已经作为可能的独立诊断被Diagnostic and Statistical Manual of Mental Disorders （5th ed）［《精神障碍诊断与统计手册》（第5版），DSM-5］［2］收录，该书对它有具体的诊断标准和条目，它与自杀观念及自杀行为存在差异，属于不同的精神心理问题。
功能性磁共振（functional magnetic resonance imaging，fMRI）是目前最常用于认知脑影像学研究的工具，不同于结构性磁共振，它可以检测脑的动态局部活动，也能够揭示复杂的脑网络系统。在一定程度上，fMRI可以获取脑部在不同任务或刺激下变化活动的信息，在临床中常用于采集多种认知活动的辅助信息。有关执行功能的研究很大一部分都是基于fMRI的静息态和任务态扫描。
The review was conceived by HE Shan, LÜ Qinyu and YI Zhenghui. The manuscript was drafted and revised by HE Shan, and reviewed by LÜ Qinyu and YI Zhenghui. All authors have read the last version of paper and consented for submission.
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所有作者声明不存在利益冲突。
COMPETING INTERESTS
All authors disclose no relevant conflict of interests.
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