Effects of Decision Making and Impulsivity on the addictive Characteristics of Non-Suicidal Self-Injurious Behavior in Adolescents with Depressive Disorders

Abstract

Abstract Objective Non-suicidal self-injurious (NSSI) behaviors pose a significant threat to the physical and psychological well-being of adolescents. This study investigated the addictive nature of NSSI behaviors and their association with impulsivity and decision-making, aiming to provide evidence-based insights for the development of multiple effective treatment interventions for adolescents with depressive disorders exhibiting addictive characteristics in their NSSI behaviors. Methods A total of 126 adolescent outpatients and inpatients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria were selected and categorized into three groups: depression without NSSI (n = 42), depression with NSSI without addictive characteristics (n = 44), and depression with NSSI and addictive characteristics (n = 40). The present study employed the Hamilton Depression Scale (HAMD-24), Chinese Revised Barratt Impulsiveness Scale Version 11 (BIS-11), Ottawa Self-Injury Inventory (OSI), and the Adolescent Non-Suicidal Self-Injury Questionnaire (ANSSIQ). Cognitive decision-making abilities were assessed using the Iowa Gambling Task (IGT). Results There were no significant differences observed in blocks 1 and 2 of the IGT among the three groups. However, the depression with NSSI addictive characteristics group exhibited significantly lower net scores in blocks 3, 4, and 5 of the IGT compared to both the depression without NSSI group and the depression with NSSI non-addictive characteristics group. The addictive characteristics of NSSI behaviors were positively correlated with the severity of NSSI behaviors, depression, and cognitive impulsiveness, and negatively correlated with the total net score of the IGT. In the mediation model, depression played a partial mediating role between cognitive impulsiveness and NSSI behavioral addiction characteristics. Conclusion Adolescents with depressive disorders exhibiting addictive NSSI behaviors demonstrate heightened cognitive impulsivity and exhibit poorer decision-making when presented with choices. Timely modulation of depressive symptoms can be effective in reducing the occurrence of the addictive characteristics of NSSI behaviors.