Cognitive Phenotype Shifts in Risk-Taking: Interplay of Non-Suicidal Self-Injury Behaviors and Intensified Depression

Abstract

ABSTRACTBackgroundNon-suicidal self-injury (NSSI) behavior is significantly prevalent in both adolescents and psychiatric populations, with the highest risk observed in individuals with major depressive disorder (MDD). NSSI can be considered a result of risky decision-making in response to negative emotions, where individuals choose self-harm over other harmless alternatives, suggesting a potential decision-making deficit in NSSI individuals. This study delves into the complex relationship between NSSI and depression severity in decision-making and its cognitive underpinnings.MethodWe assessed decision behaviors in MDD patients with and without NSSI and healthy controls using the Balloon Analogue Risk Task, which involves risk-taking, learning, and exploration in uncertain scenarios. Using computational modeling, we dissected the nuanced cognitive dimensions influencing decision behaviors. A novel statistical method was developed to elucidate the interaction effects between NSSI and depression severity.ResultContrary to common perceptions, we found that individuals with NSSI behaviors were typically more risk-averse, but as depressive symptoms intensified, they began to perceive less risk and meanwhile behave more randomly.ConclusionsThis research offers new insights into the cognitive aspects of NSSI and depression, underscoring the importance of recognizing the influence of comorbid mental disorders in deciphering the cognitive underpinnings of such behaviors, especially in the context of prevalent cross-diagnostic phenomena like NSSI behaviors.