Decision making and problem solving in adolescents who deliberately self-harm.

Area of Science:

• Adolescent psychology
• Neuroscience of decision-making
• Mental health research

Background:

• Reward-driven, risky behaviors in adolescents and adults are linked to impaired decision-making.
• Deliberate self-harm (DSH) is a high-risk behavior with limited research on its decision-making aspects.
• This study investigates decision-making and problem-solving in adolescents with current or past self-harm (SH).

Purpose of the Study:

• To assess decision-making and problem-solving abilities in adolescents with a history of self-harm.
• To differentiate decision-making patterns between adolescents with current versus past self-harm.
• To explore the relationship between self-harm cessation and decision-making improvement.

Main Methods:

• Utilized the Iowa Gambling Task (IGT) for decision-making assessment.
• Employed the Means-Ends Problem-Solving Procedure (MEPS) for problem-solving evaluation.
• Studied 133 adolescents: 57 healthy, 22 depressed controls (no SH history), and 54 with SH history (further divided into current and past SH groups).

Main Results:

• Adolescents with a history of SH did not differ from healthy or depressed controls on the IGT.
• Currently self-harming adolescents showed a trend towards higher-risk choices (p=0.06) and did not improve over time on the IGT.
• Adolescents with past SH learned low-risk strategies, similar to controls; recency of SH correlated with IGT performance. Depressed participants performed well on IGT but poorly on MEPS, while SH groups performed better than depressed participants on MEPS.

Conclusions:

• Poor decision-making is characteristic of adolescents currently engaging in self-harm, but not those with a prior history.
• Improved decision-making skills may be associated with the cessation of self-harm behaviors.
• Depressed adolescents, whether they self-harm or not, may exhibit distinct psychological profiles.