Dysfunction of goal-directed control in patients with depression and nonsuicidal self-injury

Non-suicidal self-injury (NSSI) is a common problem associated with dangerous outcomes. Dysfunction of goal-directed behavioral control may contribute to NSSI. To test this, we used a novel experimental paradigm (Pavlovian-to-Instrumental Transfer, PIT) to test whether patients with NSSI utilize Pavlovian conditioned stimuli (CSs) during goal-directed control of ongoing behavior.

Thirty-five depressed patients with NSSI (D-NSSI) and thirty-four healthy controls performed a PIT task. We measured the influence of positive and negative background CSs on instrumental responses for rewards.

The results showed that D-NSSI performed significantly lower PIT than controls, and PIT measures were negatively correlated with NSSI frequency. Furthermore, in a subset of patients exhibiting high levels of compulsivity, PIT positively moderated the relationship between compulsivity and NSSI frequency.

These results indicate that D-NSSI patients have difficulties in using different CSs to control ongoing behavior in a goal-directed manner, and the dysfunction of goal-directed control may contribute to NSSI.