Do the Negative Ways That Others Treat Us Contribute to Later Self-Harm?

Summary: Greater amygdala reactivity during the anticipation of social punishment predicted a greater risk of non-suicidal self-harm one year later in adolescents.

Source: Elsevier

Engaging in self-harming behaviors without the intention to die, or non-suicidal self-injury (NSSI), increases dramatically in the transition from childhood to adolescence and continues to grow throughout the teenage years.

Although engagement in NSSI is often associated with emotional reactivity and may occur in response to distressing social experiences, some youth are more likely than others to carry out self-injury.

How both emotional and social-environmental vulnerabilities may interact within individuals to increase developmental risk for self-harm remains unknown.

Now, a new longitudinal study in Biological Psychiatry, examines the neural-based correlates and other risk factors for self-injurious behaviors such as NSSI, an understanding of which could help bolster kids’ resilience against NSSI behaviors.

“Adolescent self-harm is a very complicated behavior with many contributing factors. We do not yet have strong objective predictors for self-harm,” said John Krystal, MD, editor of Biological Psychiatry.

NSSI behaviors include cutting or carving skin, inserting objects under nails or skin, burning skin, scraping or picking skin to the point of drawing blood, and hitting oneself on purpose.

For the study, researchers at The University of North Carolina at Chapel Hill led by Olivia H. Pollak, MA, examined adolescents’ reactivity in a brain area called the amygdala, which has been associated with emotional reactivity and sensitivity to the social environment, including reward and punishment.

The 125 participants performed a task in which they anticipated and sought to avoid peer punishment (a scowling face) and anticipated and sought to gain social reward (a smiling face) while undergoing brain imaging. Participants completed a questionnaire the year of the scan and again one year later to determine past NSSI behavior.

The teens also classified their peers (from a class roster) as those they liked most and least—an established assessment of social preference, capturing real-world experiences of peer acceptance and rejection.

This shows a sad looking man
How both emotional and social-environmental vulnerabilities may interact within individuals to increase developmental risk for self-harm remains unknown. Image is in the public domain

The researchers found that greater amygdala reactivity during anticipation of social punishment predicted greater NSSI engagement one year later among adolescents with lower peer-nominated social preference. This finding suggests that adolescents who are both more sensitive to the prospect of social punishment and who experience greater social adversity in their real-world peer network may be at heightened risk for future NSSI.

Dr. Krystal said of the findings, “This study points out that a strong brain reaction to social punishment may be a marker, perhaps even a contributor, to maladaptive responses to social stress; in this case self-harm following peer rejection.”

First author Olivia H. Pollak added, “Clinically, our findings suggest that teaching emotion regulation skills and increasing prosocial peer interactions may help protect against engagement in self-injurious behaviors in adolescence.”

About this psychology research news

Author: Press Office
Source: Elsevier
Contact: Press Office – Elsevier
Image: The image is in the public domain

Original Research: Closed access.
Neural Reactivity to Social Punishment Predicts Future Engagement in Nonsuicidal Self-injury Among Peer-Rejected Adolescents” by Olivia H. Pollak et al. Biological Psychiatry


Neural Reactivity to Social Punishment Predicts Future Engagement in Nonsuicidal Self-injury Among Peer-Rejected Adolescents


Rates of nonsuicidal self-injury (NSSI) increase dramatically in adolescence. Affective reactivity and adverse social experiences have been linked to NSSI, but less is known about whether these factors may separately or interactively predict NSSI, especially longitudinally. This study combined functional magnetic resonance imaging and a sociometric measure to test whether a combination of neural (e.g., amygdala) reactivity to social punishment and peer-nominated peer acceptance/rejection predicts NSSI longitudinally in adolescence. Amygdala reactivity was examined as a potential neural marker of affective reactivity to social punishment, which may heighten NSSI risk in contexts of social adversity.


One hundred twenty-five adolescents (63 female) completed a social incentive delay task during neuroimaging and school-based peer nominations to measure peer acceptance/rejection. NSSI engagement was assessed at baseline and 1-year follow-up.


Greater amygdala reactivity to social punishment predicted greater NSSI engagement 1 year later among adolescents with high peer rejection. This effect for the amygdala was specific to social punishment (vs. reward) and held when controlling for biological sex and pubertal development. Exploratory analyses found that ventral striatum reactivity to social reward and punishment similarly interacted with peer rejection to predict NSSI but that amygdala connectivity with salience network regions did not.


Amygdala reactivity to social punishment, in combination with high peer rejection, may increase NSSI risk in adolescence, possibly via heightened affective reactivity to adverse social experiences. Objective measures of neurobiological and social risk factors may improve prediction of NSSI, while therapeutic approaches that target affective reactivity and increase prosocial skills may protect against NSSI in adolescence.

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