Cognitive and Affective Pathways to Nonsuicidal Self-Injury Among Youth in the Adolescent Brain Cognitive Development (ABCD) Study

Nonsuicidal self-injury (NSSI) is the deliberate destruction of one's own body tissue (e.g., cutting, skin picking, biting, hitting) without conscious suicidal intent. Cognitive and affective difficulties may contribute to the development and maintenance of NSSI, such that emotion regulation may mediate the link between cognitive control difficulties and NSSI in youth. This study examined developmental links between cognitive control and emotion regulation on several facets of self-injurious thoughts and behaviors in a large sample of youth, collected via the ABCD Study (N=6447). Although a mediation of emotion regulation on cognitive control and self-injurious thoughts and behaviors was not supported, important direct effects were found between neural correlates of inhibition (at ages 9-10 years) on NSSI at 11-12 years, and behavioral measures of cognitive flexibility (at 10-11 years) and inhibition (at 9-10 years) on suicidality at 11-12 years. Further, links between poorer cognitive control and poorer emotion regulation were found. An exploratory aim of this study was examining the potential moderating role of autistic traits on significant associations. Although greater autistic traits significantly predicted presence of self-injurious thoughts and behaviors, this study did not find a moderation of autistic traits. These results provide developmental risk markers for NSSI and suicidality in youth.