Differential neural activity associated with emotion reactivity and regulation in young adults with non-suicidal self-injury

Background Emotional processing difficulties represent the core psychopathology of non-suicidal self-injury (NSSI), yet the underlying neural mechanisms remain unclear. Aims To investigate neural alterations associated with emotion reactivity and regulation in individuals with NSSI and examine whether emotional valence is related to these neural patterns. Method During functional magnetic resonance imaging scans, unmedicated young adults with NSSI (n = 29) and matched controls (n = 25) completed an emotion regulation task in which they viewed pictures of different emotional categories with instructions to either attend to or regulate their emotions. Results Individuals with NSSI showed increased neural activation in the right superior temporal gyrus (STG), right parahippocampal gyrus and right supramarginal gyrus during negative emotion reactivity and increased activation in the right middle temporal gyrus and left STG during positive emotion reactivity. Conversely, those with NSSI exhibited reduced activation in the left supplementary motor area, left inferior frontal gyrus, right putamen, right thalamus and right STG during negative emotion regulation and reduced activation in the left ventral striatum during positive emotion regulation. Notably, both hyperactivation of the STG during negative emotion reactivity and hypoactivation of the supplementary motor area during negative emotion regulation were associated with emotion dysregulation in individuals with NSSI. Conclusions We observed distinct neural patterns of emotional processing among individuals with NSSI, characterised by hyperactivation during emotion reactivity and hypoactivation during emotion regulation. Our findings provide a neurophysiological basis for therapeutic interventions that facilitate adaptive emotional processing in individuals with NSSI.