# Non-Suicidal Self-Injury in Children: Brain/behavior Alterations and Risk for Suicidal Behavior

> **NIH NIH R01** · EMMA PENDLETON BRADLEY HOSPITAL · 2020 · $174,925

## Abstract

PROJECT SUMMARY/ABSTRACT:
BACKGROUND: Non-suicidal self-injury (NSSI)—defined as deliberate destruction of one's body in the
absence of intent to die (most commonly self-cutting)—accounts for 25% of 7-24 year olds seen in emergency
departments annually for self-harm and increases the risk for a suicide attempt (SA) by as much as 7-fold.
Moreover, suicide is the second leading cause of death of 10-24 year olds in the U.S. Thus, there is a critical
need to identify the brain/behavior mechanisms underlying NSSI itself and also the circuit/behavior/symptoms
predictors of which youths engaged in NSSI-only will make a first-onset SA (and which will not). THE
PRIMARY OBJECTIVES are (1) to identify functional magnetic resonance imaging (fMRI) differences between
youths engaged in NSSI vs. controls without psychopathology, (2) to determine the circuit, behavior, and
symptom factors associated with first-onset SA, and (3) to test moderators of this relationship including
irritability, social function, and impulsive aggression. OUR CENTRAL HYPOTHESIS, based on preliminary
data from our American Foundation for Suicide Prevention study of teens engaged in NSSI-only is that (a)
youths engaged in NSSI-only without a prior SA have behavior/circuit alterations in a prefrontal cortex (PFC)-
amygdala circuit during tasks tapping implicit associations with suicide and response to peer acceptance vs.
rejection, and (b) these circuit alterations, moderated by irritability, impulsive aggression, and social
dysfunction, put youths at greater risk for future suicidal behavior. RESEARCH METHOD: We will test this
hypothesis by comparing 150 youths engaged in NSSI-only (without prior SA) vs. 50 typically-developing
control (TDC) youths on circuit, behavior, and symptom measures, and then following the sample for 18
months to delineate what distinguishes those who progress to suicidal behavior. THE RATIONALE FOR THIS
PROPOSAL is that greater knowledge of the brain/behavior mechanisms underlying NSSI and the relationship
to subsequent first-onset SA will ultimately lead to a more brain-based classification and treatment approach
for NSSI and suicide, which in turn would reduce risk, and enhance prevention for, suicidal behavior among
children and adolescents. INNOVATION: Our study is innovative because it will uniquely synergize circuit and
behavioral methods based on solid preliminary data with innovative ecological momentary assessments of
NSSI/suicide and irritability, real-world assessment of social function, longitudinal follow up, and a committed
multi-disciplinary team. SIGNIFICANCE: Our study is significant because it addresses gaps in knowledge
about bio-behavioral mechanisms of both NSSI and also of a first-onset SA highlighted by the NIMH/National
Action Alliance for Suicide Prevention's (NAASP) “Prioritized Research Agenda for Suicide Prevention” and the
June 2016 NIMH-sponsored meeting on “Mechanisms of Suicide Risk”—as these mechanisms provide the
foundation for...

## Key facts

- **NIH application ID:** 9873089
- **Project number:** 5R01MH110379-04
- **Recipient organization:** EMMA PENDLETON BRADLEY HOSPITAL
- **Principal Investigator:** DANIEL P DICKSTEIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $174,925
- **Award type:** 5
- **Project period:** 2017-03-22 → 2020-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9873089

## Citation

> US National Institutes of Health, RePORTER application 9873089, Non-Suicidal Self-Injury in Children: Brain/behavior Alterations and Risk for Suicidal Behavior (5R01MH110379-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9873089. Licensed CC0.

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