ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Mood Disorders
Decoupling reveals subtypes of nonsuicidal self-injury
Lan Hu 1
Kena Li 1
Hui He 1
Shaoqing Li 1
Nan Qiu 1
Guocheng Zhao 1
Tingyu Hu 1
Yong Chen 1
Cheng Luo 1,2
1. The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 610054, China., Chengdu, China
2. High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610056, China, Chengdu, China
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Abstract
Background: Nonsuicidal self-injury (NSSI) is a complex behavior prevalent among adolescents, particularly females and those with depression. The DSM-5 introduced recommended diagnostic criteria for NSSI, yet many adolescents engaging in NSSI do not meet these standards. The neurobiological distinctions between adolescents with NSSI who fulfill the DSM-5 criteria (NSSI+) and those who do not (NSSI-) remain unclear. Methods: Sixty-three female depressive adolescents (40 NSSI+, 23 NSSI-) and 35 healthy controls (HCs) were included and underwent resting-state functional magnetic resonance imaging, diffusion tensor imaging and high-resolution T1-weighted imaging. We explored differences in brain structure-function interactions by applying structural-functional connectivity (SC-FC) coupling analysis using multimodal neuroimaging data. Partial Spearman's correlation analyses were used to identify association between SC-FC coupling and clinical features. Results: The NSSI+ group had notably distinct SC-FC coupling in task-positive network regions including decreased SC-FC coupling (greater decoupling) in the left dorsolateral superior frontal gyrus and increased coupling in the bilateral medial precuneus and right opercular inferior frontal gyrus, as compared to the NSSI- group. Moreover, the NSSI+ group displayed widespread coupling abnormalities across multiple networks compared to the HC group, while the NSSI- group only differed in the left dorsolateral superior frontal gyrus. Correlational analyses linked decoupling indices to several clinical features, particularly in the right subgenual anterior cingulate among the NSSI- participants. Conclusions: These findings indicate that SC-FC coupling patterns distinguish NSSI subtypes in depressed female adolescents, with more severe NSSI associated with altered coupling in prefrontal, precuneus, and inferior frontal regions involved in executive control and attentional processing. The right subgenual anterior cingulate cortex—showing multiple clinical correlations—emerges as a potential target for early intervention of NSSI behavior. These findings highlight the utility of SC-FC coupling as a neural marker for NSSI subtyping and intervention planning.
Summary
Keywords
adolescents, functional magnetic brain imaging (fMRI), Neuroimaging, nonsuicidal self-injury (NSSI), Structural-functional connectivity coupling
Received
25 December 2025
Accepted
03 February 2026
Copyright
© 2026 Hu, Li, He, Li, Qiu, Zhao, Hu, Chen and Luo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Yong Chen; Cheng Luo
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