Dysfunction of goal‐directed control in patients with depression and nonsuicidal self‐injury

BACKGROUND: Non‐suicidal self‐injury (NSSI) is a common problem associated with dangerous outcomes. Dysfunction of goal‐directed behavioral control may contribute to NSSI. To test this, we used a novel experimental paradigm (Pavlovian‐to‐Instrumental Transfer, PIT) to test whether patients with NSSI utilize Pavlovian conditioned stimuli (CSs) during goal‐directed control of ongoing behavior. METHODS: Thirty‐five depressed patients with NSSI (D‐NSSI) and thirty‐four healthy controls performed a PIT task. We measured the influence of positive and negative background CSs on instrumental responses for rewards. RESULTS: The results showed that D‐NSSI performed significantly lower PIT than controls, and PIT measures were negatively correlated with NSSI frequency. Furthermore, in a subset of patients exhibiting high levels of compulsivity, PIT positively moderated the relationship between compulsivity and NSSI frequency. CONCLUSIONS: These results indicate that D‐NSSI patients have difficulties in using different CSs to control ongoing behavior in a goal‐directed manner, and the dysfunction of goal‐directed control may contribute to NSSI.