European Psychiatry (Jun 2022)
Emotional regulation in non-suicidal self-injury – research on the use of transcranial direct current stimulation (tDCS)
Abstract
Introduction DSM-5 defines non-suicidal self-injury (NSSI) as socially unaccepted, direct, repeated and deliberate harm done to one’s own body. It is estimated that in a general population approximately 13-29% of adolescents present NSSI, and 70-80% among hospitalized youth. It seems that emotional dysregulation is the core characteristic of NSSI manifesting by self-harm behaviors, impulsiveness, lack of emotional awareness and experiencing high intensity of negative emotion. Emotional dysregulation is a pivotal characteristic of NSSI. Rationale of this theory is provided by the results of psychological and psychophysiological studies as well as those presenting brain activity. Neuroimaging data point to a variant pattern of brain activity of adolescents with NSSI during perception of emotionally negative stimuli i.e. hyperactivity in amygdala – a structure responsible for fear and automatic reaction to exciting stimuli and low activity of inferior frontal gyrus area – a structure responsible for inhibition and interpretation of social interactions. This activity pattern suggests a disorder of cortico-subcortical neuronal connections. Objectives The aim was to verify tDCS as a therapeutic aid for patients who exhibit NSSI despite implementation of pharmacotherapy and psychotherapy. Methods We investigated the modulation effect of tDCS treatment at the right inferior frontal gyrus (rIFG) in hospitalized adolescents with NSSI. Results Preliminary tDCS stimulation results indicate potential usefulness of this method in regulating emotions and improving executive functions. Conclusions Prefrontal cortex stimulation may restore balance in aforementioned connections and, as a result, positively influence an emotional regulation i.e. lower the impulsiveness, agitation and, by doing so, decrease NSSI frequency. Disclosure No significant relationships.
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