What Is Rejection? Lexical, Experimental, and Analytical Specificity Is Needed to Drive Developmental Psychopathology Research Forward

There is increasing urgency in the quest to identify prospective risk factors for nonsuicidal self-injury (NSSI), driven by a growing teen mental health crisis. NSSI, which involves deliberately harming one’s physical body without suicidal intent, increases rapidly in early to middle adolescence and is a risk factor for suicidality and other mental illness ( 1 Nock M.K. Joiner Jr., T.E. Gordon K.H. Lloyd-Richardson E. Prinstein M.J. Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006; 144: 65-72 Crossref PubMed Scopus (1024) Google Scholar ). Accumulating research highlights social (e.g., rejection, poor relationships, low support) and affective (e.g., reactivity, lability, dysregulation) risk mechanisms, among others ( 2 Cipriano A. Cella S. Cotrufo P. Nonsuicidal self-injury: A systematic review. Front Psychol. 2017; 8: 1946 Crossref PubMed Scopus (234) Google Scholar ). However, social and affective risk mechanisms can be linked and may interact to confer risk for NSSI as well as mental illness more broadly ( 3 Hsu D.T. Jarcho J.M. Next up for psychiatry: Rejection sensitivity and the social brain. Neuropsychopharmacology. 2021; 46: 239-240 Crossref PubMed Scopus (10) Google Scholar ). This is particularly relevant in adolescence, a time of rapid brain development and increases in both mental health struggles and reliance on peer affiliation ( 4 Guyer A.E. Adolescent psychopathology: The role of brain-based diatheses, sensitivities, and susceptibilities. Child Dev Perspect. 2020; 14: 104-109 Crossref PubMed Scopus (21) Google Scholar ). Despite the recognition that social difficulties are a common correlate of mental illness, few studies integrate robust measures of real-world peer experience within a neuroscience framework to prospectively predict the emergence of adolescent mental health struggles. Understanding whether neural diatheses confer increased vulnerability to specific stressful peer experiences in adolescence is a critical open question—interventions designed to target neural diatheses or to promote specific types of peer experiences may be critical for prevention efforts in the future ( 4 Guyer A.E. Adolescent psychopathology: The role of brain-based diatheses, sensitivities, and susceptibilities. Child Dev Perspect. 2020; 14: 104-109 Crossref PubMed Scopus (21) Google Scholar ). SEE CORRESPONDING ARTICLE ON PAGE 40 SEE CORRESPONDING ARTICLE ON PAGE 40 Neural Reactivity to Social Punishment Predicts Future Engagement in Nonsuicidal Self-injury Among Peer-Rejected AdolescentsBiological PsychiatryVol. 94Issue 1PreviewRates of nonsuicidal self-injury (NSSI) increase dramatically in adolescence. Affective reactivity and adverse social experiences have been linked to NSSI, but less is known about whether these factors may separately or interactively predict NSSI, especially longitudinally. This study combined functional magnetic resonance imaging and a sociometric measure to test whether a combination of neural (e.g., amygdala) reactivity to social punishment and peer-nominated peer acceptance/rejection predicts NSSI longitudinally in adolescence. Full-Text PDF