The effect of increased reward sensitivity on risk decision making in adolescents with non-suicidal self-injury

Abstract Background Many studies have demonstrated decision making (DM) deficits in adolescents with self-harm, but few studies have investigated the DM ability of adolescents with non-suicidal self-injury (NSSI) under different conditions (ambiguity and risk). The difference between the two is about implicit vs. explicit rule of reward and punishment. Method We recruited 39 adolescents with NSSI and 38 healthy controls (HCs) matched for age, sex, and education level. The Iowa Gambling Task (IGT) and the Game of Dice Task (GDT) were used to compare the performance of DM between the two groups. Results The total IGT net score of NSSIs was lower than HCs, and NSSIs chose more unfavorable decks with large immediate rewards. In the GDT, the total GDT net score and positive feedback utilization rate of NSSIs were higher than controls, and NSSIs chose more safe options with high reward probability. Conclusions Our study confirmed that NSSI adolescents tend to make decisions based on the satisfaction of immediate rewards.