Adolescents with depression and self-injury show poorer behavioral inhibition, but fNIRS findings remain exploratory

Adolescents with depression who also engage in non-suicidal self-injury (NSSI) performed worse on a behavioral inhibition task than healthy peers, according to a new study published in Child and Adolescent Psychiatry and Mental Health. However, the study’s brain-imaging results did not hold up under statistical correction, and the researchers themselves caution that their neural findings should be treated as exploratory rather than confirmatory.

Impulsivity is recognized as a significant risk factor for NSSI, but the neural mechanisms linking impulsivity to self-injury are not fully understood.

The study enrolled 89 adolescents aged 12 to 18 years, divided into three groups: 33 adolescents with depression and NSSI, 26 with depression only, and 30 healthy controls. Each participant completed two computerized tasks designed to probe different facets of inhibition. The Two-choice Oddball task assessed behavioral inhibition, while the Flanker task assessed cognitive inhibition.

While the participants performed these tasks, the researchers recorded changes in oxyhemoglobin concentration in the prefrontal cortex using fNIRS. They then compared behavioral measures and channel-wise task-related HbO beta values across the three groups using one-way analysis of variance, applying Benjamini–Hochberg false discovery rate correction across the 44 valid fNIRS channels for the channel-wise analyses—a statistical safeguard designed to reduce the risk of false positives when many comparisons are made simultaneously.

The behavioral results were mixed. In the Flanker task, no significant group differences emerged in either accuracy or reaction time, indicating that the three groups performed similarly on this measure of cognitive inhibition. In the Two-choice Oddball task, however, the depression-with-NSSI group showed lower accuracy than healthy controls, which the authors interpret as suggesting poorer behavioral inhibition in this group.

The imaging results were more cautious in tone. During the Two-choice Oddball task, the researchers observed several nominal channel-wise differences in HbO beta values in prefrontal and adjacent regions across the groups. Crucially, none of these channel-wise group differences survived FDR correction across the 44 valid channels. The study’s abstract states this explicitly: the fNIRS findings should be interpreted as exploratory, and the authors conclude they should not be treated as confirmatory neural markers of depression with NSSI.

This distinction matters for how the study is understood. The confirmed finding is behavioral: adolescents with depression and NSSI showed poorer behavioral inhibition than healthy controls under the Two-choice Oddball task condition. The proposed cortical activation differences remain hypotheses for future work rather than established neural signatures.

The authors conclude that larger and better-controlled studies are needed to clarify whether and how task-related cortical activation is associated with NSSI in adolescents with depression. Until such studies are conducted, the value of this work lies in its careful behavioral characterization and its demonstration that fNIRS can be deployed in this population—an approach the authors describe as a non-invasive optical route to investigating impulsivity in adolescents.

The article was published on 30 September 2026 as an open-access research paper, and the version currently available is a peer-reviewed, accepted manuscript shared early for faster access, subject to further edits before the final Version of Record. For clinicians and researchers following the NSSI literature, the study adds a measured data point: behavioral inhibition differences are detectable in depressed adolescents with self-injury, while the search for reliable cortical markers continues.

Subject of Research: Behavioral inhibition and prefrontal cortical activation measured with fNIRS in adolescents with depression and non-suicidal self-injury

Article Title: Behavioral inhibition and task-related cortical hemodynamic responses in adolescents with depression and non-suicidal self-injury: a functional near-infrared spectroscopy study

Article References: Liu, J., Peng, T., Chen, L., Hong, L., Xu, Y., Tong, S., Xu, Z., Wang, L., & Zhao, K. (2026). Behavioral inhibition and task-related cortical hemodynamic responses in adolescents with depression and non-suicidal self-injury: a functional near-infrared spectroscopy study. Child and Adolescent Psychiatry and Mental Health. https://doi.org/10.1186/s13034-026-01181-7

Image Credits: AI Generated

DOI: 10.1186/s13034-026-01181-7

Keywords: non-suicidal self-injury, adolescent depression, behavioral inhibition, cognitive inhibition, fNIRS, prefrontal cortex, impulsivity, Two-choice Oddball task, Flanker task, oxyhemoglobin, false discovery rate correction, mental health