Attitudes toward risk and ambiguity significantly influence how individuals assess and value rewards. This fMRI study examines the reward valuation process under conditions of uncertainty and investigates the associated neural mechanisms in individuals who engage in nonsuicidal self-injury (NSSI) as a coping mechanism for psychological pain.

The study involved 44 unmedicated individuals who reported five or more NSSI episodes in the past year, along with 42 age-, sex-, handedness-, IQ-, and socioeconomic status-matched controls. During the fMRI scans, all participants were presented with decision-making scenarios involving uncertainty, both in terms of risk (known probabilities) and ambiguity (unknown probabilities).

In the NSSI group, aversive attitudes toward ambiguity were correlated with increased emotion reactivity and greater method versatility. Whole-brain analysis revealed notable group-by-condition interactions in the right middle cingulate cortex and left hippocampus. Specifically, the NSSI group showed decreased neural activation under ambiguity v. risk compared to the control group. Moreover, reduced hippocampal activation under ambiguity in the NSSI group was associated with increased emotion regulation problems.

This study presents the first evidence of reduced brain activity in specific regions during value-based decision-making under conditions of ambiguity in individuals with NSSI. These findings have important clinical implications, particularly concerning emotion dysregulation in this population. This study indicates the need for interventions that support and guide individuals with NSSI to promote adaptive decision-making in the face of ambiguous uncertainty.

Adolescents’ Internet gaming disorders might influence on their social and psychological developmental tasks and physical health negatively. Depression is the commonly co-existed conditions with addictive Internet gaming, but not much research has been reported whether depressive symptoms would precede the addictive Internet gaming in this population.

This prospective observation study was performed to make clear whether adolescents’ depressive symptoms precede their addictive Internet gaming.

Adolescents’ 1-year incidence of the addictive Internet gaming was calculated, and test their depressive symptoms increase the incidence.

In Korea, whole students of the 1st grade in three middle schools were participated in this study. Baseline assessment of 508 students was performed via standardized self-reported questionnaire on May–June, 2015. Internet game use-elicited symptom screen (IGUESS) was used to addictive Internet gaming conditions. IGUESS is the 9-itemed DSM-5 diagnostic criteria-based instrument to screen high risk of Internet gaming disorders. Depressive symptoms was measured by Child Depression Inventory (CDI) group. One year after the baseline assessment, follow-up assessment was performed. Four hundred and forty-eight students have been participated in the 1-year check up without addictive Internet gaming at baseline.

In total, 4.7% of subjects had depressive symptoms at baseline, and incidence of addictive Internet gaming was 9.2%. After adjusted by sex, Internet game use per week, and self-control status, depressive symptoms of baseline increased the 1-year incidence of addictive Internet gaming significantly (OR = 3.5, P = 0.034).

Depressive adolescents have higher possibility they could experience the addictive Internet gaming.

The authors have not supplied their declaration of competing interest.