Beyond deficits: which executive functions link to which NSSI behaviors? A network analysis

BackgroundExecutive function deficits have been demonstrated to be closely associated with non-suicidal self-injury (NSSI) among adolescents. However, no studies to date have explored how the dimensions of executive function relate to specific NSSI behaviors in a joint framework. This study aimed to examine the relationships between the two constructs at a fine-grained level and identify the central nodes and bridge nodes of their relationships using network analysis.MethodsIn this cross-sectional study, 1,300 Chinese adolescents completed the Adolescent Executive Function Scale to assess self-reported inhibitory control, cognitive flexibility, and working memory, and the 12-item behavioral subscale of the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire to measure specific NSSI behaviors. A regularized partial correlation network was estimated to investigate the connections between variables, and the expected influence (EI) and bridge expected influence (BEI) were calculated for each node.ResultsIn addition to connections within each community, network analysis revealed specific cross-community associations between executive function dimensions and NSSI behaviors. Inhibitory control was most strongly connected to B4 “Intentionally punching walls, tables, windows or the ground”; working memory was most strongly connected to B6 “Deliberately biting oneself”; and cognitive flexibility showed associations with B1 “Deliberately pinching oneself.” The most important central node was B2 “Deliberately scratching oneself,” and the critical bridge nodes were B4 “Intentionally punching walls, tables, windows or the ground” and IC “Inhibitory control.”ConclusionThese preliminary findings suggest that different dimensions of self-reported executive function difficulties exhibit distinct patterns of co-occurrence with specific NSSI behaviors. The central node and bridge nodes identified here may represent potential targets for future prevention and intervention research.