Bridging Brain and Behavior: Using Biology to Inform NSSI Interventions

Although research is increasingly considering neurobiological processes underlying psychopathology, there is a lack of a comprehensive bridge to clinical practice. One way to bridge this gap is through personalized or precision medicine. This involves using an individual’s unique biological characteristics to inform treatment rather than a traditional one-size-fits-all approach to intervention. This goal can be furthered by the Research Domain Criteria (RDoC) initiative, which aims to use multiple units of analyses (e.g., circuits, physiology, and self-report) to study discrete maladaptive behaviors that are separated into domains (e.g., negative and positive valence systems and systems for social processes). One important but understudied focus is nonsuicidal self-injury (NSSI), the overall prevalence of which has shown no reduction using conventional therapeutic and pharmaceutical interventions. The current treatments for NSSI show some modest success with a top-down approach of using existing interventions to target neurobiology but would also benefit from a bottom-up approach of creating interventions to specifically target neurobiological targets. Likewise, the field would benefit from an integration of biological and clinical trials to translate findings and move more quickly toward precision medicine. This chapter discusses prior findings of the association between NSSI and neurocircuitry, heart rate variability, and other psychophysiological markers and suggests future directions to integrate treatment targets and intervention innovations to move toward alleviating distress associated with NSSI.