Liu WG, Liu HZ, Fu HQ, Lv H, Liu C, Li CX. Development and validation of a prediction model for non-suicidal self-injury in adolescents based on functional near-infrared spectroscopy and neuropsychological assessment. World J Psychiatry 2026; 16(8): 118995 [DOI: 10.5498/wjp.118995]
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Liu WG, Liu HZ, Fu HQ, Lv H, Liu C, Li CX. Development and validation of a prediction model for non-suicidal self-injury in adolescents based on functional near-infrared spectroscopy and neuropsychological assessment. World J Psychiatry 2026; 16(8): 118995 [DOI: 10.5498/wjp.118995]
World J Psychiatry. Aug 19, 2026; 16(8): 118995 Published online Aug 19, 2026. doi: 10.5498/wjp.118995
Development and validation of a prediction model for non-suicidal self-injury in adolescents based on functional near-infrared spectroscopy and neuropsychological assessment
Hao Lv, Outpatient Clinic, Cangzhou Boshi Youmian Comprehensive Outpatient Clinic, Cangzhou 061000, Hebei Province, China
Author contributions: Liu HZ designed the study, performed statistical analysis, and drafted the manuscript; Liu WG contributed to study design and critically revised the manuscript; Fu HQ and Liu C participated in data collection and neuromodulation treatments; Lv H was responsible for patient screening and clinical evaluations; Li CX assisted with statistical analysis and figure preparation; all authors approved the final manuscript.
Supported by the Hebei Province Medical Science Research Project Plan, No. 20261305.
Institutional review board statement: The study protocol was reviewed and approved by the Ethics Committee of Cangzhou Central Hospital (No. 2025-449-01).
Informed consent statement: This study was retrospective in nature and used anonymized clinical data. The requirement for written informed consent was waived by the Ethics Committee of Cangzhou Central Hospital.
Conflict-of-interest statement: The authors declare that they have no conflict of interest related to this study.
Data sharing statement: The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Received: February 10, 2026 Revised: March 15, 2026 Accepted: April 27, 2026 Published online: August 19, 2026 Processing time: 158 Days and 13.7 Hours
Abstract
BACKGROUND
Non-suicidal self-injury (NSSI) is prevalent among adolescents worldwide, yet current identification methods rely heavily on subjective self-report tools that are prone to concealment and fail to capture the neurobiological underpinnings of the behavior. Integrating objective neuroimaging markers with neuropsychological assessment may improve early identification and risk stratification of NSSI.
AIM
To develop and validate a prediction model for NSSI behavior in adolescents based on functional near-infrared spectroscopy (fNIRS) and neuropsychological assessment indicators.
METHODS
A retrospective study was conducted, including 312 adolescents (156 NSSI cases and 156 controls) who visited the psychology department of a tertiary hospital from March 2021 to March 2024. All participants completed fNIRS assessment (verbal fluency task) and neuropsychological evaluation [Difficulties in Emotion Regulation Scale (DERS), Childhood Trauma Questionnaire (CTQ), Barratt Impulsiveness Scale-11 (BIS-11), Adolescent Self-Rating Life Events Check List (ASLEC)]. Univariate analysis was used to screen variables, and multivariate logistic regression was employed to establish the prediction model. A nomogram was constructed, and internal validation was performed using the Bootstrap method. The model’s performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA).
RESULTS
The NSSI group showed significantly lower prefrontal oxyhemoglobin concentration changes and activation integral values compared to the control group (P < 0.001). Multivariate logistic regression revealed that left dorsolateral prefrontal cortex activation integral value [odds ratio (OR) = 0.72, 95%CI: 0.58-0.89], DERS non-acceptance of emotional responses dimension (OR = 1.15, 95%CI: 1.08-1.23), CTQ emotional neglect dimension (OR = 1.12, 95%CI: 1.05-1.19), BIS-11 motor impulsiveness dimension (OR = 1.18, 95%CI: 1.09-1.28), and ASLEC interpersonal relationship dimension (OR = 1.09, 95%CI: 1.03-1.16) were independent predictors of NSSI. The prediction model based on these factors achieved an AUC of 0.891 (95%CI: 0.854-0.928), with sensitivity of 82.7% and specificity of 81.4%. Bootstrap internal validation showed a corrected AUC of 0.876. The calibration curve demonstrated good consistency between predicted and actual probabilities, and DCA indicated favorable clinical net benefit.
CONCLUSION
The prediction model based on fNIRS prefrontal activation indicators and neuropsychological assessment demonstrates good predictive performance for adolescent NSSI and can provide objective evidence for early identification and risk stratification of NSSI.
Core Tip: Non-suicidal self-injury (NSSI) in adolescents is difficult to identify early using self-report measures alone. This study developed and internally validated a prediction model integrating functional near-infrared spectroscopy prefrontal activation indicators with multidimensional neuropsychological assessments. Reduced left dorsolateral prefrontal cortex activation, emotional non-acceptance, childhood emotional neglect, motor impulsivity, and interpersonal stress were identified as independent predictors of NSSI. The nomogram-based model demonstrated good discrimination, calibration, and clinical utility, providing an objective and practical tool for early risk identification and stratified intervention in adolescent NSSI.
