This meta-analysis aims to evaluate whether the extant literature justifies any definitive conclusions about whether and how SITBs may be associated with brain differences. A total of 77 papers (N = 4,903) published through January 1, 2019 that compared individuals with and without SITBs were included, resulting in 882 coordinates. A pooled meta-analysis assessing for general risk for SITBs indicated a lack of convergence on structural differences. When all types of control groups were considered, functional differences in the left posterior cingulate cortex (PCC), right amygdala, left hippocampus, and right thalamus were significant using multi-level kernel density analysis (p corrected < 0.05) but nonsignificant using activation-likelihood estimation. These results suggest that a propensity for internally-oriented, emotional processing coupled with under-active pain processing could potentially underlie SITBs, but additional research is needed to test this possibility. Separate analyses for types of SITBs suggested that the brain differences associated with deliberate self-harm were consistent with the overall findings. Checkered moderator effects were detected. Overall, the meta-analytic evidence was not robust. More studies are needed to reach definitive conclusions about whether SITBs are associated with brain differences.
AbstractSelf-injurious thoughts and behaviors (SITBs) have long been believed to result in part from brain abnormalities. This meta-analysis aims to evaluate whether the extant literature justifies any definitive conclusions about whether and how SITBs may be associated with aberrant findings. Sixty studies published through June 1st, 2017 that compared individuals with and without SITBs were included, resulting in 734 coordinates. A pooled meta-analysis assessing for general risk for SITBs indicated a lack of convergence on structural abnormalities. Functional abnormalities in the precuneus/posterior cingulate cortex (PCC), temporal-parietal junction, and rostral-lateral prefrontal cortex were significant using multi-level kernel density analysis but nonsignificant using activation-likelihood estimation. Separate analyses for types of SITBs suggested that deliberate self-harm might be associated with abnormalities in the precuneus/PCC. Some moderator effects were detected. Overall, the meta-analytic evidence was not robust. More studies are needed to reach definitive conclusions about whether SITBs are associated with brain abnormalities.
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