Overview

The goal of this clinical trial is to evaluate the effectiveness and safety of Adolescent Self-Injury Intervention Skills Training (ASIST), a treatment program developed by the research team, compared with treatment as usual (TAU) in adolescents who engage in non-suicidal self-injury (NSSI).

The main questions it aims to answer are:

1. How do the effectiveness and safety of ASIST compare with those of treatment as usual in adolescents with NSSI?
2. How are treatment-related changes in psychological, clinical, behavioral, and biological measures associated with treatment response?
3. Can machine learning techniques be used to predict treatment responses in adolescents with NSSI?

Researchers will compare adolescents receiving ASIST with those receiving TAU to examine changes in psychological, clinical, and behavioral characteristics before and after treatment. They will also examine changes in cortisol and beta-endorphin levels, as well as brain activity and functional connectivity during task performance, to explore potential mechanisms associated with treatment response.

Participants will:

1. Receive either ASIST or TAU.
2. Complete psychological, clinical, and behavioral assessments before and after treatment.
3. Undergo measurements of cortisol and beta-endorphin levels.
4. Complete tasks during brain imaging assessments to measure brain activity and functional connectivity.

Eligibility

Inclusion Criteria:

• Adolescents aged 12 to 17 years.
• Adolescents who meet the DSM-5 diagnostic criteria for non-suicidal self-injury (NSSI) and report at least one episode of self-injurious behavior within the past month.
• Adolescents who report at least one episode of self-injurious behavior within the past year, as assessed by the Self-Harm Inventory (SHI).
• Participants currently taking psychiatric medication must have maintained a stable dosage for at least one month prior to enrollment.

Exclusion Criteria:

• History of psychotic disorders, including schizophrenia, or bipolar disorder.
• History of eating disorders.
• Presence of developmental disorders, including autism spectrum disorder.
• History of alcohol or substance abuse within the past six months.
• Presence of coexisting medical or neurological conditions.
• Changes in psychiatric medication dosage within one month prior to enrollment.
• History of an actual suicide attempt within the past year, as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS).