Social Pain Disrupts Emotion-Action Brain-State Dynamics in Adolescents with Non-Suicidal Self-Injury

Abstract

Non-suicidal self-injury (NSSI) is prevalent among adolescents with depression, but the rapid brain-state dynamics linking social distress to maladaptive behavior remain unclear. We combine an experimental pain paradigm, electroencephalography (EEG) microstate analysis, and interpretable deep sequence modeling to investigate NSSI-related neurodynamics in 106 adolescents with depression, including 67 with NSSI (DN+) and 39 without NSSI (DN-), during social pain, physical pain, and resting-state conditions. A model integrating disease-specific, domain-adversarial, consistency, and contrastive learning captures higher-order dependencies in microstate sequences. Social pain yields the strongest NSSI discrimination, with 68.55% accuracy, outperforming the best baseline by 8.94% points. Model interpretation and conventional microstate analyses reveal weakened bidirectional transitions between MS3 and MS5 in DN+ adolescents during social pain. Source reconstruction associates MS3 with emotional/interoceptive processing and MS5 with action preparation, suggesting disrupted emotion-action coupling. Time-resolved analyses show greater early-to-middle action-state recruitment and later emotion-state recruitment in DN+ adolescents. In DN- adolescents, MS5-to-MS3 dynamics mediate associations between social-evaluation sensitivity and affective outcomes, whereas this mediation is absent in DN+; conversely, MS3-to-MS5 transitions are associated with greater negative affect in DN+. Together, these findings identify disrupted emotion-action coupling as a key neurodynamic mechanism underlying altered social pain processing in adolescents with NSSI, providing a mechanistically interpretable neural signature for objective identification of NSSI.