Suicidal ideation (SI) and non-suicidal self-injury (NSSI) are two distinct yet often co-occurring risk factors for suicide deaths in adolescents. Elucidating the neurobiological patterns that specifically characterize SI and NSSI in adolescents is needed to inform the use of these markers in intervention studies and to develop brain-based treatment targets. Here, we clinically assessed 70 adolescents—49 adolescents with depression and 21 healthy controls—to determine SI and NSSI history. Twenty-eight of the depressed adolescents had a history of SI and 29 had a history of NSSI (20 overlapping). All participants underwent a resting-state fMRI scan. We compared groups in network coherence of subdivisions of the central executive network (CEN), default mode network (DMN), and salience network (SN). We also examined group differences in between-network connectivity and explored brain-behavior correlations. Depressed adolescents with SI and with NSSI had lower coherence in the ventral DMN compared to those without SI or NSSI, respectively, and healthy controls (all ps < 0.043, uncorrected). Depressed adolescents with NSSI had lower coherence in the anterior DMN and in insula-SN (all ps < 0.030, uncorrected), and higher CEN–DMN connectivity compared to those without NSSI and healthy controls (all ps < 0.030, uncorrected). Lower network coherence in all DMN subnetworks and insula-SN were associated with higher past-month SI and NSSI (all ps < 0.001, uncorrected). Thus, in our sample, both SI and NSSI are related to brain networks associated with difficulties in self-referential processing and future planning, while NSSI specifically is related to brain networks associated with disruptions in interoceptive awareness.

自杀意念（SI）和非自杀性自残（NSSI）是青少年自杀死亡的两个截然不同但经常同时发生的危险因素。需要阐明青少年中SI和NSSI特有的神经生物学模式，以指导在干预研究中使用这些标记物并制定基于脑的治疗目标。在这里，我们临床评估了70名青少年（其中49名患有抑郁症的青少年和21名健康对照），以确定SI和NSSI的病史。28名沮丧的青少年有SI病史，29名有NSSI病史（重叠20名）。所有参与者均进行了静止状态的功能磁共振成像扫描。我们比较了中央执行网络（CEN），默认模式网络（DMN）和显着网络（SN）的细分网络一致性中的组。我们还检查了网络之间的连通性之间的群体差异，并探讨了大脑与行为之间的相关性。与没有SI或NSSI和健康对照的青少年相比，患有SI和NSSI的抑郁青少年的腹侧DMN的相干性较低。p s <0.043，未校正）。与没有NSSI和健康对照者（所有ps  <0.030，未校正）相比，患有NSSI的抑郁青少年在前DMN和insula-SN中具有较低的连贯性（所有p s <0.030，未校正），并且具有较高的CEN-DMN连接性。在所有DMN子网和insula-SN中较低的网络一致性与过去一个月的SI和NSSI较高相关（所有ps  <0.001，未校正）。因此，在我们的样本中，SI和NSSI都与与自我参照处理和未来计划中的困难相关的脑网络有关，而NSSI特别与与感知觉意识中断有关的脑网络有关。