Key Publications
Genetic and Neurobiological Mechanisms Underlying Transition in Self-Injury Thoughts and Behaviors During Adolescence
2025
Journal: British Journal of Psychiatry (accepted)
Adolescence is a critical period for brain development and the emergence of self-injury thoughts and behaviors (SITBs), yet the genetic and neurobiological mechanisms underlying SITBs transition remain unclear. This study examined longitudinal data from a large cohort to explore how genetic predispositions relate to changes in SITBs during adolescence, and whether brain and clinical factors mediate this relationship. Findings revealed that genetic risk for self-harm and suicide-related behaviors was significantly associated with increased likelihood of SITBs transition, especially during early to mid-adolescence. Neuroimaging data indicated structural and functional brain alterations among at-risk youth, and mediation analyses suggested that certain brain features and general psychopathology partially explain how genetic risk translates into behavioral outcomes. These results provide valuable insights for integrating genetic, neurobiological, and clinical indicators to improve early identification and intervention strategies for adolescent suicide risk.
Multitrait genome-wide association analysis of non-suicidal self-injury and the polygenetic effects on child psychopathology and brain structures
2025
Journal: Cell Reports Medicine
We employed multi-trait genome-wide association analysis (MTAG) that jointly modelled genetic signals for self-harm, suicide attempt and non-suicidal self-injury (NSSI), thereby overcoming the limited power of prior single-phenotype studies. MTAG revealed three genome-wide significant susceptibility loci for NSSI: DCC on 18q21.2 (axon guidance), an intergenic variant at 7q31.2 previously linked to suicide attempt, and the GET1/SH3BGR region on 21q22.2 involved in protein transport and signalling. Gene- and brain-transcriptome–level analyses showed that elevated hippocampal expression of GET1/SH3BGR is associated with higher NSSI risk. Fine-mapping prioritised two likely causal variants—SH3BGR rs4281987 (posterior probability ≈ 83%) and GET1 rs2837022 (≈ 68%). Pathway enrichment implicated Notch signalling, neurodevelopment, glutamatergic transmission, protein homeostasis, synaptic signalling and cognition, providing fresh insight into the biological mechanisms underlying NSSI.
Genetic approach uncovering the pathways between childhood maltreatment and suicide attempt
2025
Journal: Molecular Psychiatry
We conducted a two-sample Mendelian randomization study using GWAS data for childhood maltreatment (n = 185,414) and suicide attempt (29,782 cases; 519,961 controls). Genetically proxied maltreatment showed a strong causal effect on suicide attempt (OR = 3.40, 95% CI = 2.34–4.96, P = 1.3 × 10⁻¹⁰). We then carried out a two-step MR mediation analysis of 58 candidate traits and identified 11 significant mediators spanning neurobiological, psychopathological, and behavioral domains, with psychopathological factors explaining 10.4 %–50.2 % of the total effect. These findings confirm a causal pathway from childhood maltreatment to suicide attempt and highlight modifiable psychopathological mechanisms for targeted prevention.
Understanding Social Influence of Non-Suicidal Self-Injury: The Interplay of Peer Networks and Adolescent Behavior
April 2025
Journal: Journal of Youth and Adolescence
This study examined both the independent and interactive effects of the number of friends engaging in NSSI, the number of claiming friends, and the extent of bridging different peer groups on adolescents’ NSSI behaviors within classroom-based social networks. The sample included 9581 Chinese adolescents (44.6% girls, Mage = 13.72, SD = 1.87) from 221 classroom-based friendship networks, comprising 4248 early adolescents and 5333 middle-to-late adolescents. Results revealed that adolescents with more friends engaging in NSSI faced a higher risk of engaging in NSSI themselves; however, this risk decreased for adolescents with more claiming friends, irrespective of age. Adolescents who acted as bridges between different peer groups and had an above-average number of claiming friends were more likely to engage in NSSI, but this was only the case in early adolescence. These findings suggest NSSI can spread through friendship networks, with social connections influencing how likely adolescents are to be affected. Incorporating social network assessments into mental health screenings might facilitate early identification and prevention of NSSI among youth.
School mental health prevention and intervention strategies in China: a scoping review
December 2024
Journal: The Lancet Regional Health-Western Pacific
Student mental health issues remain a significant global concern, imposing considerable health, social, and economic burdens. China has also published numerous national policies prioritizing this area. To further investigate the current prevention and intervention programs, we conducted a scoping review, searching six databases (three in English and three in Chinese) up to May 2024. A total of 77 eligible studies were included. Our findings highlight several gaps in current practices, such as regional disparities in school-based mental health programs, insufficient focus on younger children and developmental issues, limited comprehensive pathways from screening to classification, prevention, and intervention, and a lack of an integrated approach to promoting mental health among children and adolescents. These findings indicate an urgent need for improvements in this field, calling for future studies to help reduce the burden of mental health problems and support the holistic development of children in China.
Complex posttraumatic stress disorder (CPTSD) is uniquely linked to suicidality beyond posttraumatic stress disorder (PTSD) in adults with childhood maltreatment: A multinational study across four countries
December 2024
Journal: Social Science & Medicine
Our study investigates the association between PTSD, CPTSD, and suicidality in adults with a history of childhood maltreatment across diverse cultural settings (4 countries), finding that CPTSD is significantly linked to higher suicidality compared to PTSD alone or no disorder, highlighting the critical role of CPTSD's disturbances in self-organization in this population and emphasizing the importance of targeted screening and intervention.
June 2024
Conference: Interspeech 2024
The early detection of suicide risk is important since it enables the intervention to prevent potential suicide attempts. We studies the automatic detection of suicide risk based on spontaneous speech from adolescents, and collects a Mandarin dataset with 15 hours of suicide speech from more than a thousand adolescents aged from ten to eighteen for our experiments. To leverage the diverse acoustic and linguistic features embedded in spontaneous speech, both the Whisper speech model and textual large language models (LLMs) are used for suicide risk detection. Both all-parameter finetuning and parameter-efficient finetuning approaches are used to adapt the pre-trained models for suicide risk detection, and multiple audio-text fusion approaches are evaluated to combine the representations of Whisper and the LLM. The proposed system achieves a detection accuracy of 0.807 and an F1-score of 0.846 on the test set with 119 subjects, indicating promising potential for real suicide risk detection applications.
The p factor outweighs the specific internalizing factor in predicting recurrences of adolescent depression
March 2024
Journal: European Psychiatry
This study explored how well the general psychopathology factor (p) and the specific internalizing factor predict depression recurrence in adolescents over two years. Using data from 255 remitted depressed adolescents and 255 matched healthy controls, we found that the p factor not only distinguished between remitted and healthy adolescents but also effectively predicted future depression relapse—unlike the internalizing factor, which could only differentiate the two groups at baseline. The p factor also showed a significant decline in those who remained in remission, indicating its sensitivity to long-term recovery. These findings suggest that broad-spectrum monitoring of psychopathological symptoms, rather than focusing solely on internalizing issues, is crucial for preventing adolescent depression relapse.
.png)
Can digital self-harm relate to suicidal thoughts and behaviors beyond physical self-harm?
January, 2024
Journal: Acta Psychiatrica Scandinavica
Digital self-harm (DiSH) is a recently identified self-harm distinct from physical self-harm (PSH, also known as non-suicidal self-injury, NSSI). Although prior research has shown that DiSH was associated with suicidal thoughts and behaviors (STBs), it was still unclear whether DiSH has a unique association with STBs after controlling for PSH. A cross-sectional survey was conducted on Chinese college students. Our findings suggest that DiSH has a unique association with the risks of STBs beyond PSH. Early identification and intervention for DiSH are crucial, even for individuals who already engage in PSH.
Brain structural and functional signatures of multi-generational family history of suicidal behaviors in preadolescent children
January, 2024
Journal: Molecular Psychiatry
Parent-child transmission of suicidal behavior is known, yet three-generation effects are understudied. Using four-year longitudinal data from 9,653 pre-adolescents in the ABCD Study, this study examined behavioural and neural correlates of multi-generational family history of suicide (FHoS). Multi-generational FHoS predicted higher risks of suicide ideation, suicide attempt and broad problematic behaviours; the latter partially mediated the FHoS–suicidality link. Neuroimaging revealed reduced cortical thickness/area in the superior temporal gyrus, pre-/post-central and posterior parietal cortices, cingulate cortex and planum temporale, alongside disrupted connectivity within the default-mode, attention (ventral & dorsal), fronto-parietal and cingulo-opercular networks. These population-level findings provide the first longitudinal evidence that multi-generational FHoS confers behavioural and neurodevelopmental vulnerability in offspring, underscoring the need for early, family-focused suicide-prevention strategies.
Effectiveness of a localised and systematically developed gatekeeper training program in preventing suicide among Chinese adolescents
November 2023
Journal: Asian Journal of Psychiatry
To combat the pressing issue of contemporary suicide rates, an effective Life Gatekeeper training program was developed to educate school teachers in identifying and intervening with at-risk students. Two single-arm sequential studies evaluated the program's effectiveness, spanning implementation science stages from design to refinement. The initial study employed face-to-face training (FTF), followed by a standardized video-based ‘Train-the-trainer’ (TTT) approach. In Study 1, post-intervention and one-month follow-up results showed improved suicide literacy, reduced stigma, and increased willingness to intervene among gatekeepers. The revised TTT program (study 2) also yielded reduced stigmatization and improved intervention competence. In addition, six out of twenty teachers exhibited gatekeeper behaviors. In conclusion, both delivery methods proved effective, particularly the practical application of the TTT version, although further research is warranted to examine long-term effectiveness of the program.
Development of the Life Gatekeeper suicide prevention training programme in China: a Delphi study
Oct 2023
Journal: General Psychiatry
This Delphi study marks the first step in systematically developing the Life Gatekeeper suicide prevention program in China, aimed at equipping teachers and parents with the skills to identify and support adolescents at high risk of suicide. Using two rounds of expert consensus, the study evaluated the importance, feasibility, and appropriateness of training content and materials. Out of 207 proposed statements, 201 were endorsed by at least 80% of the expert panel and used to design the program’s content. This study lays the groundwork for locally developed, evidence-based suicide prevention efforts in Chinese schools, with further research needed to assess the program’s effectiveness.
Ecological Momentary Assessment and Machine Learning for Predicting Suicidal Ideation Among Sexual and Gender Minority Individuals
September, 2023
Journal: JAMA Network Open
This prospective study followed 103 young adults who completed twice-daily smartphone reports of mood and contextual stress over 25 days spanning the Lunar New Year and were reassessed for suicidal ideation (SI) at 1, 3, and 8 months. Machine-learning models based solely on these EMA data predicted SI at 1 month more accurately than models using baseline measures or their combination, and they maintained modest superiority at 3 and 8 months. Overall, daily mood fluctuations and situational stressors proved more informative than static risk factors for forecasting short- to mid-term SI among sexual and gender minority youth, underscoring the value of real-time monitoring to guide personalised, process-based suicide-prevention strategies.
Non-suicidal self-injury in Chinese population: a scoping review of prevalence, method, risk factors and preventive interventions
August 2023
Journal: The Lancet Regional Health–Western Pacific
Non-suicidal self-injury behavior (NSSI) is a serious public health concern that requires immediate attention. Despite the high prevalence of NSSI among the Chinese population, there is a significant gap in research on the comprehensive picture of this field. Therefore, a scoping review was conducted to investigate the prevalence, methods, risk factors, and preventive intervention programs related to NSSI in China. The review found that the estimated lifetime prevalence of NSSI among Chinese youth population is alarmingly high at 24.7% (N = 1,088,433). Common methods of NSSI include scratching, hitting, and biting. Additionally, the review synthesized 249 risk factors based on the biopsychosocial-ecological framework, highlighting the urgent need for intervention. However, only 12 empirical studies focus on NSSI prevention or intervention programs were included. These findings underscore the necessity for more clinical practices and larger studies to identify effective interventions and ultimately alleviate the burden of NSSI on the Chinese population.
Associations of bullying perpetration and peer victimization subtypes with preadolescent's suicidality, non-suicidal self-injury, neurocognition, and brain development
April 2023
Journal: BMC Medicine
This study investigated how different forms of peer victimization and bullying perpetration affect the mental health, cognitive function, and brain development of preadolescents aged 10 to 13, using data from the ABCD Study®. The findings revealed that both general and subtype-specific bullying experiences (overt, relational, reputational) are linked to increased risks of suicidality and non-suicidal self-injury, as well as distinct patterns of cognitive performance and brain abnormalities. Notably, relational bullying showed some positive associations with executive function, while overt bullying was linked to poorer outcomes. Victimization was also associated with disruptions in key brain networks involved in attention and memory. These results underscore the need for targeted, subtype-specific interventions that address the broad psychological and neurobiological impact of bullying in preadolescents.
A multicomponent digital intervention to promote help-seeking for mental health problems and suicide in sexual and gender diverse young adults: a randomized controlled trial
March 2023
Journal: PLOS Medicine
We evaluated a digital multicomponent intervention aimed at promoting help-seeking for mental health issues among LGBTQ+ young adults aged 18–29 with moderate or higher depression, anxiety, or stress levels who had not sought help in the past year. Participants (n = 144) were randomly assigned to an intervention or active control group. The intervention included online psychoeducational videos, group discussions, and brochures focused on help-seeking, while the control group received general mental health information. Results showed significant improvements in the intervention group’s help-seeking intentions for suicidal ideation and emotional problems at post-discussion, 1-month, and 3-month follow-ups. There were also notable gains in mental health literacy and knowledge related to help-seeking encouragement. Our study concluded that the intervention effectively enhanced help-seeking intentions and related knowledge, suggesting its potential for addressing other critical concerns in the LGBTQ+ community.
The transition trajectories of self-injurious thoughts and behaviours among children from a biopsychosocial perspective
January 2023
Journal: Nature Mental Health
Although self-injurious thoughts and behaviours (SITB) among children pose an imminent public health concern, the comprehensive understanding of SITB transitions remains unclear. Here we used the longitudinal data of 7,270 children from the Adolescent Brain and Cognitive DevelopmentSM Study (ABCD Study). We found that SITB transitions are linked to altered cortical areas of the dorsal lateral prefrontal cortex and the posterior cingulate cortex and altered functional connectivity between the default mode and attention networks. Additionally, high behaviour inhibition and general psychopathology (that is, p-factor) were identified as risk factors for SITB transitions, while the presence of robust family support and school support served as protective factors. Our study extends prior cross-sectional investigations by elucidating the temporal precedence of specific biopsychosocial factors, underscoring their potential predictive significance in SITB occurrence. Early identification of these factors holds great promise for targeted prevention, addressing the pressing public health concerns associated with SITB.
Blind box over-engagement and suicide risk among adolescents and young adults: results of a large-scale survey
September 2022
Journal: EClinicalMedicine
We investigated the link between blind box engagement—a form of randomized collectible toy purchase similar to gambling—and suicide risk among over 73,000 college students in Jilin Province, China. It found that blind box engagement was significantly associated with increased suicide risk in both males and females, even after controlling for factors like age, income, and substance use. Depression and anxiety were identified as mediators in this relationship. Further analysis within the blind box user group revealed that psychological tolerance (i.e., signs of addiction) increased suicide risk in both genders, while borrowing money for blind boxes was a risk factor for males. These findings suggest that blind box behavior, like gambling, may pose serious mental health risks for youth.
Precision biomarkers for mood disorders based on brain imaging
October 2020
Journal: BMJ
This article highlights the potential of brain imaging to identify precision biomarkers for mood disorders, emphasizing the need for early diagnosis and effective treatment. It discusses how current diagnostic systems struggle with the heterogeneity and overlap of symptoms, and how brain imaging can reveal underlying biological differences. The study advocates for dimensional approaches and the use of dense fMRI scanning to detect early biomarkers, suggesting that these techniques could improve diagnosis, treatment outcomes, and our understanding of mood disorders.
