Clarifying the role of pain tolerance in suicidal capability

Franklin, Joseph C.; Hessel, Elenda T.; Prinstein, Mitchell J.

doi:10.1016/j.psychres.2011.08.001

Cited by 160 publications

(137 citation statements)

References 21 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…Two studies found no significant differences in pain tolerance at all between control and experimental groups (Bohus et al, 2000;Franklin et al, 2011). The absence of significant between-group differences in pain tolerance reported by Bohus et al (2000) and Franklin et al (2011) is perhaps surprising, but the number of participants within the NSSI groups was small in both studies, potentially masking any genuine differences as a result of low statistical power.…”

Section: Strengths and Limitations Of The Evidence Altered Pain Thresmentioning

confidence: 88%

“…There was some evidence that males exhibited a higher pain tolerance than females (Gratz et al, 2011) although other studies did not find this (Franklin et al, 2012(Franklin et al, , 2011Hooley et al, 2010;Hooley & St Germain, 2014) Weinberg and Klonsky, 2012). One further study that used a mixed-gender sample (Bresin & Gordon, 2013a) did not investigate gender effects within the analyses and the remainder used only female participants.…”

Section: Gender Pain Threshold and Pain Tolerancementioning

confidence: 99%

“…Six of the cross-sectional studies reported information regarding participants' ethnicity (Bresin & Gordon, 2013a;Franklin et al, 2012Franklin et al, , 2011Gratz et al, 2011;Russ et al, 1999;Weinberg & Klonsky, 2012). The majority of participants across all samples were White.…”

Section: Sample Characteristics: Ethnicity Age and Gendermentioning

confidence: 99%

“…Hooley et al (2010) and St Germain and Hooley (2013) stipulated participants must have engaged in NSSI within the last month. Two studies used a precursor to the DSM-5 (section three) diagnosis for further study criteria for NSSI of five or more episodes, instead using more than 6 episodes within the last year (Franklin et al, 2012(Franklin et al, , 2011.…”

Section: Recency Of Nssimentioning

confidence: 99%

“…Those with a history of NSSI demonstrated a higher threshold for and endurance of pain than controls (Hooley et al, 2010;Hooley & St Germain, 2014;St Germain & Hooley, 2013), although when Hooley et al (2010) controlled for psychotropic medications, only pain endurance remained significantly different. Of the four studies that measured pain tolerance, all but one found that the NSSI group exhibited significantly higher pain tolerance than healthy controls (Franklin et al, 2011), however, one study found tolerance to be increased only under conditions of distress (Gratz et al, 2011). Those who engaged in NSSI chose higher (more intense) levels of electric shock stimuli than control participants, although they did not report greater subjective levels of pain (Weinberg & Klonsky, 2012), but conversely, no effect of NSSI was found upon pain intensity pre or post mood induction in the study by Bresin and Gordon (2013a).…”

Section: Suicidalitymentioning

confidence: 99%

See 4 more Smart Citations

Pain and self-harm: A systematic review

Kirtley

O’Carroll

O’Connor

2016

Journal of Affective Disorders

View full text Add to dashboard Cite

BackgroundA growing body of research has explored altered physical pain threshold and tolerance in non-suicidal self-injury (NSSI) and suicidal self-harm. The evidence, however, is inconsistent such that the nature of the relationship is unclear, and whether or not this effect is also present in suicidal self-harm is equivocal. MethodsA keyword search of three major psychological and medical databases (PsycINFO, Medline and Web of Knowledge) was conducted, yielding 1,873 records. Following duplicate removal and screening, 25 articles were quality assessed, and included in the final systematic review. ResultsThere is strong evidence for increased pain tolerance in NSSI, and some evidence for this in suicidal individuals, but notably, there were no prospective studies. The review found a lack of substantive focus on psychological correlates of altered pain tolerance in this population. Several candidate explanatory mechanisms were proposed within the reviewed studies. LimitationsThe current review was a narrative systematic review; methods used to assess pain were considered too heterogeneous to conduct a meta-analysis. ConclusionsThe evidence suggests that there is elevated pain tolerance among those who engage in NSSI. Future prospective research should determine if altered pain tolerance is a cause or a consequence of the behaviour. The identification of psychological correlates of increased pain tolerance is a neglected area of research. It could provide opportunities for treatment/intervention development, if mediating or moderating pathways can be identified. Too few studies have directly investigated candidate explanatory mechanisms to draw definitive conclusions.

show abstract

Section: Strengths and Limitations Of The Evidence Altered Pain Thresmentioning

confidence: 88%

Section: Gender Pain Threshold and Pain Tolerancementioning

confidence: 99%

Section: Sample Characteristics: Ethnicity Age and Gendermentioning

confidence: 99%

Section: Recency Of Nssimentioning

confidence: 99%

Section: Suicidalitymentioning

confidence: 99%

See 3 more Smart Citations

Pain and self-harm: A systematic review

Kirtley

O’Carroll

O’Connor

2016

Journal of Affective Disorders

View full text Add to dashboard Cite

show abstract

Assessment of Somatosensory Function and Self-harm in Adolescents

et al. 2021

View full text Add to dashboard Cite

IMPORTANCE Self-harm is a risk factor for suicide in adolescents, with the prevalence highest in young people in group and residential care programs. Although no established risk factors for selfharm exist, adolescents who self-harm may have decreased pain sensitivity, but this has not been systematically investigated.OBJECTIVE To assess somatosensory function using quantitative sensory testing (QST) in children and adolescents living in care grouped by the number of episodes of self-harm in the past year and compare their somatosensory profiles with community control participants to investigate associations with the incidence or frequency of self-harm. DESIGN, SETTING, AND PARTICIPANTSRecruitment for this cross-sectional study began January 2019 and ended March 2020. Exclusion criteria included intellectual disability (intelligence quotient <70), autism spectrum disorder, or recent serious injury. Children and adolescents aged 12 to 17 years with no underlying health conditions were recruited from local authority residential care settings in Glasgow, UK, and schools and youth groups in London and Glasgow, UK. The volunteer sample of 64 participants included adolescents ages 13 to 17 years (34 [53%] females; 50 [78%] living in residential care; mean [SD] age, 16.34 [1.01] years) with varying incidents of self-harm in the past year (no episodes, 31 [48%]; 1-4 episodes, 12 [19%]; and Ն5 episodes, 2 [33%]). EXPOSURES Participants were tested using a standardized QST protocol to establish baseline somatosensory function. MAIN OUTCOMES AND MEASURES Associations between somatosensory sensitivity, incidence and frequency of self-harm, residential status, age, gender, and prescription medication were calculated. Secondary outcomes assessed whether self-harm was associated with specific types of tests (ie, painful or nonpainful). RESULTS A total of 64 participants ages 13 to 17 years completed testing (mean [SD] age, 16.3 [1.0] years; 34 [53%.] females and 30 [47%] males; 50 [78%] living in group homes). Adolescents with 5or more self-harm incidences showed significant pain hyposensitivity compared with community control participants after adjusting for age, gender, and prescription drug use (SH group with 5 or more episodes vs control: −1.03 [95% CI, −1.47 to −0.60]; P < .001). Hyposensitivity also extended to nonpainful stimuli, similarly adjusted (SH group with 5 or more episodes vs control: −1.73; 95% CI, −2.62 to −0.84; P < .001). Pressure pain threshold accounted for most of the observed variance (31.1% [95% CI, 10.5% to 44.7%]; P < .001). CONCLUSIONS AND RELEVANCEThe findings of this study suggest that sensory hyposensitivity is a phenotype of Adolescents who self-harm and that pressure pain threshold has clinical potential as (continued)

show abstract

Pain persistence and lethality of suicide attempts

Paashaus

Forkmann

Glaesmer

et al. 2020

Clin Psychology and Psychoth

View full text Add to dashboard Cite

The interpersonal–psychological theory of suicide posits that elevated pain tolerance is necessary to engage in suicidal behaviour. It is assumed that suicidal intent only leads to lethal (or near lethal) suicide attempts when an individual has the capability to persist the pain involved in dying. The aim of this study was to assess whether objective pain persistence moderates the association between suicide intent and lethality of a recent suicide attempt. Ninety‐seven inpatients, who were hospitalized due to a recent suicide attempt, were interviewed regarding lifetime suicide attempts as well as their most recent suicide attempt: Method of attempt, intention to die, medical risk of death, probability of an intervention, and physical condition following the attempt were inquired. Pain persistence was examined using a pressure algometer. Contrary to the expectation, pain persistence did not moderate the association between suicide intent and lethality of a recent suicide attempt, that is, medical risk of death, probability of an intervention, or physical condition following the attempt. Future studies are needed to examine method specific pain persistence for suicidal behaviour in a longitudinal study design.

show abstract

Clarifying the role of pain tolerance in suicidal capability

Cited by 160 publications

References 21 publications

Pain and self-harm: A systematic review

Pain and self-harm: A systematic review

Assessment of Somatosensory Function and Self-harm in Adolescents

Pain persistence and lethality of suicide attempts

Contact Info

Product

Resources

About