Pain sensitivity as a state marker and predictor for adolescent non-suicidal self-injury

Abstract

Background The pain analgesia hypothesis suggests that reduced pain sensitivity (PS) is a specific risk factor for the engagement in non-suicidal self-injury (NSSI). Consistent with this, several studies found reduced PS in adults as well as adolescents with NSSI. Cross-sectional studies in adults with borderline personality disorder (BPD) suggest that PS may (partially) normalize after remission or reduction of BPD symptoms. The objective of the present study was to investigate the development of PS over 1 year in a sample of adolescents with NSSI and to investigate whether PS at baseline predicts longitudinal change in NSSI. Methods N = 66 adolescents who underwent specialized treatment for NSSI disorder participated in baseline and 1-year follow-up assessments, including heat pain stimulation for the measurement of pain threshold and tolerance. Associations between PS and NSSI as well as BPD and depressive symptoms were examined using negative binomial, logistic, and linear regression analyses. Results We found that a decrease in pain threshold over time was associated with reduced NSSI (incident rate ratio = 2.04, p = 0.047) and that higher pain tolerance at baseline predicted lower probability for NSSI (odds ratio = 0.42, p = 0.016) 1 year later. However, the latter effect did not survive Holm correction (p = 0.059). No associations between PS and BPD or depressive symptoms were observed. Conclusion Our findings suggest that pain threshold might normalize with a decrease in NSSI frequency and could thus serve as a state marker for NSSI.

Exploring Non-Suicidal Self-Injury among Young Muslims: An Integrative Study from an Islamic Perspective and Contemporary Mental Health Insights

“…This is what later becomes the initial impetus for someone to engage in self-injury, namely, the strong need to express oneself. Sexual behavior as a form of self-expression and self-harm also occurs due to the ambiguity and lack of clarity in an individual's pain threshold (Kao et al, 2024). Kao et al (2024) explored sensitivity to pain as a marker and potential predictor for NSSI in adolescents, highlighting the interaction between physical and psychological factors in self-injurious behavior.…”

“…Sexual behavior as a form of self-expression and self-harm also occurs due to the ambiguity and lack of clarity in an individual's pain threshold (Kao et al, 2024). Kao et al (2024) explored sensitivity to pain as a marker and potential predictor for NSSI in adolescents, highlighting the interaction between physical and psychological factors in self-injurious behavior. The ambiguity of this pain threshold explains that self-injury is not just a psychological phenomenon but also significantly affects an individual's physical health.…”