The role of pain in non-suicidal self-injury: Affect regulation during a painful paradigm
Non-suicidal self-injury (NSSI) is defined as the deliberate injury to the body performed without suicidal intent (Nock, 2009). NSSI is generally conceptualized as a behavioral means of emotion regulation (e.g., Klonsky, 2007). Some research suggests that the relief from pain following its offset may serve to regulate both affect and cognitive functioning among self-injurers (Franklin et al., 2010). However, existing research methodology has limited our understanding of the aspects of NSSI experience that precisely contribute to the maintenance of these behaviors; no research has explicitly examined what role the specific experience of pain may play in these hypothesized regulatory functions of NSSI. The aims of the current study were twofold. First, I sought to investigate differences at baseline between individuals with (n = 11) and without (n = 13) a history of NSSI in levels of subjectively and objectively measured emotional reactivity and cognitive functioning in response to positive and negative pictures. Second, among participants with NSSI, I sought to investigate changes in emotional reactivity indices during a topical pain induction. No significant differences were found at baseline between the NSSI and the non-NSSI group in terms of emotional reactivity. However, women in the NSSI group displayed significantly worse cognitive functioning during exposure to negative stimuli than women in the non-NSSI group. This provides preliminary support for the hypothesis that individuals who engage in NSSI may exhibit greater difficulty than non-injurers in diverting attention from negative information. Further, among those with an NSSI history, pain induction did not produce significant changes in emotional reactivity or cognitive functioning while exposed to negative stimuli. However, in response to positive stimuli, the pain induction may have resulted in improvements in subjectively reported, but not objectively measured, emotional reactivity. This suggests that the experience of pain during NSSI positively reinforces this behavior. This study's null findings should be carefully interpreted, as our analyses were underpowered. Subsequent research is needed to explore the underlying mechanisms contributing to the maintenance of NSSI.
Holman, Caroline, "The role of pain in non-suicidal self-injury: Affect regulation during a painful paradigm" (2014). ETD Collection for Fordham University. AAI1569131.