Störkel Lisa M, Karabatsiakis Alexander, Hepp Johanna, Kolassa Iris-Tatjana, Schmahl Christian, Niedtfeld Inga
Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Psychology, University of Innsbruck, Innsbruck, Austria.
Neuropsychopharmacology. 2021 Jun;46(7):1357-1363. doi: 10.1038/s41386-020-00914-2. Epub 2021 Jan 4.
Nonsuicidal self-injury (NSSI) is a prevalent and impairing behavior, affecting individuals with and without additional psychopathology. To shed further light on biological processes that precede and result from NSSI acts, we built on previous cross-sectional evidence suggesting that the endogenous opioid system, and especially β-endorphin, is involved in the psychopathology of NSSI. This is the first study assessing salivary β-endorphin in daily life in the context of NSSI acts. Fifty-one female adults with repetitive NSSI participated over a period of 15 days in an ambulatory assessment study. Salivary β-endorphin was assessed before and after engagement in NSSI, during high urge for NSSI, and on a non-NSSI day. Furthermore, NSSI specific variables such as pain ratings, as well as method, severity, and function of NSSI were assessed. We found that β-endorphin levels immediately before an NSSI act were significantly lower than directly after NSSI. However, there was no difference between β-endorphin during high urge for NSSI and post NSSI measures. We found a positive association between severity of the self-inflicted injury and β-endorphin levels, but no significant association between β-endorphin levels and subjectively experienced pain. The results of the present study indicate that it is possible to assess salivary β-endorphin in daily life in the context of NSSI. Furthermore, our results provide a first indication that NSSI acts could be associated with a momentary increase of β-endorphin, and this might reinforce NSSI engagement. More research is needed to replicate and extend our findings on peripheral β-endorphin in daily life.
非自杀性自伤行为（NSSI）是一种普遍且有害的行为，影响着有无其他精神病理学问题的个体。为了进一步揭示NSSI行为之前和之后的生物学过程，我们基于之前的横断面证据展开研究，这些证据表明内源性阿片系统，尤其是β-内啡肽，参与了NSSI的精神病理学过程。这是第一项在NSSI行为背景下评估日常生活中唾液β-内啡肽的研究。51名有重复性NSSI行为的成年女性参与了为期15天的动态评估研究。在进行NSSI行为之前和之后、处于强烈的NSSI冲动期间以及非NSSI日，均对唾液β-内啡肽进行了评估。此外，还评估了NSSI的特定变量，如疼痛评分以及NSSI的方法、严重程度和功能。我们发现，在NSSI行为即将发生前的β-内啡肽水平显著低于行为刚结束后的水平。然而，在强烈的NSSI冲动期间的β-内啡肽水平与NSSI行为后的测量结果之间没有差异。我们发现自我伤害的严重程度与β-内啡肽水平呈正相关，但β-内啡肽水平与主观感受到的疼痛之间没有显著关联。本研究结果表明，在NSSI行为背景下评估日常生活中的唾液β-内啡肽是可行的。此外，我们的结果首次表明，NSSI行为可能与β-内啡肽的瞬间增加有关，这可能会强化NSSI行为。需要更多的研究来复制和扩展我们关于日常生活中外周β-内啡肽的研究结果。
