University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Section for Experimental Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany.
Psychol Med. 2024 Jul;54(9):2291-2298. doi: 10.1017/S0033291724000461. Epub 2024 Mar 11.
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.
= 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.
We found that a decrease in pain threshold over time was associated with reduced NSSI (incident rate ratio = 2.04, = 0.047) and that higher pain tolerance at baseline predicted lower probability for NSSI (odds ratio = 0.42, = 0.016) 1 year later. However, the latter effect did not survive Holm correction ( = 0.059). No associations between PS and BPD or depressive symptoms were observed.
Our findings suggest that pain threshold might normalize with a decrease in NSSI frequency and could thus serve as a state marker for NSSI.
疼痛镇痛假说表明，疼痛敏感性降低是参与非自杀性自伤（NSSI）的特定风险因素。与此一致，几项研究发现，NSSI 患者的成年人和青少年的疼痛敏感性降低。横断面研究表明，患有边缘型人格障碍（BPD）的成年人在 BPD 症状缓解或减少后，疼痛敏感性可能（部分）恢复正常。本研究的目的是在 NSSI 青少年样本中调查疼痛敏感性在 1 年内的发展情况，并研究基线时的疼痛敏感性是否预测 NSSI 的纵向变化。
= 66 名接受 NSSI 障碍专门治疗的青少年参加了基线和 1 年随访评估，包括热痛刺激以测量疼痛阈值和耐受度。使用负二项式、逻辑和线性回归分析，研究疼痛敏感性与 NSSI 以及 BPD 和抑郁症状之间的关系。
我们发现，随着时间的推移，疼痛阈值的降低与 NSSI 的减少有关（发生率比 = 2.04， = 0.047），而基线时较高的疼痛耐受度预测 1 年后 NSSI 的可能性较低（优势比 = 0.42， = 0.016）。然而，后者的效果没有通过 Holm 校正（ = 0.059）。未观察到疼痛敏感性与 BPD 或抑郁症状之间的关联。
我们的研究结果表明，疼痛阈值可能随着 NSSI 频率的降低而恢复正常，因此可以作为 NSSI 的状态标志物。
