Pontén Moa, Lee Maria, Khoo Samantha, Nilsson Georg, Nevin Erik, Walldén Ylva, Ougrin Dennis, Cummins Tatum M, Flygare Oskar, Bjureberg Johan
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden & Stockholm Health Care Services, Region Stockholm, Sweden.
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Psychiatry Res. 2025 Sep;351:116638. doi: 10.1016/j.psychres.2025.116638. Epub 2025 Jul 11.
Pain sensitivity has been proposed as a contributing factor to self-injurious behavior (SIB). Meta-analytic results show that individuals with SIB have lower pain sensitivity than healthy controls (HC). However, these findings are primarily based on adult populations. SIB typically begins in the early teen years and is most prevalent among youth. The aim of the present meta-analysis was to quantify the association of SIB and pain thresholds and pain tolerance in young people aged 10 to 24 years.
We performed a systematic search of the literature (MEDLINE, Web of Science Core Collection and PsycINFO) up until 10 December 2024. Titles, abstracts, and full texts were independently screened by multiple reviewers. Random-effects meta-analysis was performed on two pain-related outcomes: pain threshold and pain tolerance. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. Quality assessment was performed using the Newcastle-Ottawa scale.
Of 5200 screened studies, 221 full-text articles were retrieved whereof 8 studies fulfilled the criteria (n=592). Participants ranged from 10 to 22 years. Meta-analysis demonstrated statistically significantly higher pain threshold (Hedges' g = 0.79, 95 % CI [0.13, 1.46]) in individuals with SIB compared to HC and no statistically significant difference in pain tolerance (Hedges' g = 0.39, 95 % CI [-0.02; 0.79], p = 0.056).
Young people with SIB demonstrate higher pain thresholds compared to healthy controls, suggesting that lower sensitivity to painful stimulation may be a risk factor for SIB across developmental stages. Future studies should examine whether this association is independent of psychiatric comorbidity and other confounding factors.
疼痛敏感性被认为是导致自伤行为（SIB）的一个因素。荟萃分析结果显示，自伤行为个体的疼痛敏感性低于健康对照者（HC）。然而，这些发现主要基于成年人群。自伤行为通常始于青少年早期，在年轻人中最为普遍。本荟萃分析的目的是量化10至24岁年轻人中自伤行为与疼痛阈值及疼痛耐受性之间的关联。
我们对截至2024年12月10日的文献（MEDLINE、科学网核心合集和PsycINFO）进行了系统检索。标题、摘要和全文由多名评审员独立筛选。对两个与疼痛相关的结果进行随机效应荟萃分析：疼痛阈值和疼痛耐受性。遵循系统评价和荟萃分析的首选报告项目指南。使用纽卡斯尔-渥太华量表进行质量评估。
在5200项筛选研究中，检索到221篇全文文章，其中8项研究符合标准（n = 592）参与者年龄在10至22岁之间。荟萃分析表明，与健康对照者相比，自伤行为个体的疼痛阈值在统计学上显著更高（Hedges' g = 0.79，95% CI [0.13, 1.46]），而疼痛耐受性无统计学显著差异（Hedges' g = 0.39，95% CI [-0.02; 0.79]，p = 0.056）。
与健康对照者相比，有自伤行为的年轻人表现出更高的疼痛阈值，这表明对疼痛刺激的较低敏感性可能是不同发育阶段自伤行为的一个危险因素。未来的研究应检查这种关联是否独立于精神疾病共病和其他混杂因素。
