Abstract
BackgroundBeta-endorphin (BE) has been suggested to play a central role as to why people engage in NSSI. To our knowledge, no study has systematically assessed this potential relationship in adolescents with NSSI. Methods94 adolescents with NSSI (according to DSM-5 criteria) and 35 healthy controls (HC) were enrolled. All participants received heat pain stimulation, with pain threshold and tolerance measured in °C. Plasma BE levels were assessed. Sociodemographic and clinical characteristics were obtained via semi-structured interviews and self-report questionnaires. ResultsAdolescents with NSSI showed increased pain thresholds (t(127)=2.071, p=.040), lower pain intensity (t(114)==2.122, p=.036) and lower plasma BE levels (t127==3.182, p=.002) compared to HC. Groups did not differ on pain tolerance (t(127)=0.911, p=.364). Greater pain threshold correlated positively with borderline personality disorder (BPD) symptoms (r=0.182, p=.039), while pain intensity (r=-0.206, p=.033) and BE levels (r=-0.246, p=.007) correlated negatively with depression severity. No significant relationship was found between pain threshold and plasma BE (r=-0.013, p=.882). LimitationsFuture studies should implement repeated plasma BE measures to assess BE release in association with pain in NSSI. Validity of plasma BE measures compared to central measures should be considered. Assessing the association between pain sensitivity (PS) and BE in a naturalistic setting presents a promising avenue for future research in NSSI. ConclusionsFindings support both reduced PS and basal opioid deficiency as independent biological correlates and potential risk-factors for NSSI. Further longitudinal and experimental studies are needed to investigate the role of BE levels and PS as well as their potential association.
Highlights
Non-suicidal self-injury (NSSI) is defined as the deliberate and selfinflicted hurting or destruction of one's own body tissue without suicidal intent (International Society for the Study of Self-injury, 2018; Nock, 2010)
NSSI has its onset in adolescence; with lifetime prevalence rates of 17.2% for adolescents (Swannell et al, 2014), it presents a serious threat to psychosocial development during adolescence
We found pain sensitivity (PS) to be positively associated with borderline personality disorder (BPD) severity, further supporting assumptions that psychopathology underlying NSSI has a greater effect on PS compared to the behavior itself
Summary
Non-suicidal self-injury (NSSI) is defined as the deliberate and selfinflicted hurting or destruction of one's own body tissue without suicidal intent (International Society for the Study of Self-injury, 2018; Nock, 2010). Reasons for engaging in NSSI have been linked to negative affect, dissociation and emotion dysregulation, with NSSI serving as a dysfunctional coping mechanism (Klonsky, 2007). These phenotypes underlying NSSI are commonly found in both BPD and MDD. Results: Adolescents with NSSI showed increased pain thresholds (t(127)=2.071, p=.040), lower pain intensity (t(114)==2.122, p=.036) and lower plasma BE levels (t127==3.182, p=.002) compared to HC. Greater pain threshold correlated positively with borderline personality disorder (BPD) symptoms (r=0.182, p=.039), while pain intensity (r=-0.206, p=.033) and BE levels (r=-0.246, p=.007) correlated negatively with depression severity. Limitations: Future studies should implement repeated plasma BE measures to assess BE release in association with pain in NSSI. Further longitudinal and experimental studies are needed to investigate the role of BE levels and PS as well as their potential association
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