Research output

Article in Journal ()

Pain and self-harm: A systematic review

Citation
Kirtley OJ, O'Carroll R & O'Connor RC (2016) Pain and self-harm: A systematic review, Journal of Affective Disorders, 203, pp. 347-363.

Abstract
Background 

A growing body of research has explored altered physical pain threshold and tolerance in non-suicidal self-injury (NSSI) and suicidal self-harm. The evidence, however, is inconsistent such that the nature of the relationship is unclear, and whether or not this effect is also present in suicidal self-harm is equivocal. 
Methods 
A keyword search of three major psychological and medical databases (PsycINFO, Medline and Web of Knowledge) was conducted, yielding 1,873 records. Following duplicate removal and screening, 25 articles were quality assessed, and included in the final systematic review. 
Results 
There is strong evidence for increased pain tolerance in NSSI, and some evidence for this in suicidal individuals, but notably, there were no prospective studies. The review found a lack of substantive focus on psychological correlates of altered pain tolerance in this population. Several candidate explanatory mechanisms were proposed within the reviewed studies. 
Limitations 
The current review was a narrative systematic review; methods used to assess pain were considered too heterogeneous to conduct a meta-analysis. 
Conclusions 
The evidence suggests that there is elevated pain tolerance among those who engage in NSSI. Future prospective research should determine if altered pain tolerance is a cause or a consequence of the behaviour. The identification of psychological correlates of increased pain tolerance is a neglected area of research. It could provide opportunities for treatment/intervention development, if mediating or moderating pathways can be identified. Too few studies have directly investigated candidate explanatory mechanisms to draw definitive conclusions.

Keywords
Self-harm; Suicide; NSSI; Non-suicidal self-injury; Pain

StatusPublished
AuthorsKirtley Olivia J, O'Carroll Ronan, O'Connor Rory C
Publication date10/2016
Publication date online31/05/2016
Date accepted by journal28/05/2016
PublisherElsevier
ISSN 0165-0327
LanguageEnglish

Journal
Journal of Affective Disorders: Volume 203

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