(PS8-35) Does Pain Intensity Moderate Affective Changes in Individuals with Non-Suicidal Self-Injury, Elevated Emotion Dysregulation and Healthy Controls?

Abstract Text: Non-suicidal self-injury (NSSI) is recognized as a global public health concern, with the highest prevalence among adolescents (17.2%) and young adults (13.4%). While pain infliction is theorized to serve as a core coping function in NSSI, little is known about how pain intensity relates to mood regulation. The present study examines whether perceived pain intensity moderates affective changes associated with NSSI.

The study included 81 young adults (M age = 21.6 (5.43); 87.7% female; 76.5% White) across three groups: individuals with a history of NSSI in the past year (NSSI), individuals with elevated emotion dysregulation matched to the NSSI group (ED), and healthy controls (HC). Following the Trier Social Stress Test (TSST), participants completed the Cold Pressor Task (CPT) as a proxy for NSSI, during which perceived pain intensity and affective changes were assessed. Negative valence (pleasant vs. unpleasant) and arousal (calm vs. excited) were measured using the Self-Assessment Manikin (SAM), and positive and negative affect were assessed using the Positive and Negative Affect Schedule (PANAS).

At low or average levels of pain intensity experienced during the CPT, NSSI subjects had the greatest reductions in negative valence compared to the HC, β = 1.49, t(78) = 2.78, p = .007, and ED groups, β = 1.53, t(78) = 2.83, p = .006, R2 = .29. Similarly, at low or average levels of pain intensity, NSSI subjects had significant increases in PA compared to the HC, β = -4.25, t(75) = -3.80, p < .001 and ED groups, β = -3.50, t(75) = -3.05, p = .003, R2 = .24. Only at low levels of pain intensity did the NSSI group reveal significantly different decreases in NA compared to the HC, β = 3.40, t(78) = 2.16, p = .03, R2 = .15, but not the ED group (p > .10). However, at high levels of pain intensity, affective changes did not differ across groups (all p’s > .05). Pain intensity did not moderate changes in arousal (p > .05).

Findings show that perceived pain intensity did moderate affective changes with lower pain levels relating to the greatest reductions in negative affect/valence and greater increase in positive affect in the NSSI group, whereas higher pain levels resulted in comparable adverse emotional responses across all three groups, suggesting that extreme pain may override its regulatory effects in self-injurers. These findings align with prior research, indicating that higher subjective pain is aversive across individuals and suggest that pain infliction at lower levels might serve an emotional control function.