A discovery that can benefit people seeking help for their self-harm behavior.

Scientists believe they have discovered why individuals who self-injure experience less pain than others. The key appears to be a more effective pain-modulation mechanism, which is a breakthrough that can aid those who are seeking support for self-harm.

The findings were published in Molecular Psychiatry journal.

Most individuals try to escape pain, but certain people, particularly teenagers and young adults, are prone to physical harm. Self-harm is strongly linked to other mental health concerns like anxiety and depression, however, not everyone who suffers from these conditions self-harms.

Karin Jensen, a researcher and group head at Karolinska Institutet’s Department of Clinical Neuroscience and the study’s corresponding author says that “we have long tried to understand how people who display self-injury behaviour differ from others and why the pain itself isn’t a sufficient deterrent. 

“Previous studies show that people who self-harm are generally less sensitive to pain, but the mechanisms behind it are not fully understood.”

Enduring more pain

The current study compared pain modulation in 41 women who had engaged in self-injury at least five times in the previous year to 40 matched women who had not engaged in self-injury behavior. The women, aged 18 to 35, participated in laboratory pain tests at Karolinska University Hospital on two separate dates in 2019 and 2020, during which they were asked to rate the pain they felt in response to transitory pressure and heat stimulations. MRI scans were also used to assess their brain activity during pain.

The researchers discovered that self-harming women withstood more pain on average than the controls. Similarly, the brain scans indicated distinct disparities in activation between the groups. The brain activity of the women who self-injure showed greater connections between brain areas directly engaged in pain perception and those connected to pain modulation when compared to the controls.

Another finding showed that the length, frequency, or method of self-injury had no bearing on the difference in pain modulation.

Clinically relevant information

According to Maria Lalouni, co-first author of the study, these findings indicate “that effective pain modulation is a risk factor for self-injury behaviour”.

“It also tells us more about differences in the brains of people who engage in self-injury, knowledge that can be used for improving the support provided to people seeking care for their behaviour as well as in conversations with patients to help them understand their self-injury and the need for treatment,” adds the co-author.

The study’s limitations include the fact that women who self-injure reported greater psychiatric comorbidities than the controls. They also used more medications, such as antidepressants, which the researchers took into account.

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