Childhood Adversity and Psychophysiological Reactivity to Pain in Adolescent Nonsuicidal Self-Injury

Nonsuicidal self-injury (NSSI), the intentional, self-directed act of injuring one's own body tissue, is a behavioral phenomenon closely linked to stress and its maladaptive regulation. NSSI is associated with childhood adversity that may underlie altered hypothalamic-pituitary-adrenal axis and autonomic nervous system response to stress in adolescents engaging in NSSI. Adolescents engaging in NSSI show decreased pain sensitivity and increased psychophysiological response to pain that may underlie the maintenance of the behavior and its stress-regulating function.In a secondary analysis of previously published data we aimed to address the relationship between childhood adversity and altered psychophysiological pain response in an outpatient sample of n = 30 adolescents engaging in repetitive NSSI.Greater childhood adversity is associated with greater cortisol secretion and increased and prolonged autonomic arousal following pain induction.The findings illustrate a potential neurobiological pathway linking childhood adversity to hyporesponsiveness of endogenous stress response systems that in turn show increased reactivity to the experience of pain. This hyperreactivity may counterbalance an inadequate stress response and in turn help to cope with stressful experiences. Directions for future research are discussed.