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Suicide and Self-Injury

Understanding the relationship between self-injury and pain tolerance: The role of body investment

(PS13-68) Understanding the Relationship Between Self-injury and Pain Tolerance: The Role of Body Investment

Sunday, November 17, 2024
9:00 AM – 10:00 AM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text:
Nonsuicidal self-injury (NSSI) is the intentional harming of bodily tissue without suicidal intent (Nock, 2010). People who self-injure have been shown to have higher levels of pain tolerance compared to those who do not self-injure (Koenig et al., 2016); however, the mechanisms underlying this relationship remain unclear. One possible mechanism is body investment. People who self-injure tend to have more negative views about their bodies (Hielscher et al., 2019; Muehlenkamp et al., 2005) and tend to be less emotionally invested in their bodies (Cipriano et al., 2020). It is possible that engaging in NSSI leads to a higher pain tolerance due to low levels of body investment. The goal of the present study was to test whether the reason NSSI and pain tolerance are associated is due to low body investment. We hypothesized that low levels of body investment would mediate the relationship between NSSI and pain tolerance. Participants were 63 undergraduate students  (57.1% female; 61.9% Caucasian; Mage = 19.21) who reported the presence or absence of NSSI, completed a self-report measure of body investment (The Body Investment Scale [BIS]; Orbach & Mikulincer, 1998), and tested their pain tolerance measured by the cold pressor test. A multiple mediation model was tested via bootstrapping using Model 4 of the PROCESS macro (Hayes, 2022). NSSI history was entered as the predictor, pain tolerance was entered as the outcome, and body investment was entered as the mediator. The effect of NSSI on body investment was significant (b = -.31, SE = .13, p > .001, 95% CI: -.57, -.06), as was the effect of body investment on pain tolerance (b = -63.37, SE = 28.53, p > .001, 95% CI: -120.46, -6.28). The indirect effect of NSSI history on pain tolerance through body investment was significant (b = 19.93, SE = 12.97, 95% CI: .69, 50.21), while the direct effect of NSSI on pain tolerance was not significant (b = 38.34, SE = 29.29, p = .20, 95% CI: -20.27, 96.94) consistent with full mediation. These results highlight the importance of body investment in explaining why NSSI is related to higher pain tolerance. Essentially, NSSI may make a person less emotionally invested in their body and this deficit may increase the amount of pain a person is willing to tolerate. While more research is needed, these results are consistent with previous research indicating that increasing appreciation for one’s body tends to lead to decreased engagement in NSSI (Muehlenkamp & Wagner, 2022) and treatment efforts may benefit from specifically promoting body investment in those who have a history of self-injury, as becoming more invested in and connected to one’s body, may lessen the willingness to experience pain.