The Nature of Pain Offset Relief in Nonsuicidal Self-Injury: A Laboratory Study

The majority of people who engage in nonsuicidal self-injury (e.g., cutting) report that affect regulation is their primary motivation for these painful behaviors. Unfortunately, little is known about the mechanisms that regulate affect during nonsuicidal self-injury. In the present study, we examined the role of one potential mechanism known as pain offset relief. In 42 participants (21 self-cutters, 21 controls), we measured psychophysiological indices of positive affect (startle postauricular reactivity) and negative affect (startle eyeblink reactivity) after painful electric shocks. Results provided evidence that pain offset relief is a natural and unique mechanism of affect regulation that generates simultaneous-but independent-positive and negative reinforcement. However, associations between nonsuicidal self-injury frequency and pain offset relief variables were weak and nonsignificant. Contrary to contemporary theories, this suggests that the strong association between prior and future self-injury may not be driven by opponent processes that generate stronger relief (and, thus, stronger reinforcement of self-injury) across episodes.