Expanding and clarifying the role of emotion regulation in nonsuicidal self-injury

OBJECTIVE

Deficits in emotion regulation have been implicated in nonsuicidal self-injury (NSSI) by both theory and research. Research indicates that NSSI is commonly performed as an emotion regulation strategy, as it often decreases the experience of negative affect. People who engage in NSSI often report greater emotion dysregulation than those without an NSSI history. Further, interventions that have demonstrated effectiveness in reducing NSSI involve a focus on emotion regulation skills. Given the important role of emotion regulation in NSSI, research should continue to develop our understanding of this construct.

METHODS

We conducted a review of relevant research in emotion regulation and dysregulation and specific emotion regulation strategies in NSSI.

RESULTS

First, we provide an overview of current research on emotion regulation and dysregulation in NSSI. Second, we discuss the application of a specific emotion regulation model to NSSI research, and review research on NSSI supporting the use of this model.

CONCLUSION

NSSI has been associated with an emotion regulation function and trait emotion dysregulation among people who self-injure. Relevant research provides initial support for the applicability of a specific model of emotion regulation to NSSI. We suggest directions for future research to continue to cultivate our understanding of emotion regulation in NSSI.

Gustatory pleasure and pain. The offset of acute physical pain enhances responsiveness to taste

The idea that pain may serve to produce pleasurable states has been noted by theorists and, more recently, substantiated by empirical findings. We explored the possibility that, beyond producing positive hedonic states, the offset of pain may serve to enhance the capacity for gustatory pleasure. Across three studies we examined whether pain offset may enhance responsiveness to taste. In Study 1 participants enjoyed chocolate more after the experience of pain compared to completing a similar but non-painful task. In Study 2, pain offset increased the perceived intensity of a range of tastes, both pleasant and unpleasant, indicating that the effects of pain offset are not limited to the processing of positive hedonic stimuli. In Study 3, pain offset increased sensitivity to different flavors. The findings suggest that the offset of acute pain increases awareness of, and therefore sensitivity to, gustatory input, thereby enhancing the capacity for gustatory pleasure.

The Positive Consequences of Pain: A Biopsychosocial Approach

Pain is mostly thought of as a problem-as debilitating or harmful. Despite its unpleasantness, however, under some conditions pain can be associated with positive consequences. In this review, we explore these positive biological, psychological, and social consequences of pain. We highlight three different domains in which pain may be considered to have positive consequences. First, pain facilitates pleasure by providing an important contrast for pleasurable experiences, increasing sensitivity to sensory input, and facilitating self-rewarding behavior. Second, pain augments self-regulation and enhancement by increasing cognitive control, reducing rumination, and demonstrating virtue. Third, pain promotes affiliation by arousing empathy from others, motivating social connection, and enhancing group formation. Drawing on evidence scattered across a range of academic fields, we provide for reflection on how pain is represented, generate insights into pain-seeking behavior, and draw attention to the role of painful experiences in maximizing positive outcomes.

Pain-relief learning in flies, rats, and man: basic research and applied perspectives

Memories relating to a painful, negative event are adaptive and can be stored for a lifetime to support preemptive avoidance, escape, or attack behavior. However, under unfavorable circumstances such memories can become overwhelmingly powerful. They may trigger excessively negative psychological states and uncontrollable avoidance of locations, objects, or social interactions. It is therefore obvious that any process to counteract such effects will be of value. In this context, we stress from a basic-research perspective that painful, negative events are "Janus-faced" in the sense that there are actually two aspects about them that are worth remembering: What made them happen and what made them cease. We review published findings from fruit flies, rats, and man showing that both aspects, respectively related to the onset and the offset of the negative event, induce distinct and oppositely valenced memories: Stimuli experienced before an electric shock acquire negative valence as they signal upcoming punishment, whereas stimuli experienced after an electric shock acquire positive valence because of their association with the relieving cessation of pain. We discuss how memories for such punishment- and relief-learning are organized, how this organization fits into the threat-imminence model of defensive behavior, and what perspectives these considerations offer for applied psychology in the context of trauma, panic, and nonsuicidal self-injury.

The fire-walker's high: affect and physiological responses in an extreme collective ritual

How do people feel during extreme collective rituals? Despite longstanding speculation, few studies have attempted to quantify ritual experiences. Using a novel pre/post design, we quantified physiological fluctuations (heart rates) and self-reported affective states from a collective fire-walking ritual in a Mauritian Hindu community. Specifically, we compared changes in levels of happiness, fatigue, and heart rate reactivity among high-ordeal participants (fire-walkers), low-ordeal participants (non-fire-walking participants with familial bonds to fire-walkers) and spectators (unrelated/unknown to the fire-walkers). We observed that fire-walkers experienced the highest increase in heart rate and reported greater happiness post-ritual compared to low-ordeal participants and spectators. Low-ordeal participants reported increased fatigue after the ritual compared to both fire-walkers and spectators, suggesting empathetic identification effects. Thus, witnessing the ritualistic suffering of loved ones may be more exhausting than experiencing suffering oneself. The findings demonstrate that the level of ritual involvement is important for shaping affective responses to collective rituals. Enduring a ritual ordeal is associated with greater happiness, whereas observing a loved-one endure a ritual ordeal is associated with greater fatigue post-ritual.

Pain and depression: an integrative review of neurobiological and psychological factors

The comorbidity of pain and depression has been well established in the literature and is associated with a greater burden to the individual and society than either condition alone. The relationship between pain and depression is quite complex and multiple factors must be considered when trying to disentangle the pain-depression link including shared neurobiology, precipitating environmental factors and cognitive influences. This article aims to provide an overview of the leading neurobiological and psychosocial theories that have advanced our understanding of the link between pain and depression. To this end we describe the shared neurobiological mechanisms in the brain thought to explain the overlap and consider psychological processes and how they inform a cognitive behavioral model. The article also provides an overview of the evidence based treatment for comorbid pain and depression.