4 - (OP8) The Role of Perceived Pain Intensity in Affect Regulation in Non- suicidal Self-injury

Non-suicidal self-injury (NSSI) is recognized as a global public health concern, with the highest prevalence among adolescents (17.2%) and young adults (13.4%). While physical pain plays a central role in affect regulation, relatively little is known about how the perceived intensity of pain shapes these regulatory effects. The present study examined the relationship between perceived pain intensity and the magnitude of affective change.

The study included 81 young adults (M age = 21.6 (5.43); 87.7% female; 76.5% White) across three groups: individuals with a history of NSSI in the past year (NSSI), individuals with elevated emotion dysregulation matched to the NSSI group (ED), and healthy controls (HC). Following the Trier Social Stress Test (TSST), participants completed the Cold Pressor Task (CPT) as a proxy for NSSI, during which perceived pain intensity (0-100) and affective changes were assessed. Negative valence (pleasant vs. unpleasant) and arousal (calm vs. excited) were measured using the Self-Assessment Manikin (SAM), and positive and negative affect were assessed using the Positive and Negative Affect Schedule (PANAS).

Linear mixed models were used to examine affective change from post-TSST to post-CPT as a function of group and perceived pain intensity. Across all outcomes (PA, NA, valence and arousal), the Time × Group × Pain Intensity interactions were nonsignificant (all ps > .05), indicating that pain intensity did not differentially affect affective change across groups. Collapsing across groups, pain intensity significantly moderated changes in valence (B = 0.05, t(77) = 4.01, p <.001) and arousal (B = –0.04, t(77) = –2.67, p = .009), such that higher perceived pain was associated with greater increases in unpleasantness and decreases in calmness following the pain task. Pain intensity did not moderate changes in PA or NA (ps > .05).

Findings indicate that although pain intensity did not differentially affect affective change across the three groups, higher perceived pain during the task was associated with increased unpleasantness and decreased calmness. These results align with prior research suggesting that higher levels of pain may become aversive across individuals, limiting and overriding its regulatory effects. Overall, pain may serve an emotional control function primarily when experienced at milder levels of intensity.