A psychophysiological investigation of self-harm ideation and enactment

Kirtley, Olivia Jane (2015) A psychophysiological investigation of self-harm ideation and enactment. PhD thesis, University of Glasgow.

Abstract

Background:

Many individuals have thoughts of self-harm, but only a proportion act upon them and engage in self-harm behaviour. Currently, our ability to differentiate which individuals who think about self-harm will translate those thoughts into actions, is limited, and is a critically important area for future research to inform suicide prevention efforts. This thesis presents three empirical studies underpinned by the recently proposed model of suicidal behaviour, the Integrated Motivational-Volitional model (IMV; O’Connor, 2011), which specifically makes predictions about factors which differentiate between suicidal thoughts and behaviours. Two putative variables within this model may be sensitivity to emotional and physical pain; indeed threshold and tolerance for physical pain have been found to be elevated in individuals who have engaged in self-harm, relative to healthy controls. Furthermore, previous research has suggested that elevated physical pain tolerance may be potentiated by an individual’s state of distress. Emotional pain sensitivity, however, has been demonstrated to be reduced in those who have engaged in self-harm. Whether changes in sensitivity to emotional and physical pain are a cause or a consequence of self-harm, is unknown, and could be an important target for treatment and intervention development.

Methods:

A systematic review of the literature around physical pain and self-harm (n = 25 studies) was conducted in order to assess the quality and extent of the existing knowledge in this area. Three empirical studies were then conducted investigating the relationship between emotional and physical pain in self-harm ideation and enactment. Two of these (n = 102; n = 88) were laboratory studies, employing a combination of self-report and behavioural measures of emotional and physical pain sensitivity, and one took the form of a large online self-report study (n = 351).

Results:

The studies within this thesis found no evidence to suggest that behavioural threshold or tolerance for physical pain is elevated in self-harm ideation or enactment. Furthermore, pain tolerance does not appear to differ as a function of stress. Self-reported sensitivity to emotional pain was highest in those who had engaged in self-harm, followed by those who had ideated about self-harm and was lowest in healthy controls. There were no significant associations between self-reported and behavioural measures of emotional and physical pain sensitivity. Negative mood decreased following administration of a painful stimulus for all groups (controls, self-harm ideation and self-harm enactment). As predicted, motivational phase variables within the IMV did not differ significantly between the ideation and enactment groups, however, volitional phase variables did exhibit a significant difference.

Conclusions:

The findings from this thesis provide some support for the IMV model of suicidal behaviour (O’Connor, 2011), demonstrating that the volitional phase variables impulsivity and exposure to social modelling of self-harm, differentiate between those with thoughts (only) of self-harm and those who have gone on to engage in the behaviour. This is an important finding with implications for intervention and treatment development. The similar pattern of elevated emotional pain sensitivity across self-harm ideation and enactment suggests that this could be a pre-motivational phase variable within the IMV. The lack of expected between-group differences in behavioural measures of emotional and physical pain call into question the findings of previous studies. Furthermore, as neither of the laboratory studies presented within this thesis found significant differences in pain threshold or tolerance between self-harm ideation, self-harm enactment and control groups, there is a clear need for more research in this area.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Keywords: Self-harm, self-harm ideation, suicide, pain, emotion, psychophysiology.
• Subjects: B Philosophy. Psychology. Religion > BF Psychology
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Supervisor's Name: O'Connor, Prof. Rory C. and O'Carroll, Prof. Ronan E.
• Date of Award: 2015
• Depositing User: Ms Olivia Jane Kirtley
• Unique ID: glathesis:2015-7162
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 29 Mar 2016 12:24
• Last Modified: 19 Apr 2016 07:59
• URI: https://theses.gla.ac.uk/id/eprint/7162