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A meta-analysis on pain sensitivity in self-injury

Published online by Cambridge University Press:  11 March 2016

J. Koenig ,
J. F. Thayer  and
M. Kaess
J. Koenig*
Affiliation:
Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany Department of Psychology, The Ohio State University, Columbus, OH, USA
J. F. Thayer
Affiliation:
Department of Psychology, The Ohio State University, Columbus, OH, USA
M. Kaess
Affiliation:
Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
*
*Address for correspondence: Dr J. Koenig, Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115 Heidelberg, Germany. (Email: [email protected])
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Abstract

Individuals engaging in self-injurious behavior (SIB) frequently report absence of pain during acts of SIB. While altered pain sensitivity is discussed as a risk factor for the engagement in SIB, results have been mixed with considerable variance across reported effect sizes, in particular with respect to the effect of co-morbid psychopathology. The present meta-analysis aimed to summarize the current evidence on pain sensitivity in individuals engaging in SIB and to identify covariates of altered pain processing. Three databases were searched without restrictions. Additionally a hand search was performed and reference lists of included studies were checked for potential studies eligible for inclusion. Thirty-two studies were identified after screening 720 abstracts by two independent reviewers. Studies were included if they reported (i) an empirical investigation, in (ii) humans, including a sample of individuals engaging in (iii) SIB and a group of (iv) healthy controls, (v) receiving painful stimulation. Random-effects meta-analysis was performed on three pain-related outcomes (pain threshold, pain tolerance, pain intensity) and several population- and study-level covariates (i.e. age, sex, clinical etiology) were subjected to meta-regression. Meta-analysis revealed significant main effects associated with medium to large effect sizes for all included outcomes. Individuals engaging in SIB show greater pain threshold and tolerance and report less pain intensity compared to healthy controls. Clinical etiology and age are significant covariates of pain sensitivity in individuals engaging in SIB, such that pain threshold is further increased in borderline personality disorder compared to non-suicidal self-injury. Mechanisms underlying altered pain sensitivity are discussed.

Keywords

Borderline personality disorderdeliberate self-harmmeta-analysisnon-suicidal self-injurypain sensitivityself-injury
Type
Review Article
Information
Psychological Medicine , Volume 46 , Issue 8 , June 2016 , pp. 1597 - 1612
Copyright
Copyright © Cambridge University Press 2016 

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References

APA (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edn. American Psychiatric Publishing: Arlington, VA.Google Scholar
Aslaksen, PM, Myrbakk, IN, Høifødt, RS, Flaten, MA (2007). The effect of experimenter gender on autonomic and subjective responses to pain stimuli. Pain 129, 260–268.CrossRefGoogle ScholarPubMed
Barnow, S, Limberg, A, Stopsack, M, Spitzer, C, Grabe, HJ, Freyberger, HJ, Hamm, A (2012). Dissociation and emotion regulation in borderline personality disorder. Psychological Medicine 42, 783–794.CrossRefGoogle ScholarPubMed
Bartley, EJ, Fillingim, RB (2013). Sex differences in pain: a brief review of clinical and experimental findings. British Journal of Anaesthesia 111, 52–58.CrossRefGoogle Scholar
Basoglu, C, Cetin, M, Ebrinc, S, Maden, B, Balibey, H, Baykiz, AF (2002). Hypnotizability, pain threshold and dissociative experiences in patients with borderline personality disorder and self-mutilating behavior. European Neuropsychopharmacology 12, 433–434.CrossRefGoogle Scholar
Bekrater-Bodmann, R, Chung, B, Schmahl, C, Flor, H (2014). Nociception and pain perception in borderline personality disorder [Abstract]. International Congress on Borderline Personality Disorder and Allied Disorders, p. 14. http://www.cpo-media.net/ESSPD/Final_Borderline2014/HTML/.Google Scholar
Bekrater-Bodmann, R, Chung, BY, Richter, I, Wicking, M, Foell, J, Mancke, F, Schmahl, C, Flor, H (2015). Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion. Pain 156, 2084–2092.CrossRefGoogle ScholarPubMed
Boerner, KE, Birnie, KA, Caes, L, Schinkel, M, Chambers, CT (2014). Sex differences in experimental pain among healthy children: a systematic review and meta-analysis. Pain 155, 983–993.CrossRefGoogle ScholarPubMed
Bohus, M, Limberger, M, Ebner, U, Glocker, FX, Schwarz, B, Wernz, M, Lieb, K (2000). Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behavior. Psychiatry Research 95, 251–260.CrossRefGoogle ScholarPubMed
Bracken-Minor, KL, McDevitt-Murphy, ME (2014). Differences in features of non-suicidal self-injury according to borderline personality disorder screening status. Archives of Suicide Research: Official Journal of the International Academy for Suicide Research 18, 88–103.CrossRefGoogle ScholarPubMed
Bresin, K, Gordon, KH (2013 a). Changes in negative affect following pain (vs. nonpainful) stimulation in individuals with and without a history of nonsuicidal self-injury. Personality Disorders 4, 62–66.CrossRefGoogle ScholarPubMed
Bresin, K, Gordon, KH (2013 b). Endogenous opioids and nonsuicidal self-injury: a mechanism of affect regulation. Neuroscience and Biobehavioral Reviews 37, 374–383.CrossRefGoogle ScholarPubMed
Brickman, LJ, Ammerman, BA, Look, AE, Berman, ME, McCloskey, MS (2014). The relationship between non-suicidal self-injury and borderline personality disorder symptoms in a college sample. Borderline Personality Disorder and Emotion Dysregulation 1, 14.CrossRefGoogle Scholar
Brunner, R, Kaess, M, Parzer, P, Fischer, G, Carli, V, Hoven, CW, Wasserman, C, Sarchiapone, M, Resch, F, Apter, A, Balazs, J, Barzilay, S, Bobes, J, Corcoran, P, Cosmanm, D, Haring, C, Iosuec, M, Kahn, JP, Keeley, H, Meszaros, G, Nemes, B, Podlogar, T, Postuvan, V, Saiz, PA, Sisask, M, Tubiana, A, Varnik, A, Wasserman, D (2014). Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries. Journal of Child Psychology and Psychiatry, and Allied Disciplines 55, 337–348.CrossRefGoogle ScholarPubMed
Bungert, M, Koppe, G, Niedtfeld, I, Vollstädt-Klein, S, Schmahl, C, Lis, S, Bohus, M (2015). Pain processing after social exclusion and its relation to rejection sensitivity in borderline personality disorder. PLoS ONE 10, e0133693 CrossRefGoogle ScholarPubMed
Cárdenas-Morales, L, Fladung, A-K, Kammer, T, Schmahl, C, Plener, PL, Connemann, BJ, Schönfeldt-Lecuona, C (2011). Exploring the affective component of pain perception during aversive stimulation in borderline personality disorder. Psychiatry Research, 186, 458–460.CrossRefGoogle ScholarPubMed
Carpenter, RW, Trull, TJ (2015). The pain paradox: borderline personality disorder features, self-harm history, and the experience of pain. Personality Disorders 6, 141–151.CrossRefGoogle ScholarPubMed
Carpenter, R, Wood, P, Trull, T (2012). The importance of individual differences in pain tolerance on individuals with borderline personality disorder features in a cold pressor task [Abstract]. Society for Psychophysiological Research Meeting. Psychophysiology 49, S40–S40.Google Scholar
Dao, TT, LeResche, L (2000). Gender differences in pain. Journal of Orofacial Pain 14, 169–184; discussion 184–195.Google ScholarPubMed
Edwards, RR, Fillingim, RB, Ness, TJ (2003). Age-related differences in endogenous pain modulation: a comparison of diffuse noxious inhibitory controls in healthy older and younger adults. Pain 101, 155–165.CrossRefGoogle ScholarPubMed
Fillingim, RB, King, CD, Ribeiro-Dasilva, MC, Rahim-Williams, B, Riley, JL (2009). Sex, gender, and pain: a review of recent clinical and experimental findings. Journal of Pain 10, 447–485.CrossRefGoogle Scholar
Franklin, JC, Aaron, RV, Arthur, MS, Shorkey, SP, Prinstein, MJ (2012). Nonsuicidal self-injury and diminished pain perception: the role of emotion dysregulation. Comprehensive Psychiatry 53, 691–700.CrossRefGoogle ScholarPubMed
Franklin, JC, Hessel, ET, Prinstein, MJ (2011). Clarifying the role of pain tolerance in suicidal capability. Psychiatry Research 189, 362–367.CrossRefGoogle ScholarPubMed
Franklin, JC, Puzia, ME, Lee, KM, Lee, GE, Hanna, EK, Spring, VL, Prinstein, MJ (2013). The nature of pain offset relief in nonsuicidal self-injury a laboratory study. Clinical Psychological Science 2167702612474440.CrossRefGoogle Scholar
Gibson, SJ, Farrell, M (2004). A review of age differences in the neurophysiology of nociception and the perceptual experience of pain. Clinical Journal of Pain 20, 227–239.CrossRefGoogle ScholarPubMed
Glenn, JJ, Michel, BD, Franklin, JC, Hooley, JM, Nock, MK (2014). Pain analgesia among adolescent self-injurers. Psychiatry Research 220, 921–926.CrossRefGoogle ScholarPubMed
Gratz, KL, Hepworth, C, Tull, MT, Paulson, A, Clarke, S, Remington, B, Lejuez, CW (2011). An experimental investigation of emotional willingness and physical pain tolerance in deliberate self-harm: the moderating role of interpersonal distress. Comprehensive Psychiatry 52, 63–74.CrossRefGoogle ScholarPubMed
Hamza, C, Willoughby, T, Armiento, J (2014). A laboratory examination of pain threshold and tolerance among nonsuicidal self-injurers with and without self-punishing motivations. Archives of Scientific Psychology, 33–42.CrossRefGoogle Scholar
Higgins, J, Green, S (2011). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 (http://handbook.cochrane.org).Google Scholar
Higgins, JPT, Thompson, SG (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine 21, 1539–1558.CrossRefGoogle ScholarPubMed
Hooley, JM, Ho, DT, Slater, J, Lockshin, A (2010). Pain perception and nonsuicidal self-injury: a laboratory investigation. Personality Disorders 1, 170–179.CrossRefGoogle ScholarPubMed
Hooley, JM, St. Germain, SA (2013). Nonsuicidal self-injury, pain, and self-criticism does changing self-worth change pain endurance in people who engage in self-injury? Clinical Psychological Science 2167702613509372.Google Scholar
Hozo, SP, Djulbegovic, B, Hozo, I (2005). Estimating the mean and variance from the median, range, and the size of a sample. BMC Medical Research Methodology 5, 1–10.CrossRefGoogle ScholarPubMed
Jochims, A, Ludäscher, P, Bohus, M, Treede, R-D, Schmahl, DC (2006). Schmerzverarbeitung bei Borderline-Persönlichkeitsstörung, Fibromyalgie und Posttraumatischer Belastungsstörung [Pain processing in patients with borderline personality disorder, fibromyalgia, and post-traumatic stress disorder]. Der Schmerz 20, 140–150.CrossRefGoogle Scholar
Kállai, I, Barke, A, Voss, U (2004). The effects of experimenter characteristics on pain reports in women and men. Pain 112, 142–147.CrossRefGoogle ScholarPubMed
Kemperman, I, Russ, MJ, Clark, WC, Kakuma, T, Zanine, E, Harrison, K (1997). Pain assessment in self-injurious patients with borderline personality disorder using signal detection theory. Psychiatry Research 70, 175–183.CrossRefGoogle ScholarPubMed
Klonsky, ED (2007). The functions of deliberate self-injury: a review of the evidence. Clinical Psychology Review 27, 226–239.CrossRefGoogle ScholarPubMed
Klossika, I, Schmahl, C (2010). Influence of anticipation on pain processing in patients with borderline personality disorder [Abstract]. Society of Biological Psychiatry. Biological Psychiatry 67, 100s.Google Scholar
Kluetsch, RC, Schmahl, C, Niedtfeld, I, Densmore, M, Calhoun, VD, Daniels, J, Kraus, A, Ludaescher, P, Bohus, M, Lanius, RA (2012). Alterations in default mode network connectivity during pain processing in borderline personality disorder. Archives of General Psychiatry 69, 993–1002.CrossRefGoogle ScholarPubMed
Knapp, G, Hartung, J (2003). Improved tests for a random effects meta-regression with a single covariate. Statistics in Medicine 22, 2693–2710.CrossRefGoogle ScholarPubMed
Lautenbacher, S, Krieg, JC (1994). Pain perception in psychiatric disorders: a review of the literature. Journal of Psychiatric Research 28, 109–122.CrossRefGoogle ScholarPubMed
Ludäscher, P, Bohus, M, Lieb, K, Philipsen, A, Jochims, A, Schmahl, C (2007). Elevated pain thresholds correlate with dissociation and aversive arousal in patients with borderline personality disorder. Psychiatry Research 149, 291–296.CrossRefGoogle ScholarPubMed
Ludäscher, P, Greffrath, W, Schmahl, C, Kleindienst, N, Kraus, A, Baumgärtner, U, Magerl, W, Treede, RD, Bohus, M (2009). A cross-sectional investigation of discontinuation of self-injury and normalizing pain perception in patients with borderline personality disorder. Acta Psychiatrica Scandinavica 120, 62–70.Google ScholarPubMed
Ludäscher, P, Jochims, A, Bohus, M, Greffrath, W, Treede, R, Schmahl, C (2005). Elevated pain threshold in borderline patients assessed by different methods [Abstract]. Society of Biological Psychiatry. Biological Psychiatry 57, 91s.Google Scholar
Ludäscher, P, Valerius, G, Stiglmayr, C, Mauchnik, J, Lanius, RA, Bohus, M, Schmahl, C (2010). Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study. Journal of Psychiatry & Neuroscience 35, 177–184.CrossRefGoogle ScholarPubMed
Ludäscher, P, von Kalckreuth, C, Parzer, P, Kaess, M, Resch, F, Bohus, M, Schmahl, C, Brunner, R (2015). Pain perception in female adolescents with borderline personality disorder. European Child & Adolescent Psychiatry 24, 351–357.CrossRefGoogle ScholarPubMed
Lu, Q, Zeltzer, L, Tsao, J (2013). Multiethnic differences in responses to laboratory pain stimuli among children. Health Psychology 32, 905–914.CrossRefGoogle ScholarPubMed
Magerl, W, Burkart, D, Fernandez, A, Schmidt, LG, Treede, R-D (2012). Persistent antinociception through repeated self-injury in patients with borderline personality disorder. Pain 153, 575–584.CrossRefGoogle ScholarPubMed
McCown, W, Galina, H, Johnson, J, DeSimone, PA, Posa, J (1993). Borderline personality disorder and laboratory-induced cold pressor pain: evidence of stress-induced analgesia. Journal of Psychopathology and Behavioral Assessment 15, 87–95.CrossRefGoogle Scholar
McCoy, K, Fremouw, W, McNeil, DW (2010). Thresholds and tolerance of physical pain among young adults who self-injure. Pain Research & Management: 15, 371–377.CrossRefGoogle ScholarPubMed
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. British Medical Journal 339, b2535.CrossRefGoogle ScholarPubMed
Moran, P, Coffey, C, Romaniuk, H, Olsson, C, Borschmann, R, Carlin, JB, Patton, GC (2012). The natural history of self-harm from adolescence to young adulthood: a population-based cohort study. Lancet 379, 236–243.CrossRefGoogle ScholarPubMed
Muehlenkamp, JJ, Claes, L, Havertape, L, Plener, PL (2012). International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child and Adolescent Psychiatry and Mental Health 6, 10.CrossRefGoogle ScholarPubMed
Niedtfeld, I, Schulze, L, Kirsch, P, Herpertz, SC, Bohus, M, Schmahl, C (2010). Affect regulation and pain in borderline personality disorder: a possible link to the understanding of self-injury. Biological Psychiatry 68, 383–391.CrossRefGoogle Scholar
Nock, MK (2010). Self-injury. Annual Review of Clinical Psychology 6, 339–363.CrossRefGoogle ScholarPubMed
Orbach, I, Mikulincer, M, King, R, Cohen, D, Stein, D (1997). Thresholds and tolerance of physical pain in suicidal and nonsuicidal adolescents. Journal of Consulting and Clinical Psychology 65, 646–652.CrossRefGoogle ScholarPubMed
Orbach, I, Palgi, Y, Stein, D, Har-Even, D, Lotem-Peleg, M, Asherov, J, Elizur, A (1996 a). Tolerance for physical pain in suicidal subjects. Death Studies 20, 327–341.CrossRefGoogle ScholarPubMed
Orbach, I, Stein, D, Palgi, Y, Asherov, J, Har-Even, D, Elizur, A (1996 b). Perception of physical pain in accident and suicide attempt patients: self-preservation vs self-destruction. Journal of Psychiatric Research 30, 307–320.CrossRefGoogle ScholarPubMed
Pavony, MT, Lenzenweger, MF (2013). Somatosensory processing and borderline personality disorder features: a signal detection analysis of proprioception and exteroceptive sensitivity. Journal of Personality Disorders 27, 208–221.CrossRefGoogle ScholarPubMed
Racine, M, Tousignant-Laflamme, Y, Kloda, LA, Dion, D, Dupuis, G, Choinière, M (2012 a). A systematic literature review of 10 years of research on sex/gender and experimental pain perception – part 1: are there really differences between women and men? Pain 153, 602–618.CrossRefGoogle ScholarPubMed
Racine, M, Tousignant-Laflamme, Y, Kloda, LA, Dion, D, Dupuis, G, Choinière, M (2012 b). A systematic literature review of 10 years of research on sex/gender and pain perception – part 2: do biopsychosocial factors alter pain sensitivity differently in women and men? Pain 153, 619–635.CrossRefGoogle ScholarPubMed
Rahim-Williams, B, Riley, JL, Williams, AKK, Fillingim, RB (2012). A quantitative review of ethnic group differences in experimental pain response: do biology, psychology, and culture matter? Pain Medicine 13, 522–540.CrossRefGoogle ScholarPubMed
Riley, JL, Robinson, ME, Wise, EA, Myers, CD, Fillingim, RB (1998). Sex differences in the perception of noxious experimental stimuli: a meta-analysis. Pain 74, 181–187.CrossRefGoogle ScholarPubMed
Rokyt, R, Yamamotová, A (2013). Sex differences in pain perception and interpretation. Activitas Nervosa Superior Rediviva 55, 125–134.Google Scholar
Russ, MJ, Campbell, SS, Kakuma, T, Harrison, K, Zanine, E (1999). EEG theta activity and pain insensitivity in self-injurious borderline patients. Psychiatry Research 89, 201–214.CrossRefGoogle ScholarPubMed
Russ, MJ, Roth, SD, Lerman, A, Kakuma, T, Harrison, K, Shindledecker, RD, Hull, J, Mattis, S (1992). Pain perception in self-injurious patients with borderline personality disorder. Biological Psychiatry 32, 501–511.CrossRefGoogle ScholarPubMed
Russ, MJ, Shearin, EN, Clarkin, JF, Harrison, K, Hull, JW (1993). Subtypes of self-injurious patients with borderline personality disorder. American Journal of Psychiatry 150, 1869–1871.Google ScholarPubMed
Scammacca, N, Roberts, G, Stuebing, KK (2014). Meta-analysis with complex research designs dealing with dependence from multiple measures and multiple group comparisons. Review of Educational Research 84, 328–364.CrossRefGoogle ScholarPubMed
Schmahl, C, Bohus, M, Esposito, F, Treede, R-D, Di Salle, F, Greffrath, W, Ludäscher, P, Jochims, A, Lieb, K, Scheffler, K, Hennig, J, Seifritz, E (2006). Neural correlates of antinociception in borderline personality disorder. Archives of General Psychiatry 63, 659–667.CrossRefGoogle ScholarPubMed
Schmahl, C, Greffrath, W, Baumgärtner, U, Schlereth, T, Magerl, W, Philipsen, A, Lieb, K, Bohus, M, & Treede, R-D (2004). Differential nociceptive deficits in patients with borderline personality disorder and self-injurious behavior: laser-evoked potentials, spatial discrimination of noxious stimuli, and pain ratings. Pain 110, 470–479.CrossRefGoogle ScholarPubMed
Schmahl, C, Jochims, A, Valerius, G, Schulze, T, Rietschel, M, Skowronek, M, Smolka, M, Bohus, M (2008 a). COMT val158met polymorphism and pain processing in borderline personality disorder. Biological Psychiatry 63, 161S–161S.Google Scholar
Schmahl, C, Jochims, A, Valerius, G, Schulze, T, Rietschel, M, Smolka, M, Bohus, M (2006). COMT val158met polymorphism and pain processing in borderline personality disorder. Neuropsychopharmacology 31, S85–S86.Google Scholar
Schmahl, C, Klossika, I, Bohus, M (2008 b). Pain anticipation: a mechanism involved in affect regulation in BPD? International Journal of Psychology 43, 388–388.Google Scholar
Schmahl, C, Klossika, I, Bohus, M (2008 c). Pain anticipation – a mechanism involved in affect regulation in BPD? Biological Psychiatry 63, 132S–132S.Google Scholar
Schmahl, C, Ludäscher, P, Greffrath, W, Kraus, A, Valerius, G, Schulze, TG, Treutlein, J, Rietschel, M, Smolka, MN, Bohus, M (2012). COMT val158met polymorphism and neural pain processing. PLoS ONE 7, e23658.CrossRefGoogle ScholarPubMed
Schmahl, C, Meinzer, M, Zeuch, A, Fichter, M, Cebulla, M, Kleindienst, N, Ludäscher, P, Steil, R, Bohus, M (2010). Pain sensitivity is reduced in borderline personality disorder, but not in posttraumatic stress disorder and bulimia nervosa. World Journal of Biological Psychiatry 11, 364–371.CrossRefGoogle Scholar
Schmahl, C, Niedtfeld, I, Klossika, I (2010). Affective and cognitive aspects of pain processing in borderline personality disorder [Abstract]. European College of Neuropsychopharmacology (ECNP) Congress. European Neuropsychopharmacology S192.CrossRefGoogle Scholar
Schmid, MM, Freudenmann, RW, Keterling, I, Cárdenas-Morales, L, Connemann, BJ, Gunst, IM, Schönfeldt-Lecuona, C (2011). Transitionale Objekte und Schmerzwahrnehmung bei Patienten mit Borderline-Persönlichkeitsstörung [Translational objects and pain in Borderline patients]. Nervenheilkunde 30, 602–607.Google Scholar
Schoenleber, M, Berenbaum, H, Motl, R (2014). Shame-related functions of and motivations for self-injurious behavior. Personality Disorders 5, 204–211 CrossRefGoogle ScholarPubMed
Schönfeldt-Lecuona, C, Cárdenas Morales, L, Wietasch, A, Kammer, T (2008). Pain threshold in borderline personality disorder: exploring the clinical use of peripheral magnetic stimulation [Abstract]. International Conference on Transcranial Magnetic and Direct Current Stimulation Program. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 259.CrossRefGoogle Scholar
Schönfeldt-Lecuona, C, Connemann, BJ, Fladung, A-K, Kammer, T, Schmahl, C, Plener, PL, Cárdenas-Morales, LK (2011). P02–407 – Pain perception in borderline personality disorder explored using PMS. European Psychiatry 26, (Suppl. 1), 1003.CrossRefGoogle Scholar
Smith, NB (2014). Physiological Responses to Pain in Self-Injurers: an In-Depth Investigation . Southern Methodist University (http://gradworks.umi.com/36/44/3644262.html).Google Scholar
St. Germain, SA (2011). Expanding the Conceptualization of Self-Injurious Behavior: Are All Forms of Self-Injury Created Equal? Harvard University (http://gradworks.umi.com/34/91/3491893.html).Google Scholar
Swannell, SV, Martin, GE, Page, A, Hasking, P, St John, NJ (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide & Life-Threatening Behavior 44, 273–303.CrossRefGoogle ScholarPubMed
Thompson, SG, Higgins, JPT (2002). How should meta-regression analyses be undertaken and interpreted? Statistics in Medicine 21, 1559–1573.CrossRefGoogle ScholarPubMed
Wallace, B, Dahabreh, I, Trikalinos, T, Lau, J, Trow, P, Schmid, C (2012). Closing the gap between methodologists and end-users: R as a computational back-end. Journal of Statistical Software 49, 1115.CrossRefGoogle Scholar
Wan, X, Wang, W, Liu, J, Tong, T (2014). Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Medical Research Methodology 14, 135.CrossRefGoogle ScholarPubMed
Weinberg, A, Klonsky, ED (2011). The effects of self-injury on acute negative arousal: a laboratory simulation. Motivation and Emotion 36, 242–254.CrossRefGoogle Scholar
Wiebe, N, Vandermeer, B, Platt, RW, Klassen, TP, Moher, D, Barrowman, NJ (2006). A systematic review identifies a lack of standardization in methods for handling missing variance data. Journal of Clinical Epidemiology 59, 342–353.CrossRefGoogle ScholarPubMed
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