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Co-Occurring Trauma and Non-Suicidal Self-Injury Among People With Chronic Pain: A Systematic Review

  • Psychological and Behavioral Aspects of Headache and Pain (D Buse, Section Editor)
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Abstract

Purpose of Review

Trauma and posttraumatic stress are common among individuals with chronic pain and contribute to increased morbidity and impairment. Individuals with trauma and chronic pain may be prone to non-suicidal self-injury, a relatively common yet risky self-regulatory behavior. There is a dearth of research on the intersection of trauma, chronic pain, and non-suicidal self-injury (NSSI). We conducted a systematic review of the extant literature.

Recent Findings

Five quantitative and eight case reports were identified. Only one quantitative study reported specifically on NSSI. Self-harm rates varied across studies, though appeared elevated among patients with chronic pain. Childhood trauma was linked to this co-occurrence.

Summary

Causal links between trauma, NSSI, and pain are proposed, highlighting the need for a comprehensive theoretical model. We recommend assessing for childhood trauma when treating patients with chronic pain and querying regarding NSSI when patients present with indicators of NSSI risk and to treat or refer such patients to specialized treatment.

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Acknowledgements

We would like to acknowledge the American Psychological Association Society of Clinical Psychology (Division 12) Research Assistance Task Force for facilitating this work.

Funding

This manuscript was prepared with support from the Vanderbilt Patient Centered Outcomes Research Education and Training Initiative and the Agency for Healthcare Research and Quality (AHRQ 6K12HS022990-04) and by Vanderbilt University Medical Center CTSA award No. UL1TR000445 from the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent official views of the National Center for Advancing Translational Sciences or the National Institutes of Health.

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  1. School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, NJ, USA

    Benjamin Norman Johnson & Lindsey McKernan

  2. Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA

    Lindsey McKernan

  3. Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, USA

    Lindsey McKernan

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  1. Benjamin Norman Johnson
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Correspondence to Benjamin Norman Johnson.

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Johnson, B.N., McKernan, L. Co-Occurring Trauma and Non-Suicidal Self-Injury Among People With Chronic Pain: A Systematic Review. Curr Pain Headache Rep 25, 70 (2021). https://doi.org/10.1007/s11916-021-00984-x

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