Research shows differences in brain during self-injury
A study led by Dr. Elizabeth Osuch of the Department of Psychiatry has shown that there are functional brain differences between people who deliberately self-harm and those who don’t. The finding, which was reported in the journal Psychiatry Research: Neuroimaging, helps increase understanding of why pain, which should be aversive, becomes reinforcing for some people.
Deliberate self-harm, also known as non-suicidal self-injury (NSSI) is increasingly common in youth and remains one of the most misunderstood and maligned mechanisms for coping. Dr. Osuch, a Lawson scientist, found differences in the neurocircuitry of the brain between youth who engage in deliberate self-harm and those who don’t.
The researchers used functional magnetic resonance imaging (fMRI), which looks at blood oxygenation in the brain to detect areas of activity, to compare the pain/reward-processing neurocircuitry of the brain between patients who use NSSI and those who do not. A painfully cold (ice water) and comparison cool (room temperature) stimulus was administered to subjects’ forearm under two conditions: self-administered and experimenter administered (as a control).
“Our study showed that pain/reward processing neurocircuitry is abnormal in NSSI patients compared with non-NSSI patients,” says Dr. Osuch. “NSSI patients feel extreme relief during the painful stimulus to the extent that it feels rewarding. Non-NSSI subjects do not experience the same pain as relief or as a reward.”
Analysis of the brain scans showed reduced functional connectivity between the parts of the brain that experience emotion and those that regulate emotion in the NSSI patients. These findings help to inform how pain is associated with reward for NSSI patients, but not for non-NSSI patients.
“We know that the part of the brain that processes pain is fundamentally different in these patients. We don’t know if this change occurs at birth or over time. However, by better understanding the functional brain correlates of this behavior, it means treatment possibilities increase through medication or other therapies,” says Dr. Osuch.
Dr. Osuch explains further, “There are lots of misconceptions about people who hurt or cut themselves, so proving the correlation of functional brain differences in NSSI vs. non-NSSI patients shows the reason behind the cutting. It’s not necessarily about NSSI patients manipulating others through their self-injury acts; it’s their brains reacting differently to the painful stimulus. One of the beneficial ‘side effects’ of brain imaging studies is to destigmatize these behaviours and takes them out of the unknown and misunderstood.”
Dr. Elizabeth Osuch is an associate professor of psychiatry and The Dr. Joseph Rea Chair in Mood Disorders at the Schulich School of Medicine and Dentistry and the Chair/Medical Director of the First Episode Mood and Anxiety Program (FEMAP) at London Health Sciences Centre.