Pain in adolescence linked to increased risk of self-harm
Adolescents who report pain at the age of 18 are at higher risk of later self-harm. This is shown by a new study from Karolinska Institutet, published in Psychiatry Research. The findings suggest that pain may form part of the chain of events leading to self-harming behaviour.
A new study from Karolinska Institutet has examined the association between pain symptoms and self-harm during childhood and adolescence. The researchers followed 16,948 twin pairs born in Sweden between 1992 and 2010. Participants reported pain at the ages of 9 and 18 and were subsequently followed through national registers until a maximum age of 24.
The aim was to investigate how genetic and environmental factors influence both pain and self-harm, as well as how the associations between pain and self-harming behaviour develop over time. Using so-called twin models, the researchers were able to estimate how much of the variation could be explained by heredity, shared environment or individual experiences.
“We see that both genetic factors and individual environmental factors play a role in both pain and self-harm in childhood as well as adolescence,” says Jenny Rickardsson, researcher at the Department of Clinical Neuroscience, Karolinska Institutet.
The results also show that pain before and up to the age of 18 was associated with a higher likelihood of later self-harm. Adolescents with pain symptoms had approximately a 60 per cent higher risk of self-harm compared with peers without pain. The association could not be explained by factors such as family environment or genetic similarity between twins.
“Our analyses suggest that pain may partly lie within the causal pathway leading to self-harming behaviour, and that the association is not solely due to familial factors,” says Jenny Rickardsson.
The study further shows that the shared family environment had little impact on either pain or self-harm, while genetic factors and individual experiences accounted for a larger proportion of the variation.
The study is based on data from the Swedish Twin Registry and was funded by Fonden för Psykisk Hälsa and Hjärnfonden. The researchers report no conflicts of interest that may have influenced the results.
Publication
Genetic and environmental factors in pain symptoms and self-harm, and their association. A twin study Jenny Rickardsson, Mark J. Taylor, Paul Lichtenstein, Henrik Larsson, Sebastian Lundström , Karin Jensen , Maria Lalouni, Psychiatry Research, online 19 January 2026, Version of Record 26 January 2026, doi:10.1016/j.psychres.2026.116962