Self-injury: Pain and Stress Mechanisms

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DESCRIPTION (provided by applicant): Goals: My research has dealt primarily with the behavioral mechanisms underlying chronic SIB among individuals with developmental disorders. A more complete understanding of the pathophysiology of SIB will require integrating our rich understanding of pain neurobiology and stress psychobiology with our emerging understanding of the role of early experience on multiple pain and stress-sensitive physiological systems. Research: During my R29 funding period, I extended the opioid model of SIB in line with clinical features suggestive of altered pain processing, formed collaborative relations, and began developing the necessary expertise allowing me to seek funding to test an integrative pain and stress model of SIB in adults. The purpose of the funded R01 is to compare socially and nonsocially-mediated SIB adult cases on a set of behavioral and biological measures related to sensory function, stress physiology, and pain behavior. Career Plan: The career development plan uses a translational research training framework as an organizing set of principles to guide research and training goals specific to new developments in neuroscience and behavioral genetics, integrating the wider research program of developmental psychopathology, and expanding the self- injury research agenda to embrace gene-environmental interplay and improve our understanding of individual vulnerability. Preliminary work and collaborative relations are described to support the need for release time to enhance my training and research into these related areas. The plan emphasizes the need to extend self- injury research to issues germane to pediatric and neurological research (i.e., pain regulation, high risk populations), and to include other systems important in the regulation of pain (i.e., peripheral and central transmission mechanisms), stress (i.e., the HPA axis), and the autonomic nervous system (i.e., fronto-limbic and autonomic circuitry). Specifically, I want to gain the expertise to test the following three preliminary hypotheses. First, there will be differences in hypothalamic-pituitary-adrenal (HPA) axis activity (cortisol) and sensory function (detection thresholds) in children with severe neurological impairment and self-injury compared with matched controls without self-injury (between group analyses). Second: the frequency and temporal sequencing of self-injury will be correlated with HPA axis activity and sensory function (within group analyses). Third, the relation between HPA axis activity, sensory function, and SIB will change over time such that the degree of dysregulation in the former predicts increasing severity in the latter (prospective analysis). Institution and Environment Commitment: The Department of Educational Psychology and the University of Minnesota are committed to this award and provide rich resources for my career development.