Author

Author ORCID Identifier

https://orcid.org/0009-0006-6399-418X

Document Type

Dissertation

Date of Award

2026

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

S. Jean Caraway

Abstract

Pain is a pervasive global health concern that affects approximately one in five adults worldwide and carries substantial psychological and economic costs. Chronic and persistent pain often co-occurs with emotional dysregulation and maladaptive coping behavior, suggesting the involvement of complex biopsychosocial mechanisms including personality pathology. Specifically, borderline personality disorder (BPD) features, have been associated with altered pain perception, increased emotional reactivity, and higher engagement in non-suicidal self-injury (NSSI). Further, hormonal fluctuations across menstrual cycle phases have been linked to variability in pain sensitivity, though findings remain inconsistent. Despite the growing body of literature on pain and personality, little is known about how these factors intersect with perceived pain relief and self-injurious behavior. The present study examined associations among BPD features, menstrual cycle phases, perceived pain relief, and NSSI recency to better understand psychological and physiological influences on pain modulation. Participants included 668 undergraduate students (M = 19.41 years, SD = 2.49) from a Midwestern university, using SONA and completed an online Qualtrics survey. Measures included the Personality Assessment Inventory – Borderline Scale, the Brief Pain Inventory, and the Inventory of Statements About Self-Harm. Relative to available comparison samples, the present sample demonstrated higher rates of persistent pain and comparable rates of lifetime non-suicidal self-injury. Analyses included correlations, hierarchical regressions, and moderation analyses to test direct and interactive effects of BPD features, perceived pain relief, , sex and the menstrual cycle phases on NSSI recency. Additional analyses compared outcomes across the follicular and luteal phases and examined patterns within participants reporting and not reporting hormonal contraceptive use. Analyses revealed that greater BPD features were associated with shorter NSSI recency indicating more frequent self-injury among participants with higher borderline features. Menstrual cycle phase and sex were not significantly associated with NSSI recency, and no significant differences were observed across follicular and luteal phases for primary variables. The results of this study underscore the value of biopsychosocial framework for understanding pain-related behavior and highlights the need for integrated interventions targeting emotional regulation and pain sensitivity among individuals with BPD features.

Subject Categories

Clinical Psychology | Psychology

Keywords

Non Provided

Number of Pages

138

Publisher

University of South Dakota

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