Table 2.

Summary of reviewed quantitative/empirical studies (k = 5)

Year	Author(s)	N	% Female	Average age	Study type	Sample	Assessment of chronic pain	Assessment of trauma	Assessment of self-harm	Rate of chronic pain diagnosis	Rate of trauma	Rate of PTSD	Rate of Self-Harm	Rate of NSSI	Primary findings
2020	Hayes et al	56,187	9.6%	57.2	Retrospective cohort study	Veterans with chronic, non-cancer pain on long-term opioid therapy	Medical record diagnosis of arthritis, back pain, neck pain, neuropathic pain, or headache/migraine	Medical record diagnosis of PTSD	Medical record designation of ICD-9 self-injury code (E950-E959 & V62.84)	100%	N/A	5.6%	1.5%	N/A	Patients with increasing opioid treatment dosages reported higher rates of self-injury than those with maintained opioid dosages (over 1 year), controlling for PTSD, average pain, and other covariates.
2011	Okifuji & Benham	260	62%	41.7	Cross-sectional clinical interview study	Consecutively admitted adult patients presenting to University-based, tertiary-care, multidisciplinary pain treatment center	“Comprehensive, interdisciplinary pain evaluation”	Semi-structured interview of history of childhood sexual and physical abuse and adulthood experience of domestic violence	Clinical evaluation: 1. “Have you done anything in the past to intentionally harm yourself?” 2. “What did you do?” 3. “What happened after you did it?” 4. “Did you mean to kill yourself or want to die at that point?”	100%	19% childhood sexual abuse 18% childhood physical abuse 9% adult domestic abuse	N/A	25.4%	18.8%	Only 4 (6.1%) of self-harmers reported both suicide and NSSI histories, suggesting little overlap between these subpopulations. Childhood physical and sexual abuse, but not adult domestic violence, was associated with increased rates of Hx of NSSI (though not Hx of suicide attempts or presence of current SI).
2009	Sansone et al	117	62.4%	44.5	Cross-sectional clinical interview/self-report study	Consecutively recruited adult patients with chronic, non-cancer pain referred to a pain management specialist	Clinical evaluation of chronic pain	Self-report evaluation of childhood trauma: “Prior to the age of 12, did you ever experience [sexual/physical/emotional abuse, physical neglect, witness violence]?” [yes/no]	Self-Harm Inventory (Sansone et al., 1998)	100%	N/A (not reported)	N/A	52.1%	N/A	Found comparable strength of associations (moderate to large) between sexual, physical, emotional, and vicarious traumas and self-harm, assessed regardless of suicidal intent. Furthermore, found that 21.4% of patients endorsed a history of five or more types of self-harm.
2006	Sansone et al	87	58.6 %	43	Cross-sectional self-report study	Convenience sample of adult out-patients at an internal medicine training clinic associated with a community hospital	Pain disorders self-reported, though sample recruited from internal medicine clinic	Self-report evaluation of childhood trauma: “Prior to the age of 12, did you ever experience [sexual/physical/emotional abuse, physical neglect, witness violence]?” [yes/no]	Self-Harm Inventory (Sansone et al., 1998)	< 100% (78 diagnoses; unknown # of patients Dxd)	N/A (not reported)	N/A	N/A (not reported; 19.5% endorsed a Hx of 5 or more types of SH)	N/A	Physical abuse, emotional abuse, and witnessing violence (but not sexual abuse or physical neglect) were each significantly associated (small-to-moderate correlation) with the number of pain disorders endorsed. Only witnessing violence was uniquely predictive.
2001	Sansone et al	17	70.6 %	48.9	Cross-sectional clinical interview/self-report study	Convenience sample of adult patients with chronic pain treated in a family medicine clinic	Self-selected for inclusion and self-report regarding duration of pain	Self-report evaluation of childhood trauma (sexual, physical, emotional abuse, and witnessing violence) [yes/no]	Self-Harm Inventory (Sansone et al., 1998)	100%	52.9% any trauma 11.8% sexual abuse 17.6% physical abuse 23.5% emotional abuse 47.0% witnessing violence	N/A	N/A (not reported; 27.8% endorsed a Hx of 5 or more types of SH)	N/A	Self-harm correlated moderately (though not significantly) and strongly with two measures of BPD (PDQ-R and DIB, respectively), strongly with somatic preoccupation, moderate-to-strongly (though not significantly) with number of types of child abuse, and moderately (though not significantly) with pain intensity.

Note. All studies include assessment or description of patient chronic pain, trauma, and self-harm and utilize quantitative/empirical methodology. “Self-harm” includes suicidal self-injury, while “NSSI” only includes non-suicidal self-injury.

N study sample size, PTSD posttraumatic stress disorder, NSSI non-suicidal self-injury, ICD International Classification of Diseases, SH self-harm, Hx history, SI suicidal ideation, Dxd diagnosed, BPD borderline personality disorder, PDQ-R Personality Diagnostic Questionnaire-Revised, DIB Diagnostic Interview for Borderlines