From Guild Wars Wiki
- Concise description
Players take 20 damage when they activate a skill.
- Edge of Reason
- Depths of Madness (environment effect)
- Cower in Fear
- Veiled Nightmare
- Repressive Energy
- Enduring Torment
- Shroud of Darkness
- Demonic Miasma
- Corrupted Haiju Lagoon Water
- Party members suffer this effect while in the Domain of Pain and during the Gate of Pain; it does not affect allies that are not party members.
- The penalty is applied after skill activation; interrupted, failed, and canceled skills do not trigger the effect.
- The damage is applied before the Divine Favor healing bonus is applied, so monk skills that heal the entire party will keep a primary monk healed while healing the entire party.
- Union affects the damage, reducing it to 5.