Lifetime Non-suicidal Self-injury Research Articles

Nonsuicidal Self-Injury in Adolescent and Emerging Adult Childhood Cancer Survivors: A First Exploration.

Purpose: This study examines nonsuicidal self-injury (NSSI) in adolescent and emerging adult survivors of childhood cancer, aiming to gain a first understanding of the phenomenon, its relation to general and cancer-specific functioning, and the stability of NSSI engagement over time. Methods: Dutch-speaking survivors (n = 125, age range = 14-25 years) participated in the first three annual waves of the Longitudinal Identity Study of Childhood Cancer Survivors study. Descriptive characteristics of lifetime NSSI were calculated. Multivariate analysis of variance (MANOVA) and χ2-analyses were performed to examine differences in demographic and clinical characteristics between survivors with and without lifetime NSSI. To assess differences in general and cancer-specific functioning between survivors with and without lifetime NSSI, two MANOVA analyses were performed. Finally, prevalence rates of current NSSI across the three waves were calculated, followed by χ2-analyses to explore differences in current NSSI over time. Results: The prevalence and characteristics of lifetime NSSI engagement resembled those in the general population. Although demographic and clinical characteristics were unrelated to NSSI engagement, several meaningful differences were found in both general and cancer-specific functioning between survivors with and without NSSI. Survivors with lifetime NSSI experienced more depressive symptoms and difficulties with identity formation (i.e., lower levels of identity synthesis and higher levels of identity confusion). In addition, they experienced more post-traumatic stress symptoms and cancer-related worries, and identified less as a "cancer patient." Conclusions: This study provides a first understanding of NSSI engagement in survivors of childhood cancer, mapping the characteristics of NSSI and its associations with both general and cancer-specific functioning.

Polygenic risk for suicide attempt is associated with lifetime suicide attempt in US soldiers independent of parental risk

BackgroundSuicide is a leading cause of death worldwide. Whereas some studies have suggested that a direct measure of common genetic liability for suicide attempts (SA), captured by a polygenic risk score for SA (SA-PRS), explains risk independent of parental history, further confirmation would be useful. Even more unsettled is the extent to which SA-PRS is associated with lifetime non-suicidal self-injury (NSSI). MethodsWe used summary statistics from the largest available GWAS study of SA to generate SA-PRS for two non-overlapping cohorts of soldiers of European ancestry. These were tested in multivariable models that included parental major depressive disorder (MDD) and parental SA. ResultsIn the first cohort, 417 (6.3 %) of 6573 soldiers reported lifetime SA and 1195 (18.2 %) reported lifetime NSSI. In a multivariable model that included parental history of MDD and parental history of SA, SA-PRS remained significantly associated with lifetime SA [aOR = 1.26, 95%CI:1.13–1.39, p < 0.001] per standardized unit SA-PRS]. In the second cohort, 204 (4.2 %) of 4900 soldiers reported lifetime SA, and 299 (6.1 %) reported lifetime NSSI. In a multivariable model that included parental history of MDD and parental history of SA, SA-PRS remained significantly associated with lifetime SA [aOR = 1.20, 95%CI:1.04–1.38, p = 0.014]. A combined analysis of both cohorts yielded similar results. In neither cohort or in the combined analysis was SA-PRS significantly associated with NSSI. ConclusionsPRS for SA conveys information about likelihood of lifetime SA (but not NSSI, demonstrating specificity), independent of self-reported parental history of MDD and parental history of SA. LimitationsAt present, the magnitude of effects is small and would not be immediately useful for clinical decision-making or risk-stratified prevention initiatives, but this may be expected to improve with further iterations. Also critical will be the extension of these findings to more diverse populations.

Investigating suicidal behavior among prisoners in the light of the behavioral addiction approach: results of a multicenter cross-sectional study.

The behavioral addiction model posits that repetitive suicidal behaviors can serve as maladaptive strategies for managing stress and negative emotional states, akin to substance addiction. Both behaviors involve negative emotions, offer temporary psychological relief, and persist, indicating shared neurobiological mechanisms. This study explored psychometric differences among major repeaters, occasional attempters, and non-suicidal prisoners. A multi-centre cross-sectional survey of 363 inmates across four prisons assessed depression, cognitive-emotional regulation, impulsivity, perceived stress, lifetime non-suicidal self-injury and suicide attempts. Mild depression, moderate suicidal ideation, and moderate impulsivity were common, with nearly half of the participants having attempted suicide at least once. Hierarchical multiple regression analyses revealed that repeated suicidal behavior in the past increases susceptibility to future suicidal thoughts, with suicide attempts serving as a maladaptive emotion regulation strategy among repeated attempters. The results reveal differences in emotional dysregulation, impulsivity, and stress coping strategies among the studied groups, reinforcing the idea of suicidality as a form of behavioral addiction. The addiction approach helps explain the sensitivity to later suicidal thoughts in former attempters and self-harmers, offering valuable insights for tailored interventions within correctional settings.

The Prediction Model of Non-Suicidal Self-Injury in Psychiatric Patients Using Decision Tree Analysis.

The prevalence rate of non-suicidal self-injury (NSSI) in the clinical population is higher than that in the community sample, necessitating the need to investigate the predicting factors of NSSI in this group. The present study aimed to develop a prediction model of NSSI among psychiatric patients in Korea. Decision tree analysis was conducted on a sample of 224 psychiatric patients. Emotion regulation strategies (rumination, cognitive reappraisal, and expressive suppression), impulsivity, problematic alcohol use, working memory, depressive mood, and gender were included in the model as predictors of NSSI. Results indicated that rumination, problematic alcohol use, and working memory predicted lifetime NSSI engagement among psychiatric patients. The best predictor of lifetime NSSI engagement was rumination. Specifically, when the level of rumination was high, the level of working memory was lower, and the risk of NSSI was higher. In the case of low levels of rumination, the higher the level of problematic alcohol use, the higher the risk of NSSI. The highest prevalence of lifetime NSSI engagement was found in a subgroup of patients with high levels of rumination and low levels of working memory. The major contribution of this study is finding a combination of factors to predict the high-risk group of NSSI among psychiatric patients in Korea. This study provides evidence on the effect of rumination, working memory, and problematic alcohol use on NSSI. It is suggested that clinicians and researchers should pay more attention to emotion regulation and related vulnerabilities in preventing and treating NSSI.

A comparison of retrospectively reported and ecological momentary assessment-reported perceived social support in predicting ecological momentary assessment-reported non-suicidal self-injury.

Non-suicidal self-injury (NSSI) urges and behaviors are associated with lower perceived social support and related constructs (e.g., perceived rejection). However, no studies have examined the concordance of retrospective (baseline) and ecological momentary assessment (EMA) perceived social support assessments. Retrospective and EMA reports are often only weakly to moderately correlated; measurement approaches may, therefore, impact observed associations between variables. We tested whether average EMA-reported perceived emotional social support uniquely predicts EMA-reported NSSI urges and behaviors above baseline-reported retrospective self-report of perceived emotional social support alone. 93 young adults (ages 18-34) with past-month NSSI urges or behaviors and lifetime NSSI behaviors completed a semi-structured interview, self-report surveys, and a 2-week EMA protocol. Baseline- and EMA-reported perceived emotional social support were positively correlated (Kendall's tau-b = 0.51). Average EMA-reported social support was uniquely associated with EMA-reported NSSI urges but not NSSI behaviors. EMA-reported perceived emotional social support captured information not represented by baseline reports alone, but improvement in model fit was modest. EMA-reported social support may further improve the estimation of EMA-reported NSSI urges if modeled as a proximal predictor of NSSI. Further work is needed to clarify temporal directions between social support and NSSI urges. Limitations are discussed.

DSM-5 non-suicidal self-injury disorder in a community sample: comparing NSSI engagement, recency and severity among emerging adults.

Up to one in five emerging adults engage in non-suicidal self-injury (NSSI). Providing a better understanding of factors that differentiate between who engages in lifetime NSSI and who is more likely to engage in recent and clinically severe NSSI can provide meaningful information for prevention and intervention of NSSI. The present study (n = 669) considered NSSI lifetime engagement (no prior history of NSSI vs. lifetime NSSI), recency [past NSSI (>12 months ago) vs. recent (≤12-month) NSSI], and clinical severity among those with recent NSSI (subthreshold vs. DSM-5 NSSI disorder). The prevalence of NSSI disorder was 8.4% in emerging adults aged 18 to 26 years old. Higher anxiety levels were related to NSSI engagement, but only depressive symptoms and NSSI versatility were consistently associated with more recent NSSI and NSSI disorder. A stepped-care approach may be required in addressing NSSI among emerging adults.

Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury

BackgroundChild maltreatment can increase the risk of lifetime non-suicidal self-injury (NSSI) and suicidal self-injury (SSI), but there is limited knowledge regarding the differences of potentially psychological mechanisms between NSSI with and without SSI. MethodsParticipants, 3918 community-based Chinese young men aged 18–34 years in Chengdu, were included in this study. We investigated the association between depression, anxiety, psychosis, child maltreatment, adulthood traumatic events, impulsivity, alcohol dependence, drug abuse, and lifetime of NSSI among participants with and without SSI. Parallel mediation analysis was utilized to explore the mediators for the relation between child maltreatment and NSSI. ResultsThe prevalence of lifetime NSSI was 6.1 % (95 % CI: 5.4 %–6.9 %) among young men. Anxiety and impulsivity partially mediated the effect of child maltreatment on NSSI either with (indirect effect: 51.2 %) or without SSI (indirect effect: 34.3 %). Depression was independently and significantly associated with only NSSI but not with NSSI+SSI. Alcohol dependence and psychosis were independently and significantly associated with NSSI+SSI and mediated the effect of child maltreatment on NSSI+SSI. LimitationsThe cross-sectional survey data limits the robustness of the proof to the causal relationships. ConclusionsAnxiety and impulsivity are associated with NSSI either with or without SSI and partially mediate the effect of child maltreatment on NSSI. Depression is associated with only NSSI, while alcohol dependence and psychosis are only associated with NSSI+SSI. It could be crucial to improve treatment and recovery of alcohol dependence and psychosis for preventing young men engaged in NSSI from attempting SSI.

Nonsuicidal Self-Injury in Preadolescents.

There is a dearth of literature on the prevalence and predictors of nonsuicidal self-injury (NSSI) history and onset among preadolescent youth. This gap in the literature is significant given evidence suggesting that NSSI is a robust predictor of negative mental health outcomes, and that early onset NSSI may be associated with a more severe course of self-injurious thoughts and behaviors. This study aimed to evaluate sociodemographic characteristics, psychiatric disorders, and suicidal ideation (SI) in relation to NSSI onset and history in preadolescents. Data were drawn from the Adolescent Brain and Cognitive Development (ABCD) study, which recruited a diverse sample of 11 875 youth aged 9 to 10 years. The primary outcome measures were lifetime history and recent onset of NSSI. Measures included sociodemographics and the K-SADS diagnostic interview assessing psychopathology and SI. Female sex and identifying as Black were associated with lower odds of lifetime NSSI. Identifying as a sexual minority, having unmarried parents, and a low family income were associated with higher odds of lifetime NSSI. Although depression was most predictive of NSSI history and onset, a range of internalizing and externalizing disorders, greater comorbidity, and SI also were predictive. Given that NSSI was associated with a range of mental health disorders and comorbidity, it may be best conceptualized as a transdiagnostic phenomenon. Findings highlight key sociodemographic and diagnostic factors that may help to direct screening efforts in preadolescents, particularly sexual minority status and depression.

Nonsuicidal self-injury methods among U.S. Veterans: Latent class analysis and associations with psychosocial outcomes

Nonsuicidal self-injury (NSSI) is a debilitating concern among U.S. veterans, with wall/object-punching commonly endorsed as an NSSI method. We examined how this behavior relates to other NSSI methods and psychosocial outcomes. We conducted a latent class analysis (LCA) of NSSI methods among 1,138 Gulf War Era veterans, (77.9% male), 21.7% of whom endorsed lifetime NSSI. We categorized classes based on their associations with age, sex, combat and military sexual assault exposure, then examined the association of class membership with psychosocial indicators. LCA results supported four classes: 1) High punching/banging NSSI (2.5%); 2) Multimethod NSSI methods (6.3%); 3) High-risk, multimethod NSSI (3.1%); and 4) Low-risk NSSI (88.1%). Psychosocial indicators (suicide attempt, ideation, possible depressive or posttraumatic stress disorders, poor psychosocial functioning) were worse for members of the NSSI classes versus those in the low-risk group. A subset of U.S. veterans may engage in NSSI primarily via punching/banging methods. All patterns of NSSI engagement were associated with negative psychosocial outcomes relative to those in the low-risk class of the behavior.

Non-suicidal self-injury, suicidal behaviors, and mental health symptoms among sexual minority youth with juvenile justice system involvement

Sexual minority youth have long remained an understudied population within the juvenile justice system, despite emerging evidence suggesting that sexual minority youth are overrepresented. Recent literature indicates that system-involved sexual minority youth may have more behavioral health concerns than their heterosexual counterparts. Even so, more work is needed to elucidate the unique needs of sexual minority youth who become involved in the system, especially as it pertains to suicidal behaviors and non-suicidal self-injury (NSSI). The present study provided a descriptive evaluation of the prevalence of sexual minority youth making early system contact and their mental health concerns. Of the 218 justice-involved youth from a Northeastern family court in the sample, over a quarter identified as a sexual minority (n = 58). Our findings indicated that these youth evidenced significantly higher scores on a mental health screener compared to their heterosexual counterparts, evidencing greater symptomology on scales indicative of depression/anxiety, thought disturbance, etc. Further, sexual minority youth reported higher rates of lifetime, past year, and past month NSSI as well as lifetime and past year suicide attempts. These findings highlight the need to support the well-being of sexual minority youth in the juvenile justice system by screening for and addressing their mental health needs in this unique setting.

Implicit Assessment of Non-Suicidal Self-Injury: Group Differences in Temporal Stability of the Self-Injury Implicit Association Test (SI-IAT)

Objective We examine differences on the Self-Injury Implicit Association Test (SI-IAT) by history of non-suicidal self-injury (NSSI), in a test-retest design, to examine short-term temporal stability of SI-IAT scores. Method Treatment-seeking participants (N = 113; 58% female; 89% White; Mage = 30.57) completed the SI-IAT and self-report measures at two time points (M Timeframe = 3.8 days). Results Data suggested NSSI (51% of the sample endorsed lifetime NSSI) was related to Time 1 (T1) identity and attitude, and affected stability of scores. T1 and T2 SI-IAT identity and attitude were more strongly related for participants with NSSI history. NSSI characteristics (recency; number of methods) affected stability. Conclusions The short-term test-retest reliability of the SI-IAT is strong among those with NSSI history from T1 to T2. However, the SI-IATs use with participants without a history of NSSI was not supported beyond its established ability to differentiate between groups by NSSI history. This test may provide clinically-relevant assessment among those with a history of NSSI.

Non-suicidal self-injury in Portuguese college students: relationship with emotion regulation, resilience and self-compassion

Non-Suicidal Self-Injury (NSSI) are behaviors relatively frequent among college students and seem to be associated to difficulties in emotion regulation. Less is known, however, about the relationship of NSSI with protective factors such as resilience and self-compassion. The aims of this study are to compare three groups of Portuguese college students (without NSSI, past NSSI, and current NSSI) regarding difficulties in emotion regulation, resilience, and self-compassion and to evaluate the predictors of NSSI considering demographics and those risk and protective factors. Three hundred and eighty-five college students were evaluated through self-report measures. Ninety participants (23.4%) reported lifetime NSSI. These participants reported higher difficulties in emotion regulation and lower resilience and self-compassion than the group without NSSI. The group with current NSSI presented the lowest levels of resilience and self-compassion. Lifetime NSSI was significantly associated with past suicide attempts. Past psychopathology and lower self-compassion were predictors of NSSI. Interventions for decrease NSSI in college students should promote adaptive emotion regulation strategies, resilience, and self-compassion.

The effect of interoceptive awareness as the underlying mechanism between anxiety and NSSI behaviors

The association between anxiety symptoms and non-suicidal self-injury (NSSI) behaviors requires further clarification. We aimed to examine the potential indirect effect of three dimensions of interoceptive awareness. The effect of study variables on lifetime NSSI behaviors was initially tested on 5281 participants, and then the indirect effects were further clarified among individuals with NSSI behaviors. We found that emotional awareness and body listening exerted opposing indirect effects on the frequency of NSSI behaviors. Future preventive intervention programs should focus on enhancing individuals' abilities to integrate their body and emotions, as this has been strongly highlighted.

Experiential Avoidance, Posttraumatic Stress Disorder, and Self-Injurious Thoughts and Behaviors: A Moderation Analysis in a National Veteran Sample.

Experiential avoidance (EA) is associated with posttraumatic stress disorder (PTSD) and self-injurious thoughts and behaviors (SITBs) across different populations, and extant literature has demonstrated a strong relationship between PTSD and SITBs. However, no study has explored the potential moderating role EA plays in the association of PTSD with nonsuicidal self-injury (NSSI), suicidal ideation, and suicide attempts. The objective of the present study was to determine if EA would moderate the association with PTSD and SITBs such that the association between PTSD and individuals SITBs would be stronger among individuals with higher EA. In a large national sample of Gulf War Era veterans (N = 1,138), EA was associated with PTSD, lifetime and past-year NSSI, current suicidal ideation, and lifetime suicide attempts in bivariate analyses. Multivariate analyses detected a significant EA by PTSD interaction on lifetime NSSI (AOR = 0.96), past-year NSSI (AOR = 1.03), and suicide attempts (AOR =1.03). Probing of the interactions revealed that the respective associations between PTSD, lifetime and past-year NSSI, and suicide attempts were stronger at lower levels of EA (i.e., better), counter to our hypotheses. These preliminary findings contextualize the relationship between these variables in a Gulf War veterans sample and signal the need to further investigate these relationships. Further, these findings highlight the need for advancement in assessment and intervention of EA and SITBs.

Body regard disrupts emotional cascade processes in nonsuicidal self-injury.

This study sought to empirically examine the Emotional Cascade Model of nonsuicidal self-injury (NSSI), and to examine if body regard mitigates these variables' impact on NSSI in college students. We tested a three-way interaction between emotional reactivity, maladaptive cognitive regulation strategies, and body regard predicting NSSI frequency. Two thousand sixty-six undergraduate students (Mage = 20.38; 72.4% identified as female; 91.7% White; 22.7% with NSSI) completed measures of emotion reactivity, maladaptive cognitive regulation strategies, body regard, and lifetime NSSI frequency. The three-way interaction between emotion reactivity, maladaptive cognitive regulation strategies, and body regard was significant. The interaction effect of emotional reactivity and maladaptive cognitive regulation strategies on NSSI was significant when body regard was low but not significant at average and high levels of body regard. The highest NSSI frequency was reported by those high in emotion reactivity and maladaptive cognitive regulation strategies, and low in body regard. These results support the emotional cascade theory of NSSI, and support assertions that body regard might act as a protective barrier against NSSI in the context of heightened emotion reactivity and maladaptive cognitive regulation strategies.

Negative association between non-suicidal self-injury in adolescents and default mode network activation during the distraction blocks of a rumination task.

Rumination, or repetitive and habitual negative thinking, is associated with psychopathology and related behaviors in adolescents, including non-suicidal self-injury (NSSI). Despite the link between self-reported rumination and NSSI, there is limited understanding of how rumination is represented at the neurobiological level among youth with NSSI. We collected neuroimaging and rumination data from 39 adolescents with current or past NSSI and remitted major depression. Participants completed a rumination induction fMRI task, consisting of both rumination and distraction blocks. We examined brain activation associated with total lifetime NSSI in the context of the rumination versus distraction contrast. Lifetime NSSI was associated with a greater discrepancy in activation during rumination relative to distraction conditions in clusters including the precuneus, posterior cingulate, superior, and middle frontal gyrus, and cerebellum. Difficulties associated with rumination in adolescents with NSSI may be related to requiring greater cognitive effort to distract from ruminative content in addition to increased attention in the context of ruminative content. Increasing knowledge of neurobiological circuits and nodes associated with rumination and their relationship with NSSI may enable us to better tailor interventions that can facilitate lasting well-being and neurobiological change.

Self-injurious thoughts and behaviors in Russian patients with epilepsy: A prospective observational study

ObjectiveA two-stage study aimed to estimate the prevalence of different types of self-injurious behaviors (suicidal ideation (SI), suicide attempts (SA), and nonsuicidal self-injury (NSSI)) in Russian patients with epilepsy (PWE), to identify factors associated with such behaviors, and to assess their impact on 3-year mortality. MethodsWe enrolled 459 consecutive adult PWE from two level 2 outpatient epilepsy centers in Moscow. The study consisted of two phases - first, we assessed all demographic and clinical characteristics and patients' history of SI, SA, and NSSI. In the second phase, three years after the initial screening, we analyzed patients' medical records to assess how self-injurious thoughts and behaviors were related to actual mortality. ResultsIn our sample, the total lifetime and 12-month prevalence of SI was 20% and 5.7%, of SA was 8.3% and 0.7%, and of NSSI was 15.3% and 2.8%, respectively. We found no differences between deceased and alive PWE regarding lifetime and 12-month prevalence of SI, SA, and NSSI. Higher seizure frequency, lifetime NSSI and lifetime diagnosis of mental disorder were associated with SI, whereas traumatic brain injury (TBI), substance abuse, and NSSI were associated with SA in PWE. SignificanceOur study adds to the existing data on the prevalence of different types of suicidal behaviors in PWE and advances research on NSSI in this population. However, more research is needed on the long-term consequences of different types of self-injurious behaviors.

The psychosocial consequences of covid-19 in adolescents with nonsuicidal self-injury

BackgroundYoung people have been especially affected by the psychosocial consequences of the covid-19 pandemic. Covid-19 has potentially also been more stressful for vulnerable groups with mental health problems.MethodsIn this cross-sectional study, the psychosocial effects of covid-19 in a vulnerable group of adolescents with nonsuicidal self-injury (NSSI) from a sample of 1602 Swedish high-school students were examined. Data were collected in 2020 and 2021. First, adolescents with and without NSSI were compared on how they perceived the psychosocial impact of covid-19, and second, a hierarchical multiple regression analysis was used to examine whether lifetime NSSI experience was associated with perceived psychosocial consequences of covid-19, when demographic variables and symptoms of mental health problems were controlled for. Interaction effects were also examined.ResultsSignificantly more individuals with NSSI reported being burdened by covid-19 compared to those without NSSI. When demographic variables and mental health symptoms were controlled for, adding NSSI experience did not, however, increase the amount of variance explained in the model. The total model explained 23.2% of the variance in perceived psychosocial impact of covid-19. Perceiving the family’s financial situation as poor and neither good nor bad, studying a theoretical high school program, symptoms of depression and difficulties with emotion regulation were significantly associated with perceived negative psychosocial impact of the covid-19 pandemic. There was a significant interaction effect between NSSI experience and depressive symptoms. The effect of NSSI experience was larger when depressive symptoms were lower.ConclusionsLifetime NSSI experience in itself was not associated with psychosocial covid-19 consequences when other variables were controlled for, whereas symptoms of depression and difficulties with emotion regulation were. Results imply that vulnerable adolescents with mental health symptoms need special attention and access to mental health support in order to prevent further stress and worsening of mental health symptoms in the wake of the covid-19 pandemic.

Gender identity-based disparities in self-injurious thoughts and behaviors among pre-teens in the United States.

Transgender individuals are at heightened risk for self-injurious thoughts and behaviors (SITBs). Evidence suggests that middle childhood-aged transgender individuals experience elevated rates of non-suicidal self-injury (NSSI) and passive suicidal ideation (SI), compared to cisgender children. Little is known about gender identity-based disparities in SI more broadly and suicidal behavior (SB) in children aged 9 and 10. The aim of this study was to examine gender identity-based disparities in SITBs among children in middle childhood (pre-teens) in a US-based sample. Using data from the 3.0 baseline release of the Adolescent Brain Cognitive Development (ABCD) study, logistic regression models, unadjusted and adjusted for covariates, were performed to examine gender identity-based disparities in SITBs. In a model adjusted for birth sex, race/ethnicity, and household income, transgender children were at significantly higher odds for current (adjusted odds ratio [AOR]=6.34) but not lifetime NSSI compared with cisgender children. Transgender children were at significantly higher odds for current and lifetime SI (AOR=13.03; AOR=5.39, respectively) and SB (AOR=14.21; AOR=12.64, respectively) compared with cisgender children. Gender identity-based disparities in SITBs may be present as early as age 9 and 10, demonstrating the need for SITB prevention and intervention efforts specific to transgender children.

Comparing Differences between Two Groups of Adolescents Hospitalized for Self-Harming Behaviors with and without Personality Disorders.

Self-harm (non-suicidal self-injury (NSSI) and suicidal behavior (SB)) is frequent display during adolescence. Patients with personality disorders (PDs) frequently self-harm. However, few studies have focused on the role of PDs in self-harming adolescents. In this study, we collected 79 adolescents hospitalized due to self-harm (88.6% female; 78.5% Caucasian) and divided them into two groups, with or without a diagnosis of PD. The socio-demographic and psychological-clinical data were collected through a structured interview by clinicians. Univariate, subgroup, and multiple logistic regression analyses were performed. Univariate analysis showed that adolescents with a PD and self-harm had (1) an older age at hospitalization (p < 0.01); (2) experienced physical and sexual abuse (p = 0.05, and p < 0.01, respectively); (3) ADHD (p = 0.05); (4) a greater number of SA (p < 0.01); and (5) probability of being a major NSSI patient (>20 lifetime NSSI episodes) (p < 0.01). After multivariate stratified analysis, the results indicated that an older age, and particularly major NSSI status were predictors of PD diagnosis. Early identification and a better understanding of the characteristics of adolescent PDs can assist clinicians in intervening earlier and developing more rational treatment strategies to reduce the long-term effects of PDs.