Differences in Cortisol Levels in Adolescents with a History of Non-Suicidal Self-Injury and Suicide Attempts
Non-suicidal self-injury (NSSI) is deliberately causing physical harm to oneself without the intent to die. However, those who engage in NSSI often also experience suicidal ideation and may attempt suicide. The hypothalamic-pituitary-adrenal (HPA) axis, which regulates stress by releasing the stress hormone cortisol, has been shown to be hypoactive in those who engage in NSSI. More work is needed to elucidate the effects of HPA axis activity in the context of NSSI and suicidality. In this present study, salivary cortisol levels obtained during a social stressor were examined in 112 adolescents assigned female at birth assigned to three groups: those with a history of NSSI, those with a history of NSSI and one or more suicide attempts, and controls with no history of NSSI or suicide attempt. A trend-level interaction showed cortisol levels in response to stress were lower in both NSSI groups than the controls, with a more blunted response in the NSSI and suicide attempt group, suggesting that suicidality may cause a larger degree of dysfunction in the HPA axis.