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Adolescent girls’ stress responses as prospective predictors of self-injurious thoughts and behaviors: A person-centered, multilevel study

Published online by Cambridge University Press:  25 March 2021

Jason José Bendezú*
The Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
Casey D. Calhoun
Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
Megan W. Patterson
Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
Abigail Findley
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, USA
Karen D. Rudolph
Department of Psychology, University of Illinois, Urbana, IL, USA
Paul Hastings
Department of Psychology, University of California – Davis, CA, USA
Matthew K. Nock
Department of Psychology, Harvard University, Cambridge, MA, USA
Mitchell J. Prinstein
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, USA
Author for Correspondence: Jason José Bendezú, Institute of Child Development, 206A ChDev, 51 E River Parkway, Minneapolis, MN 55455; E-mail:


Adolescent risk for self-injurious thoughts and behaviors (STBs) involves disturbance across multiple systems (e.g., affective valence, arousal regulatory, cognitive and social processes). However, research integrating information across these systems is lacking. Utilizing a multiple-levels-of-analysis approach, this person-centered study identified psychobiological stress response profiles and linked them to cognitive processes, interpersonal behaviors, and STBs. At baseline, adolescent girls (N = 241, Mage = 14.68 years, Range = 12–17) at risk for STBs completed the Trier Social Stress Test (TSST), questionnaires, and STB interviews. Positive affect (PA), negative affect (NA), and salivary cortisol (SC) were assessed before and after the TSST. STBs were assessed again during 3, 6, and 9 month follow-up interviews. Multitrajectory modeling of girls’ PA, NA, and SC revealed four profiles, which were compared on cognitive and behavioral correlates as well as STB outcomes. Relative to normative, girls in the affective distress, hyperresponsive, and hyporesponsive subgroups were more likely to report negative cognitive style (all three groups) and excessive reassurance seeking (hyporesponsive only) at baseline, as well as nonsuicidal self-injury (all three groups) and suicidal ideation and attempt (hyporesponsive only) at follow-up. Girls’ close friendship characteristics moderated several profile–STB links. A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.

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Copyright © The Author(s), 2021. Published by Cambridge University Press

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