News Release

Adolescent girls at risk for self-injury can be identified using a short psychological profile

The avoidance of upsetting emotions and difficulty regulating one's behavior identified as key differences between girls who self-harm and those who did not

Peer-Reviewed Publication


Washington, DC, September 9, 2020 - A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports on three key factors found amongst adolescents that could be used to predict the first occurrence of nonsuicidal self-harm, over a 3 year period. Factors included low conscientiousness, high avoidance and parent's substance abuse history.

"Self-injury is common in adolescents, especially among girls," stated lead author Monika Waszczuk, PhD, an Assistant Professor at the Department of Psychiatry, Stony Brook University, New York. "This largely hidden condition is characterized by deliberate self-inflicted harm, such as cutting or burning. Many young people who experienced this potentially life-threatening behavior do not seek treatment, and more than half continue to self-harm into adulthood.

"To help identify adolescent girls who may need support prior to the first occurrence of self-injury, we sought a better understanding of psychological vulnerabilities to this behavior."

The findings are based on the Adolescent Development of Emotions and Personality Traits study: an ongoing longitudinal project tracking the health and wellbeing of girls from Long Island, New York. The study began in 2013.

A sample of 462 girls between the ages of 13-15-years old who had never experienced self-harm at the start of the study completed measures of psychological vulnerabilities, including personality traits and psychological symptoms. Mental health was also assessed in parents of participants. Next, girls were asked about self-injury during interviews conducted multiple times over the three-year follow up period.

Over the course of the study, 42 girls reported that they started to self-harm. Their baseline psychological vulnerabilities were compared to the remaining 420 girls who never self-injured. Girls who began to self-harm were found to have significantly lower baseline levels of conscientiousness and higher levels of avoidance. They were also twice as likely to have a parent who had a substance abuse problem at some point in life. A psychological profile combining these factors achieved a good accuracy in distinguishing girls who initiated self-harm during the following three years in this study from those who did not.

"These results point to two main psychological pathways to adolescent self-harm. The first is disinhibition - an urgency to act and a difficulty regulating one's behavior, often when faced with strong negative emotions," described Molly Gromatsky, PhD, who led the study during her graduate training and is now a Postdoctoral researcher at the James J. Peters VA Medical Center in the Bronx, New York. "The second pathway is avoidance of upsetting memories or thoughts, with self-harm used as a maladaptive coping strategy to distract from intense negative feelings. Parental substance abuse might play a role via inherited genetic susceptibility to mental health problems, as well as via environmental transmission of risk."

Based on past research, traumatic experiences such as violence and abuse, as well as childhood poverty and bullying have significant impacts on nonsuicidal self-harm and other psychological vulnerabilities. This study did not directly assess these factors, however, so determining whether the avoidance trait specifically leads to avoidance of traumatic memories as a step in the development of nonsuicidal self-harm will be an important topic for future research.

"In addition to expanding our understanding of the development of self-harm, the present study derived a personality profile with a good ability to identify adolescent girls who are at risk of initiating self-harm. If replicated in independent samples, this small set of traits would allow for a rapid psychological screening that is feasible to collect in community samples of adolescents (e.g., in schools or primary care, facilitating targeted prevention)." said lead author Roman Kotov, PhD, a Professor at the Department of Psychiatry, Stony Brook University, New York.


Notes for editors

The article is "Prospective Prediction of First Onset of Nonsuicidal Self-Injury in Adolescent Girls," by Molly A. Gromatsky, MA, Shuyao He, MS, Greg Perlman, PhD, Daniel N. Klein, PhD, Roman Kotov, PhD, Monika A. Waszczuk, PhD ( It currently appears on the JAACAP Articles In Press page and will appear in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 59, issue 9 (September 2020), published by Elsevier.

Dr. Waszczuk is an Assistant Professor at the Department of Psychiatry, Stony Brook University, New York. She is interested in studying how genetics, environmental exposures, and psychological vulnerabilities contribute to emotional problems, such as depression and self-harm, in young people.

Dr. Gromatsky is a Postdoctoral Researcher at the Mental Illness Research, Education and Clinical Center (MIRECC) at the James J. Peters VA Medical Center (JJPVAMC) in the Bronx, New York. Her research focuses on the role of risk and resiliency factors associated with suicide, and she hopes to assist in the development of screening tools to inform effective outreach interventions and treatment development.

Dr. Kotov is a Professor at the Department of Psychiatry, Stony Brook University, New York. He is one of the Principal Investigators of the ADEPT study. His area of expertise is personality research and statistical analyses.

Copies of this paper are available to credentialed journalists upon request; please contact the JAACAP Editorial Office at or +1 202 587 9674. Journalists wishing to interview the authors may contact Monika Waszczuk, at


Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

About Elsevier Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we're committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers.

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