Reciprocal Associations Between Adolescent Girls’ Chronic Interpersonal Stress and Nonsuicidal Self-Injury: A Multi-wave Prospective Investigation

Adam Bryant Miller, Katherine P. Linthicum, Sarah W. Helms, Matteo Giletta, Karen D. Rudolph, Paul D. Hastings, Matthew K. Nock, Mitchell J. Prinstein

Research output: Contribution to journalArticlepeer-review


Purpose: Nonsuicidal self-injury (NSSI) is associated with increased risk of suicide attempts. Theories of NSSI assert interpersonal stress as a common risk factor for, and perhaps consequence of, NSSI. Prior research has not examined reciprocal associations between chronic interpersonal stress and NSSI. This study used a multiwave, prospective design to address this gap in a sample of adolescent girls, a group with elevated risk for both chronic interpersonal stress and NSSI. Pubertal development was examined as a moderator of the reciprocal associations. Methods: Adolescent girls (N = 220; ages 12–16, M age = 14.69 years) at heightened risk for NSSI completed a baseline assessment and follow-up assessments over 18 months, divided into two 9-month epochs (Time 1 and 2). Pubertal development was assessed via self- and parent-report. Chronic interpersonal stress was assessed using a semistructured interview at the end of each time period. NSSI was measured using a semistructured clinical interview every 3 months within both time periods to enhance accurate reporting. Results: Path models revealed that chronic romantic stress during Time 1, but not peer or parent–child stress, predicted NSSI during Time 2 among girls with more advanced pubertal development. Moreover, NSSI during Time 1 predicted higher levels of chronic romantic and parent–child stress during Time 2. Conclusions: Results revealed a reciprocal relationship between chronic romantic stress and engagement in NSSI. Further, this association may be best understood in the context of pubertal development.

Original languageEnglish (US)
Pages (from-to)694-700
Number of pages7
JournalJournal of Adolescent Health
Issue number6
StatePublished - Dec 2018


  • Adolescent dating
  • NSSI
  • Pubertal development
  • Romantic stress
  • Self-injury

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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