The Influence of Cortisol on non suicidal self injury with a focus on adolescents

Non-suicidal self-injury (NSSI) is a prevalent behavioral concern among adolescents, characterized by deliberate self-inflicted harm without suicidal intent. While psychological and social factors have been widely examined, increasing attention has turned to the biological underpinnings of NSSI, particularly the role of the hypothalamic-pituitary-adrenal (HPA) axis and its primary hormonal output, cortisol. This paper explores the influence of cortisol dysregulation on the emergence, maintenance, and severity of NSSI in adolescents. Findings indicate that individuals engaging in NSSI often exhibit either blunted or heightened cortisol responses, reflecting maladaptive neuroendocrine adaptations to chronic stress. Neurobiological evidence further reveals that brain regions sensitive to cortisol, including the amygdala, prefrontal cortex, and anterior cingulate cortex, show structural and functional differences in adolescents with NSSI. Additionally, cortisol’s effects on memory, cognitive bias, and behavioral reinforcement loops suggest it plays a central role in both the subjective experience of stress and the compulsive nature of NSSI. Recognizing cortisol as a potential biomarker may enhance diagnostic precision and inform the development of targeted, neurobiologically-informed interventions for at-risk youth.