Non-suicidal self-injury (NSSI) is highly prevalent among adolescents receiving mental health services; it has been increasingly linked to impairments in personality development. However, less is known about how NSSI relates to the dimensional construct of the level of personality functioning (LPF). This study examined associations between LPF and NSSI characteristics in a clinical adolescent sample. The participants were 104 adolescents receiving mental health services in Lithuania (M age = 15.03 years, SD = 1.47). LPF was assessed by using the clinician-rated Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1), and NSSI was assessed by using a researcher-developed questionnaire. Overall, 71.2% of adolescents reported a history of NSSI. NSSI prevalence increased progressively with greater impairments in personality functioning, from 20.0% among adolescents with normative functioning to 95.8% among those with severe impairment. Self-functioning impairments demonstrated stronger associations with NSSI than interpersonal functioning impairments. Although the age of onset and lifetime frequency of NSSI did not significantly differ across LPF, higher levels of personality dysfunction were associated with more recent NSSI and a greater likelihood of self-injury requiring medical attention. Emotion regulation was the most frequently endorsed function of NSSI, whereas adolescents with greater personality dysfunction more often reported interpersonal motives. The findings underscore the importance of assessing personality functioning in adolescents who self-injure to facilitate early identification and timely intervention for youth at risk for persistent and clinically severe NSSI.
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