Hypothalamic-pituitary-adrenal axis dysregulation in depressed adolescents with non-suicidal self-injury.

•Cortisol was assessed in the context of the Trier Social Stress Test.•Participants included adolescents with depression who had or had not repeatedly engaged in non-suicidal self-injury.•Adolescents who engaged in non-suicidal self-injury showed evidence of lower overall cortisol levels and less reactivity.•Adolescents who engaged in non-suicidal self-injury had higher ratings of expressed stress.•These results suggest that physiological and behavioral stress functioning differs considerably across these groups of adolescents.