Skip to main content
SpringerLink
Log in

Post-Dexamethasone Cortisol, Self-Inflicted Injury, and Suicidal Ideation Among Depressed Adolescent Girls

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

Although the dexamethasone suppression test (DST) has limited use as a biomarker of depression given inadequate sensitivity and specificity, it marks prospective risk for suicide among adults. However, few studies have examined associations between the DST, suicidal ideation, and self-inflicted injury (SII) among adolescents, even though SII is the single best predictor of eventual suicide. We evaluated the DST as a correlate of suicidal ideation and retrospective reports of self-inflicted injury (SII) among adolescent girls, ages 13–17, with histories of depression (n = 28) or depression and self-harm (n = 29). Lower post-DST cortisol was associated with suicidal ideation and SII, over-and-above parent-reports and combined parent-/self-reports of internalizing and externalizing behavior. These findings are consistent with recent acquired capacity models of stress-related psychopathology in which hypothalamic-pituitary adrenal (HPA) axis function is altered through epigenetic/allostatic mechanisms among vulnerable individuals who incur adversity early in life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Achenbach, T. M. (1991a). Manual for the child behavior checklist/4-18 and 1991 profile. Burlington: University of Vermont Department of Psychiatry.

    Google Scholar 

  • Achenbach, T. M. (1991b). Manual for the youth self-report and 1991 profile. Burlington: University of Vermont Department of Psychiatry.

    Google Scholar 

  • Acock, A. C. (2005). Working with missing values. Journal of Marriage and the Family, 2005(67), 1012–1028. doi:10.1111/j.1741-3737.2005.00191.x.

    Article  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4, text revisionth ed.). Washington, DC: Author.

    Google Scholar 

  • Arana, G. W., Baldessarini, R. J., & Ornsteen, M. (1985). The dexamethasone suppression test for diagnosis and prognosis in psychiatry. Commentary and review. Archives of General Psychiatry, 42, 1193–1204.

    Article  PubMed  Google Scholar 

  • Aston-Jones, G., Iba, M., Clayton, E., Rajkowski, J., & Cohen, J. (2007). The locus coeruleus and regulation of behavioral flexibility and attention: Clinical implications. In G. A. Ordway, M. A. Schwartz, & A. Frazer (Eds.), Brain norepinephrine: Neurobiology and therapeutics (pp. 196–235). New York: Cambridge University Press.

    Chapter  Google Scholar 

  • Beauchaine, T. P., Neuhaus, E., Brenner, S. L., & Gatzke-Kopp, L. (2008). Ten good reasons to consider biological processes in prevention and intervention research. Development and Psychopathology, 20, 745–774. doi:10.1017/S0954579408000369.

    Article  PubMed Central  PubMed  Google Scholar 

  • Beauchaine, T. P., Klein, D. N., Crowell, S. E., Derbidge, C., & Gatzke-Kopp, L. M. (2009). Multifinality in the development of personality disorders: a biology × sex × environment interaction model of antisocial and borderline traits. Development and Psychopathology, 21, 735–770. doi:10.1017/S0954579409000418.

    Article  PubMed Central  PubMed  Google Scholar 

  • Beauchaine, T. P., Neuhaus, E., Zalewski, M., Crowell, S. E., & Potapova, N. (2011). Effects of allostatic load on neural systems subserving motivation, mood regulation, and social affiliation. Development and Psychopathology, 23, 975–999. doi:10.1017/S0954579411000459.

    Article  PubMed  Google Scholar 

  • Burkea, H. M., Davis, M. C., Otte, C., & Mohr, D. C. (2005). Depression and cortisol responses to psychological stress: a meta-analysis. Psychoneuroendocrinology, 30, 846–856. doi:10.1016/j.psyneuen.2005.02.010.

    Article  Google Scholar 

  • Caroll, B. J., Curtis, G. C., & Mendels, J. (1976). Neuroendocrine regulation in depression I. Limbic system-adrenocortical dysfunction. Archives of General Psychiatry, 33, 1039–1044.

    Article  Google Scholar 

  • Casat, C. D., & Powell, K. (1988). The dexamethasone suppression test in children and adolescents with major depressive disorder: a review. Journal of Clinical Psychiatry, 49, 390–393.

    PubMed  Google Scholar 

  • Cecchi, M., Khoshbouei, H., Javors, M., & Morilak, D. A. (2002). Modulatory effects of norepinephrine in the lateral bed nucleus of the stria terminalis on behavioral and neuroendocrine responses to acute stress. Neuroscience, 112, 13–21.

    Article  PubMed  Google Scholar 

  • Center for Disease Control. (2006). CDC injury fact book. Atlanta: National Center for Injury Prevention Control.

    Google Scholar 

  • Center for Disease Control. (2009). CDC injury research agenda, 2009–2018. Atlanta: National Center for Injury Prevention Control.

    Google Scholar 

  • Coryell, W., & Schlesser, M. A. (1981). Suicide and the dexamethasone test in unipolar depression. American Journal of Psychiatry, 138, 1120–1121.

    Article  PubMed  Google Scholar 

  • Coryell, W., & Schlesser, M. A. (2008). The dexamethasone suppression test and suicide prediction. American Journal of Psychiatry, 158, 748–753. doi:10.1176/appi.ajp.158.5.748.

    Article  Google Scholar 

  • Crowell, S. E., Beauchaine, T. P., McCauley, E., Smith, C., Stevens, A. L., & Sylvers, P. (2005). Psychological, autonomic, and serotonergic correlates of parasuicidal behavior in adolescent girls. Development and Psychopathology, 17, 1105–1127. doi:10.1037/0022-006X.73.3.371.

    Article  PubMed  Google Scholar 

  • Crowell, S. E., Beauchaine, T. P., & Linehan, M. (2009). A biosocial developmental model of borderline personality: elaborating and extending Linehan’s theory. Psychological Bulletin, 135, 495–510. doi:10.1037/a0015616.

    Article  PubMed Central  PubMed  Google Scholar 

  • Crowell, S. E., Beauchaine, T. P., Hsiao, R. C., Vasilev, C. A., Yaptangco, M., Linehan, M. M., & McCauley, E. (2012). Differentiating adolescent self-injury from adolescent depression: possible implications for borderline personality development. Journal of Abnormal Child Psychology, 40, 45–57. doi:10.1007/s10802-011-9578-3.

    Article  PubMed Central  PubMed  Google Scholar 

  • Crowell, S. E., Baucom, B. R., Yaptangco, M., Bride, D., Hsiao, R., McCauley, E., & Beauchaine, T. P. (2013). Emotion dysregulation and dyadic conflict in depressed and typical adolescents: Evaluating concordance across psychophysiological and observational measures. Biological Psychology, 98, 50-58. doi:10.1016/j.biopsycho.2014.02.009.

  • Crowell, S. E., Derbidge, C., & Beauchaine, T. P. (2014). Developmental approaches to understanding self-injury and suicidal behaviors. In M. K. Nock (Ed.), Oxford handbook of suicide and self-injury. New York: Oxford University Press.

    Google Scholar 

  • Cullen, K. R., Westlund, M. K., LaRiviere, L. L., & Klimes-Dougan, B. (2013). An adolescent with nonsuicidal self-injury: a case and discussion of neurobiological research on emotion regulation. American Journal of Psychiatry, 170, 828–831. doi:10.1176/appi.ajp.2013.12121598.

    Article  PubMed Central  PubMed  Google Scholar 

  • Dahl, R. E., Kaufman, J., Ryan, N. D., Perel, J., Al-Shabbout, M., Birmaher, B., Nelson, B., & Puig-Antich, J. (1992). The dexamethasone suppression test in children and adolescents: a review and a controlled study. Biological Psychiatry, 32, 109–126.

    Article  PubMed  Google Scholar 

  • De Bellis, M. D., Baum, A. S., Birmaher, B., Keshavan, M. S., Eccard, C. H., Boring, A. M., Jenkins, F. J., & Ryan, N. D. (1999). Developmental traumatology part I: biological stress systems. Biological Psychiatry, 45, 1259–1270. doi:10.1016/S0006-3223(99)00044-X.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131, 483–509. doi:10.1007/s10826-006-9031-3.

    Article  PubMed  Google Scholar 

  • Derbidge, C., & Beauchaine, T. P. (2014). A developmental model of self-inflicted injury, borderline personality, and suicide risk. In M. Lewis & K. Rudolph (Eds.), Handbook of developmental psychopathology (3rd ed., pp. 521–542). New York: Springer.

    Chapter  Google Scholar 

  • Detke, M. J., Rickels, M., & Lucki, I. (1995). Active behaviors in the rat forced swimming test differentially produced by serotonergic and noradrenergic antidepressants. Psychopharmacology, 121, 66–72.

    Article  PubMed  Google Scholar 

  • Dietrich, A., Ormel, J., Buitelaar, J. K., Verhulst, F. C., Hoekstra, P. J., & Hartman, C. A. (2013). Cortisol in the morning and dimensions of anxiety, depression, and aggression in children from a general population and clinic-referred cohort: an integrated analysis. Psychoneuroendocrinology, 38, 1281–1298. doi:10.1016/j.psyneuen.2012.11.013.

    Article  PubMed  Google Scholar 

  • Doom, J. R., & Gunnar, M. R. (2013). Stress physiology and developmental psychopathology: past, present, and future. Development and Psychopathology, 25, 1359–1373. doi:10.1017/S0954579413000667.

    Article  PubMed  Google Scholar 

  • Extein, I., Rosenburg, G., Pottash, A., & Gold, M. (1982). The dexamethasone suppression test in depressed adolescents. American Journal of Psychiatry, 139, 1617–1619.

    Article  PubMed  Google Scholar 

  • Gadow, K. D., & Sprafkin, J. (1997). Adolescent symptom inventory 4 screening manual. Stony Brook: Checkmate Plus.

    Google Scholar 

  • Gadow, K. D., Sprafkin, J., Carlson, G., Schneider, J., Nolan, E. E., Mattison, R. E., & Rundberg-Rivera, V. (2002). A DSM-IV-referenced adolescent self-report rating scale. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 671–679.

    Article  PubMed  Google Scholar 

  • Graham, J. W. (2009). Missing data analysis: making it work in the real world. Annual Review of Psychology, 60, 549–576. doi:10.1146/annurev.psych.58.110405.085530.

    Article  PubMed  Google Scholar 

  • Gunnar, M. R., & Vazquez, D. M. (2001). Low cortisol and a flattening of expected daytime rhythm: potential indices of risk in human development. Development and Psychopathology, 13, 515–538.

    Article  PubMed  Google Scholar 

  • Hamza, C. A., Stewart, S. L., & Willoughby, T. (2012). Examining the link between nonsuicidal self-injury and suicidal behavior: a review of the literature and an integrated model. Clinical Psychology Review, 32, 482–495. doi:10.1016/j.cpr.2012.05.003.

    Article  PubMed  Google Scholar 

  • Hawkins, J., & Catalano, R. (2001). Social development of youth project, third and ninth grade survey. Unpublished survey. Center for Law and Justice.

  • Heim, C., Newport, D. J., Mletzko, T., Miller, A. H., & Nemeroff, C. B. (2008). The link between childhood trauma and depression: insights from HPA axis studies in humans. Psychoneuroendocrinology, 33, 693–710. doi:10.1016/j.psyneuen.2008.03.008.

    Article  PubMed  Google Scholar 

  • Hilbe, J. M. (2011). Negative binomial regression (2nd ed.). New York: Cambridge University Press.

    Book  Google Scholar 

  • Joiner, T. E., Jr. (2005). Why people die by suicide. Cambridge: Harvard University Press.

    Google Scholar 

  • Joiner, T. E., Jr., Van Orden, K. A., Witte, T. K., Selby, E. A., Ribeiro, J. D., Lewis, R., & Rudd, M. D. (2009). Main predictions of the interpersonal–psychological theory of suicidal behavior: empirical tests in two samples of young adults. Journal of Abnormal Psychology, 118, 634–646. doi:10.1037/a0016500.

    Article  PubMed Central  PubMed  Google Scholar 

  • Jokinen, J., & Nordstrom, P. (2009). HPA axis hyperactivity and attempted suicide in young adult mood disorder inpatients. Journal of Affective Disorders, 116, 117–120.

    Article  PubMed  Google Scholar 

  • Kaess, M., Hille, M., Parzer, P., Maser-Gluth, C., Resch, F., & Brunner, R. (2012). Alterations in the neuroendocrinological stress response to acute psychosocial stress in adolescents engaging in nonsuicidal self-injury. Psychoneuroendocrinology, 37, 157–161.

    Article  PubMed  Google Scholar 

  • Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., Williamson, D., & Ryan, N. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.

    Article  PubMed  Google Scholar 

  • Kirschbaum, C., Wüst, S., & Hellhammer, D. (1992). Consistent sex differences in cortisol responses to psychological stress. Psychosomatic Medicine, 54, 648–657.

    Article  PubMed  Google Scholar 

  • Klein, D. N., Kujawa, A. J., Black, S. R., & Pennock, A. T. (2013). Depressive disorders. In T. P. Beauchaine & S. P. Hinshaw (Eds.), Child and adolescent psychopathology (2nd ed., pp. 543–575). Hoboken: Wiley.

    Google Scholar 

  • Klengel, T., Mehta, D., Anacker, C., Rex-Haffner, M., Pruessner, J. C., Pariante, C. M., Pace, T. W., Mercer, K. B., Mayberg, H. S., Bradley, B., Nemeroff, C. B., Holsboer, F., Heim, C. M., Ressler, K. J., Rein, T., & Binder, E. B. (2013). Allele-specific FKBP5 DNA demethylation mediates gene-childhood trauma interactions. Nature Neuroscience, 16, 33–41. doi:10.1038/nn.3275.

    Article  PubMed Central  PubMed  Google Scholar 

  • Klonsky, E. D., May, A. M., & Glenn, C. R. (2013). The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. Journal of Abnormal Psychology, 122, 231–237. doi:10.1037/a0030278.

    Article  PubMed  Google Scholar 

  • Knorr, U., Vinberg, M., Kessing, L. V., & Wetterslev, J. (2010). Salivary cortisol in depressed patients versus control persons: a systematic review and meta-analysis. Psychoneuroendocrinology, 35, 1275–1286. doi:10.1016/j.psyneuen.2010.04.001.

    Article  PubMed  Google Scholar 

  • Linehan, M. (1993). Cognitive–behavioral treatment of borderline personality disorder. New York: Guilford Press.

    Google Scholar 

  • Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., & Wagner, A. W. (2006). Suicide attempt self-injury interview (SASII): development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychological Assessment, 18, 303–312. doi:10.1037/1040-3590.18.3.303.

    Article  PubMed  Google Scholar 

  • Lloyd-Richardson, E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine, 37, 1183–1192. doi:10.1017/S003329170700027X.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lopez-Duran, P., Kovacs, M., & George, C. J. (2009). Hypothalamic-pituitary-adrenal axis dysregulation in depressed children and adolescents: a meta-analysis. Psychoneuroendocrinology, 34, 1272–1283. doi:10.1016/j.psyneuen.2009.03.016.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 10, 434–445. doi:10.1038/nrn2639.

    Article  PubMed  Google Scholar 

  • Maniglio, R. (2011). The role of child sexual abuse in the etiology of suicide and non-suicidal self-injury. Acta Psychiatrica Scandinavica, 124, 30–41. doi:10.1111/j.1600-447.2010.01612.x.

    Article  PubMed  Google Scholar 

  • McGowan, P. O., Sasaki, A., D’Alessio, A. C., Dymov, S., Labonté, B., Szyf, M., Turecki, G., & Meany, M. J. (2009). Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature Neuroscience, 12, 342–348. doi:10.1038/nn.2270.

    Article  PubMed Central  PubMed  Google Scholar 

  • Merikangas, K. R., He, J.-P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., & Georgiades, K. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the national Comorbidity survey replication–adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989. doi:10.1016/j.jaac.2010.05.017.

    Article  PubMed Central  PubMed  Google Scholar 

  • Morilak, D. A. (2007). Norepinephrine and stress. In G. A. Ordway, M. A. Schwartz, & A. Frazer (Eds.), Brain norepinephrine: Neurobiology and therapeutics (pp. 275–296). New York: Cambridge University Press.

    Chapter  Google Scholar 

  • Natsuaki, M. N., Klimes-Dougan, B., Ge, X., Shirtcliff, E. A., Hastings, P. D., & Zahn-Waxler, C. (2009). Early pubertal maturation and internalizing problems in adolescence: sex differences in the role of cortisol reactivity to interpersonal stress. Journal of Clinical Child and Adolescent Psychology, 38, 513–524. doi:10.1080/15374410902976320.

    Article  PubMed Central  PubMed  Google Scholar 

  • Nock, M. K. (2008). Actions speak louder than words: an elaborated theoretical model of the social functions of self-injury and other harmful behaviors. Applied and Preventive Psychology, 12, 159–168. doi:10.1016/j.appsy.2008.05.002.

    Article  PubMed Central  PubMed  Google Scholar 

  • Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339–363. doi:10.1146/annurev.clinpsy.121208.131258.

    Article  PubMed  Google Scholar 

  • Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents. JAMA Psychiatry, 70, 300–310. doi:10.1001/2013.jamapsychiatry.55.

    Article  PubMed  Google Scholar 

  • Norden, K. A., Klein, D. N., Donaldson, S. K., Pepper, C. M., & Klein, L. M. (1995). Reports of the early home environment in DSM-III personality disorders. Journal of Personality Disorders, 9, 213–223.

    Article  Google Scholar 

  • Pedhazur, E. J. (1997). Multiple regression in behavioral research. New York: Wadsworth.

    Google Scholar 

  • Pfeffer, C. R., Stokes, P., & Shindledecker, R. (1991). Suicidal behavior and HPA axis indices in child psychiatric inpatients. Biological Psychiatry, 29, 909–917.

    Article  PubMed  Google Scholar 

  • Preskorn, S. H., & Baker, B. (2002). The overlap of DSM-IV syndromes: potential implications for the practice of polypsychopharmacology, psychiatric drug development, and the human genome project. Journal of Psychiatric Practice, 8, 170–177.

    Article  PubMed  Google Scholar 

  • Reynolds, W. M., & Mazza, J. J. (1999). Assessment of suicidal ideation in inner-city children and young adolescents: reliability and validity of the Suicidal Ideation Questionnaire—JR. School Psychology Review, 28, 17–30.

    Google Scholar 

  • Roy, A., Agren, H., Pickar, D., Linnoila, M., Doran, A. R., Cutler, N. R., & Paul, S. M. (1986). Reduced CSF concentrations of homovanillic acid and homovanillic acid to 5-hydroxyindoleacetic acid ratios in depressed patients: relationship to suicidal behavior and dexamethasone nonsuppression. American Journal of Psychiatry, 143, 1539–1545.

    Article  PubMed  Google Scholar 

  • Ruiz, M., Lind, U., Gåfvels, M., Eggertsen, G., Carlstedt-Duke, J., Nilsson, L., Holtmann, M., Stierna, P., Wikström, A. C., & Werner, S. (2001). Characterization of two novel mutations in the glucocorticoid receptor gene in patients with primary cortisol resistance. Clinical Endocrinology, 55, 363–371. doi:10.1046/j.1365-2265.2001.01323.x.

    Article  PubMed  Google Scholar 

  • Rush, A. J., Giles, D. E., Schlesser, M. A., Orsulak, P. J., Parker, C. R., Jr., Weissenburger, J. E., Crowley, G. T., Khatami, M., & Vasavada, N. (1996). The dexamethasone suppression test in patients with mood disorders. Journal of Clinical Psychiatry, 57, 470–484.

    Article  PubMed  Google Scholar 

  • Simpson, K. L., & Lin, R. C. S. (2007). Neuroanatomical and chemical organization of the locus coeruleus. In G. A. Ordway, M. A. Schwartz, & A. Frazer (Eds.), Brain norepinephrine: Neurobiology and therapeutics (pp. 9–52). New York: Cambridge University Press.

    Chapter  Google Scholar 

  • Thompson, W. (2012). Long term follow up of suicide in a clinically depressed community sample. Journal of Affective Disorders, 139, 52–55. doi:10.1016/j.jad.2012.02.012.

    Article  Google Scholar 

  • Van Zomeren-Dohm, A., Xu, X., Thibodeau, E., & Cicchetti, D. (2014). Child maltreatment and vulnerability to externalizing spectrum disorders. In T. P. Beauchaine & S. P. Hinshaw (Eds.), Oxford handbook of externalizing spectrum disorders. New York: Oxford University Press.

    Google Scholar 

  • Wikgren, M., Maripuu, M., Karlsson, T., Nordfjäll, K., Bergdahl, J., Hultdin, J., Del-Favero, J., Roos, G., Nilsson, L. G., Adolfsson, R., & Norrback, K.-F. (2012). Short telomeres in depression and the general population are associated with a hypocortisolemic state. Biological Psychiatry, 71, 294–300. doi:10.1016/j.biopsych.2011.09.015.

    Article  PubMed  Google Scholar 

  • Yates, T. M. (2009). Developmental pathways from child maltreatment to nonsuicidal self-injury. In M. K. Nock (Ed.), Understanding nonsuicidal self-injury: Origins, assessment, and treatment (pp. 117–137). Washington: American Psychological Association. doi:10.1037/11875-007.

    Chapter  Google Scholar 

  • Young, E. A. (1998). Sex differences and the HPA axis: implications for psychiatric disease. Journal of Gender Specific Medicine, 1, 21–27.

    PubMed  Google Scholar 

Download references

Research reported in this article was supported by National Institute of Mental Health grants MH074196 and MH63699.

Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA

    Theodore P. Beauchaine

  2. Department of Psychology, University of Utah, Salt Lake City, UT, USA

    Sheila E. Crowell

  3. Department of Psychiatry, University of Washington, Washington, DC, USA

    Ray C. Hsiao

Authors
  1. Theodore P. Beauchaine
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sheila E. Crowell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ray C. Hsiao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Theodore P. Beauchaine.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Beauchaine, T.P., Crowell, S.E. & Hsiao, R.C. Post-Dexamethasone Cortisol, Self-Inflicted Injury, and Suicidal Ideation Among Depressed Adolescent Girls. J Abnorm Child Psychol 43, 619–632 (2015). https://doi.org/10.1007/s10802-014-9933-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-014-9933-2

Keywords

Search

Navigation