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Background: nonsuicidal self-injury (NSSI) behavior in adolescent girls is considered a clinically significant manifestation of emotional dysregulation associated with anxiety, depression, and impaired social adaptation. Considerable differences in the severity, functional significance, and predictors of such episodes make it difficult to develop a unified approach to the diagnosis and management of adolescents with NSSI. The aim was to identify and describe the clinical and social characteristics of adolescent girls with NSSI and to analyze their relationship with psychoemotional indicators. Patients and methods: the study included 186 girls aged 12–17 years, who were hospitalized in the “Specialized Psychoneurological Hospital” of Krasnodar Region in 2022–2024. Along with the clinical assessment of the past medical history and mental state, the following instrumental methods were used: Children's Depression Inventory (CDI) by M. Kovacs, the method of multidimensional assessment of children's anxiety, the questionnaire of social-psychological adaptation (SPA) by K. Rogers and R. Diamond, Reasons for Self-Injury Scale (N.A. Polskaya), Child and Adolescent Social Support Scale (CASSS) by K. Malecki. Hierarchical clustering, elbow method, and K-means algorithm were used for the analysis. Statistical processing was performed in Python and Statistica. Results: three stable clusters were identified as follows: with low, moderate and high severity of NSSI. Patients with high NSSI intensity committed severe and multiple self-harms. The mental state of these patients was characterized by high levels of anxiety and depression, decreased adaptation, and low levels of social support. The cluster with moderate NSSI severity was distinguished by the predominance of compulsive NSSI forms and an average level of psychological vulnerability. Patients with low NSSI severity demonstrated favorable results on all scales. Significant differences were obtained between patients of the three clusters on the scales of anxiety, depression, adaptation, and social support (p < 0.001). Conclusion: the cluster approach allowed us to form typical psychosocial profiles of girls with NSSI, which has practical significance for the development of differentiated and personalized approaches to prevention and therapy and psychosocial assistance programs.