Past research has identified self-harm risk and protective factors including depression, anxiety and low self-esteem. This study identified five distinct psychological profiles among adolescents with recent self-harm. Profiles with psychological difficulties included: Anxiety symptoms; Impulsive; Pathological; and Pathological-Impulsive. One group of adolescents with recent self-harm appeared psychologically ‘normal’ on the domains measured. Adolescents with different risk factors may require disparate strategies for treatment.