Background

For typically developing adolescents, being bullied is associated with increased risk of suicidality. Although adolescents with autism spectrum disorder (ASD) are at increased risk of both bullying and suicidality, there is very little research that examines the extent to which an experience of being bullied may increase suicidality within this specific population. To address this, we conducted a retrospective cohort study to investigate the longitudinal association between experiencing bullying and suicidality in a clinical population of 680 adolescents with ASD. Electronic health records of adolescents (13–17 years), using mental health services in South London, with a diagnosis of ASD were analyzed. Natural language processing was employed to identify mentions of bullying and suicidality in the free text fields of adolescents' clinical records. Cox regression analysis was employed to investigate the longitudinal relationship between bullying and suicidality outcomes. Reported experience of bullying in the first month of clinical contact was associated with an increased risk suicidality over the follow‐up period (hazard ratio = 1.82; 95% confidence interval = 1.28–2.59). In addition, female gender, psychosis, affective disorder diagnoses, and higher intellectual ability were all associated with suicidality at follow‐up. This study is the first to demonstrate the strength of longitudinal associations between bullying and suicidality in a clinical population of adolescents with ASD, using automated approaches to detect key life events within clinical records. Our findings provide support for identifying and dealing with bullying in schools, and for antibullying strategy's incorporation into wider suicide prevention programs for young people with ASD. Autism Res 2020, 13: 988‐997. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. Lay Summary We investigated the relationship between bullying and suicidality in young people with autism spectrum disorder (ASD). We examined the clinical records of adolescents (aged 13–18 years old) with ASD in South London who were receiving treatment from Child and Adolescent Mental Health Services. We found that if they reported being bullied in the first month after they were first seen by mental health services, they were nearly twice as likely to go on to develop suicidal thoughts or behaviors.

The competencies of children, particularly their understanding of the more complex probabilistic concepts, have not been thoroughly investigated. In the present study participants were required to choose the more likely of two events, a single event, and a joint event (conjunctive or disjunctive). It was predicted that the operation of the representativeness heuristic would result in erroneous judgements when children compared an unlikely component event with a likely-unlikely conjunction (the conjunction fallacy) and when a likely component event was compared to a likely-unlikely disjunction. The results supported the first prediction with both older children aged between 9 and 10 years and younger children aged between 4 and 5 committing the conjunction fallacy. However, the second prediction was not confirmed. It is proposed that the basis of representativeness judgements may differ between the conjunctive and disjunctive cases with absolute frequency information possibly playing a differential role.

Aims and method This study aimed to investigate the prevalence of adverse childhood experiences (ACEs) among patients in a female forensic psychiatric in-patient medium-secure unit, and to analyse the link between ACEs, adulthood self-harm and associated comorbidities and risk factors. The study used a cross-sectional design, with data gathered from the anonymised electronic health records of patients. Results It was found that there was a high prevalence of both ACEs and self-harm among this patient group, and that there was a relationship between the two; those with more ACEs were more likely to have self-harmed during adulthood. Of the individual ACE categories, it was also demonstrated that emotional abuse had a significant association with adulthood self-harm. Clinical implications In medium-secure settings for women, implementation of trauma-informed care will be beneficial because of the high number of those with mental disorders who have experienced adversity during their childhood.