Autistic traits in adults who have attempted suicide

Abstract

Background An emerging literature suggests that autistic adults are at increased risk of experiencing suicidal thoughts, making suicidal plans and attempts, and dying by suicide. However, few studies have investigated whether autistic traits are related to suicidal behaviour. The current study examined autistic traits in a sample of adults who reported at least one suicide attempt. Methods An online questionnaire was advertised between June and September 2017 on suicide prevention websites, research databases, and social media. Participants reported whether they had ever attempted suicide (yes/no), and if so, how many times they had attempted (once/more than once). They also reported diagnosed and suspected mental health or neurodevelopmental conditions, and completed the Autism Spectrum Quotient (AQ). Two hundred forty-five adults accessed the survey; 132 reported having attempted suicide and also completed the AQ. It was hypothesised that AQ total scores and subscale scores would be higher in adults who had attempted suicide more than once compared to adults who had attempted once. These hypotheses were tested using an independent samples t test, Mann-Whitney U tests, and binary logistic regression. Results Most participants were female (83.3%, male = 12.9%, other = 3.8%), and ages ranged from 18 to 65 (median = 36.00; IQR = 19.00). Total AQ scores, as well as communication and imagination subscale scores were significantly higher in adults who had attempted suicide more than once compared to adults who had attempted suicide once. Even after removing participants with diagnosed or suspected autism ( n = 34), 40.6% had an AQ score indicative of clinical concern (≥ 26). Conclusions The findings suggest that high levels of autistic traits may frequently be present in adults who have attempted suicide, and that AQ scores are higher in those with a history of more than one suicide attempt. It may be possible to better identify suicide risk by screening autistic adults with mental health conditions for suicidal thoughts and behaviours, and by screening people with suicidal thoughts and/or behaviours for autism.

Examining the Relationship Between Autism Traits and Sleep Duration as Predictors of Suicidality

“…Further, Pelton and Cassidy (2017)'s findings that autism traits are significantly associated with suicidal behaviours are corroborated by our findings. However, our exploratory findings did not replicate Richards et al (2019) in that the association between suggested autism diagnosis and lifetime suicide attempt was non-significant. It is possible that the exploratory Chi-square analyses between suggested autism diagnosis and suicide attempt were nonsignificant because of the smaller number of participants providing data regarding suicide attempts (n = 260).…”

“…Although the exact risk for suicide ideation and attempts remain unclear (Zahid and Upthegrove 2017), reports estimate suicide ideation to occur in up to 72%, and suicide attempt between 7 and 47% of child, adolescent, and adult samples with autism spectrum conditions (Hedley and Uljarević 2018;Zahid and Upthegrove 2017). Adults with autism experience significantly more suicidal thoughts compared with adults in the general population (66% vs. 17%; Cassidy et al 2014); and are more likely to attempt suicide more than once (Richards et al 2019). Cassidy et al (2018) have also indicated that people with autism report suicide risk scores significantly above the clinical cutoff compared to general population adults (72% vs. 33%).…”

Development and Validation of the Suicide Behaviours Questionnaire – Autism Spectrum Conditions in Autistic, Possibly Autistic and Non-Autistic Adults.

“…However, the SBQ-ASC can be used to identify the presence of suicidal thoughts and behaviours in autistic adults, and those with high autistic traits or suspected autism (but not diagnosed). This is incredibly important considering that 40.6% of adults who attempt suicide score above the cut-off for clinical concern on a validated measure of autistic traits [12], and 41% of those who die by suicide have evidence of high autistic traits and were not diagnosed before they died [13]. Considering that clinicians are likely to encounter autistic/possibly autistic adults experiencing suicidality, the SBQ-ASC could be potentially useful for identifying presence of suicidal thoughts and behaviours in these groups.…”

“…45% of women with high autistic traits in the region of clinical concern for possible autism reported making a suicide plan, and 16% had attempted suicide [11]. 40.6% of those with a lifetime history of suicide attempt(s), without autism diagnosis or suspected autism, scored above the clinical cut-off for possible autism on a validated measure of autistic traits [12]. 41% of those who died by the suicide in the UK had evidence of high autistic traits, and none were diagnosed before they died [13].…”

Is Camouflaging Autistic Traits Associated with Suicidal Thoughts and Behaviours? Expanding the Interpersonal Psychological Theory of Suicide in an Undergraduate Student Sample

“…Research shows that self-reported autistic traits are associated with suicidal thoughts and behaviours (Cassidy et al 2018c;Pelton and Cassidy 2017;Paquette-Smith et al 2014;Takara and Kondo 2014;Cassidy et al 2014), and 40% of adults who have attempted suicide meet the cut-off for clinical concern on a validated autism screening instrument (Richards et al 2019). Suicide theories developed for the general population stress the importance of difficulties commonly experienced by autistic people and those with high autistic traits in the formation of suicidal intent.…”