Development and validation of the suicidal behaviours questionnaire - autism spectrum conditions in a community sample of autistic, possibly autistic and non-autistic adults

Cassidy, Sarah; Bradley, Louise; Cogger-Ward, Heather; Rodgers, Jacqui

doi:10.1186/s13229-021-00449-3

Cited by 38 publications

(35 citation statements)

References 57 publications

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“…Although the DERS and SBQ-R have been used in online survey research [ 52 , 53 ], to the best of our knowledge, no formal tests of validity have been conducted. We still elected to use these scales as there is no existing validated instrument for emotion regulation and suicide behaviors and because, of the existing scales, these have the best psychometric properties, are valid and reliable across demographic groups, and are least burdensome to administer owing to a shorter length and ease of understanding [ 27 , 54 - 66 ].…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Mental Health Apps for Distress During COVID-19 in US Unemployed and Essential Workers: Remote Pragmatic Randomized Clinical Trial

Comtois¹,

Mata-Greve²,

Johnson³

et al. 2022

JMIR Mhealth Uhealth

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Background During the COVID-19 pandemic, the general public was concerned about the mental health impacts of unemployment due to COVID-19 and the stress essential workers experienced during this time. Several reports indicated that people in distress were turning to digital technology, but there was little evidence about the impact of these tools on mitigating distress. Objective This study seeks to determine the acceptability, feasibility, usability, and effectiveness of mobile mental health apps for decreasing mental health symptoms in essential workers and unemployed individuals with suicide risk. Methods We recruited participants who indicated that they were unemployed because of COVID-19 or were COVID-19–designated essential workers. Participants were randomized to 1 of 4 free commercial mobile apps for managing distress that were (1) highly rated by PsyberGuide and (2) met the criteria for intervention features these participants indicated were desirable in a previous survey. Participants used the apps for 4 weeks and completed baseline and 4-week self-assessments of depression, anxiety emotional regulation, and suicide risk. Results We found no differences between the apps in any outcome but did find significant changes in depression and anxiety over time (Patient Health Questionnaire [PHQ]-9: estimate=–1.5, SE 0.2, 95% CI –1.1 to –1.8, P<.001; Generalized Anxiety Disorder Scale [GAD]-7: estimate=–1.3, SE 0.2, 95% CI –1.0 to –1.6, P<.001). We found no significant changes in suicidal behavior (Suicide Behaviors Questionnaire-Revised [SBQ-R]) or emotional regulation (Difficulties in Emotion Regulation Scale – Short Form [DERS-SF]) for the 4 weeks. We did find a significant dose-response pattern for changes in depression and anxiety. Using the app at least once a week resulted in greater improvements in treatment conditions over time on depression (estimate=–0.6, SE 0.2, 95% CI 1.0-0.2, P=.003) and anxiety (estimate=0.1, SE 0.2, 95% CI 0.4-0.6, P=.78). There was no association between app frequency and changes in suicidal behavior (SBQ-R) or emotional regulation (DERS-SF). We further found a significant difference between the conditions with regard to app usability, with the control app being the most usable (meanBeautiful Mood 72.9, SD 16.7; meanCOVID Coach 71.2, SD 15.4; meanCalm 66.8, SD 17.3; mean7 Cups 65.2, SD 17.7). We found no significant differences for app acceptability or appropriateness. Conclusions Few studies have evaluated prospectively the utility and usability of commercial apps for mood. This study found that free, self-guided commercial mobile mental health apps are seen as usable, but no one app is superior to the other. Although we found that regular use is indicated for effects on depression and anxiety to occur in those who are more symptomatic, regression to the mean cannot be ruled out. Trial Registration ClinicalTrials.gov NCT04536935; https://tinyurl.com/mr36zx3s

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Section: Methodsmentioning

confidence: 99%

Effectiveness of Mental Health Apps for Distress During COVID-19 in US Unemployed and Essential Workers: Remote Pragmatic Randomized Clinical Trial

Comtois¹,

Mata-Greve²,

Johnson³

et al. 2022

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…Last, it is important to note that the SBQ-R was not designed specifically for use with autistic people. Although a version of this instrument has now been validated for use in autistic adults (Cassidy et al, 2021), it was not available when the present study was conceived.…”

Section: Limitationsmentioning

confidence: 99%

The association between COVID‐19, personal wellbeing, depression, and suicide risk factors in Australian autistic adults

et al. 2021

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The COVID-19 pandemic has had a significant impact on the mental health and wellbeing of the world's population, with particularly negative effects on vulnerable populations, including autistic people. Although some consensus regarding specific impact on aspects of wellbeing and mental health in autism is starting to emerge, it is unclear whether the pandemic has increased suicide risk. The goals of this study were to examine (a) potential associations between COVID-19 impact and depression, personal wellbeing, and suicide risk factors in Australian autistic adults and (b) age and gender effects. The COVID-19 Impact Scale (CIS), Personal Wellbeing Index, Patient Health Questionnaire, and the Suicide Behavior Questionnaire, Revised (SBQ-R), were administered to 111 autistic adults aged 20 to 71 years during the second wave of the COVID-19 pandemic in Australia. COVID-19 impact showed small associations with poorer personal wellbeing (r = À0.224, p = 0.023, [À0.409, À0.016]) and higher depressive symptoms (r = 0.268, p = 0.006, [0.056, 0.445]) and was not associated with the SBQ-R suicide risk score (r = 0.081, p = 0.418, [À0.118, 0.264). No significant effects were identified for age. Although model results were similar for women and men, the strength of the associations between personal wellbeing and depression (z = À2.16, p = 0.015), and depression and SBQ-R suicide risk (z = 1.961, p = 0.025), were stronger in women than in men. Qualitative analysis of an open response question from the CIS suggested that the pandemic had both positive and negative impacts on participants. The COVID-19 pandemic has had a large impact on the mental health and wellbeing of the world's population, particularly vulnerable populations such as autistic people. It is not known if these impacts on mental health and wellbeing have increased suicide risk. Our findings suggest that the impact of the COVID-19 pandemic may be associated with poorer wellbeing and higher depression, but is not associated with suicide risk. Overall, autistic people reported both positive and negative impacts of the pandemic on their lives.

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“…6 Autistic people (diagnosed and undiagnosed), are also more likely to experience perseverative suicidal thoughts, and impulsively attempt suicide without a plan during a crisis when means for self-harm were present, which could particularly increase their risk of death by suicide. 20,21…”

Section: Introductionmentioning

confidence: 99%

Autism and autistic traits in those who died by suicide in England

et al. 2022

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Background Autism and autistic traits are risk factors for suicidal behaviour. Aims To explore the prevalence of autism (diagnosed and undiagnosed) in those who died by suicide, and identify risk factors for suicide in this group. Method Stage 1: 372 coroners’ inquest records, covering the period 1 January 2014 to 31 December 2017 from two regions of England, were analysed for evidence that the person who died had diagnosed autism or undiagnosed possible autism (elevated autistic traits), and identified risk markers. Stage 2: 29 follow-up interviews with the next of kin of those who died gathered further evidence of autism and autistic traits using validated autism screening and diagnostic tools. Results Stage 1: evidence of autism (10.8%) was significantly higher in those who died by suicide than the 1.1% prevalence expected in the UK general alive population (odds ratio (OR) = 11.08, 95% CI 3.92–31.31). Stage 2: 5 (17.2%) of the follow-up sample had evidence of autism identified from the coroners’ records in stage 1. We identified evidence of undiagnosed possible autism in an additional 7 (24.1%) individuals, giving a total of 12 (41.4%); significantly higher than expected in the general alive population (1.1%) (OR = 19.76, 95% CI 2.36–165.84). Characteristics of those who died were largely similar regardless of evidence of autism, with groups experiencing a comparably high number of multiple risk markers before they died. Conclusions Elevated autistic traits are significantly over-represented in those who die by suicide.

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Development and validation of the suicidal behaviours questionnaire - autism spectrum conditions in a community sample of autistic, possibly autistic and non-autistic adults

Cited by 38 publications

References 57 publications

Effectiveness of Mental Health Apps for Distress During COVID-19 in US Unemployed and Essential Workers: Remote Pragmatic Randomized Clinical Trial

Effectiveness of Mental Health Apps for Distress During COVID-19 in US Unemployed and Essential Workers: Remote Pragmatic Randomized Clinical Trial

The association between COVID‐19, personal wellbeing, depression, and suicide risk factors in Australian autistic adults

Autism and autistic traits in those who died by suicide in England

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