Suicide and Autism: A Lifespan Perspective

Abstract

People with Autism Spectrum Disorder (ASD) are at increased risk of suicidal behaviour compared to the general population; the largest population-based study to date demonstrates a sevenfold increased risk of premature death by suicide. This chapter provides an overview of: a) the current literature regarding risk and prevalence of suicide behaviour in autism; b) the role of intellectual disability/intellectual developmental disorder in suicide in autism; c) correlates, risk and protective factors; d) dimensional constructs of suicide, including autistic traits; e) current approaches to suicide assessment, including potential modifications and; f) suicide prevention and service access. We consider these topics by drawing on state-of-theart research, the perspective of lived experience, and consideration of the potential impacts of major events such as the coronavirus (COVID-19) pandemic.

The Suicide Assessment Kit-Modified Interview (SAK-MI): Development and Validation of a Modified Clinical Interview for the Assessment of Suicidal Thoughts and Behavior in Autistic Adults

“…In autism, self-injurious behavior associated with the restricted and repetitive behavior domain (e.g., head-banging, biting, scratching) is relatively common, and may be considered part of, or a symptom of the autism diagnosis. Hence, clinicians may not consider it a 'red flag' for STB in the same way as they might in other (non-autistic) populations (Hedley et al, 2022). Other self-injurious behaviors related to co-occurring psychopathology, such as cutting, are also prevalent in the autistic population (Moseley et al, 2020) and may be associated with STB (Cassidy, Bradley, Shaw, et al, 2018).…”

The Suicidal Ideation Attributes Scale-Modified (SIDAS-M): Development and preliminary validation of a new scale for the measurement of suicidal ideation in autistic adults

“…In addition, instruments not designed for use with autistic people can be problematic when used by this population due to use of different vocabulary, confusing terms, complex sentence structure or grammar, imprecise response options, and inclusion of ableist language or concepts (Nicolaidis et al, 2020). Indeed, recent research has identified a clear need for instruments that can be used to assess suicide behavior in autistic people, in both research and clinical settings (Cassidy et al, 2018b; Hedley et al, 2022).…”