Links between self-injury and suicidality in autism

Abstract Background Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism...

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Main Authors: R. L. Moseley, N. J. Gregory, P. Smith, C. Allison, S. Baron-Cohen
Format: Article
Language:English
Published: BMC 2020-02-01
Series:Molecular Autism
Subjects:
Online Access:https://doi.org/10.1186/s13229-020-0319-8
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author R. L. Moseley
N. J. Gregory
P. Smith
C. Allison
S. Baron-Cohen
author_facet R. L. Moseley
N. J. Gregory
P. Smith
C. Allison
S. Baron-Cohen
author_sort R. L. Moseley
collection DOAJ
description Abstract Background Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism, motivate investigating the link between self-injury, suicide ideation, and attempts which has been reported in typically developing individuals. Method One hundred three autistic participants completed the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Suicide Behaviors Questionnaire (SBQ-R), and the Interpersonal Social Evaluation List (ISEL-12) across two online studies. Logistic regression was conducted to predict self-harming status via responses to questions on suicidality, and to predict whether certain self-injurious behaviors, including cutting, were especially associated with suicide ideation and attempts. Non-parametric correlation analysis examined relationships between suicide ideation/attempts and other variables that might characterize self-harmers especially at risk of suicidality. These included perceived access to social support, purposes or reasons for self-injury, the number of different self-injurious behaviors engaged in, the duration and lifetime incidence of self-injury, and the individual’s feelings about their self-injury. Results While self-injuring status was significantly predicted by responses to a question on suicide ideation and attempts, there was no relationship between suicide ideation/attempts and a participant’s personal feelings about their self-injury. The method of cutting was also predicted by suicide ideation and attempts, though other methods common in autistic people were at borderline significance. Use of self-injury for the regulation of low-energy emotional states like depression, for self-punishment or deterrence from suicide, and for sensory stimulation, was associated with suicide ideation and attempts, as was the number of self-injurious behaviors engaged in. There was no significant relationship between suicide ideation/attempts and the duration and lifetime incidence of self-injury or social support. Conclusions These preliminary data suggest that while individuals might frame their self-injury as a positive or neutral thing, there remains a concerning relationship between self-injury and suicidality which exists regardless of individual feelings on self-injury. This is consistent with the theoretical perspective that self-injury can be a “gateway” through which individuals acquire capability for lethal suicidal behaviors. The data highlight that particular methods (cutting) and reasons for self-injury may be of significant concern, but this information, which might be of extreme value for clinicians, requires further investigation and validation.
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spelling doaj.art-e47fe86505ba4de797328d6563e6b7f82022-12-21T23:04:46ZengBMCMolecular Autism2040-23922020-02-0111111510.1186/s13229-020-0319-8Links between self-injury and suicidality in autismR. L. Moseley0N. J. Gregory1P. Smith2C. Allison3S. Baron-Cohen4Department of Psychology, Bournemouth UniversityDepartment of Psychology, Bournemouth UniversityAutism Research Centre, Department of Psychiatry, University of CambridgeAutism Research Centre, Department of Psychiatry, University of CambridgeAutism Research Centre, Department of Psychiatry, University of CambridgeAbstract Background Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism, motivate investigating the link between self-injury, suicide ideation, and attempts which has been reported in typically developing individuals. Method One hundred three autistic participants completed the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Suicide Behaviors Questionnaire (SBQ-R), and the Interpersonal Social Evaluation List (ISEL-12) across two online studies. Logistic regression was conducted to predict self-harming status via responses to questions on suicidality, and to predict whether certain self-injurious behaviors, including cutting, were especially associated with suicide ideation and attempts. Non-parametric correlation analysis examined relationships between suicide ideation/attempts and other variables that might characterize self-harmers especially at risk of suicidality. These included perceived access to social support, purposes or reasons for self-injury, the number of different self-injurious behaviors engaged in, the duration and lifetime incidence of self-injury, and the individual’s feelings about their self-injury. Results While self-injuring status was significantly predicted by responses to a question on suicide ideation and attempts, there was no relationship between suicide ideation/attempts and a participant’s personal feelings about their self-injury. The method of cutting was also predicted by suicide ideation and attempts, though other methods common in autistic people were at borderline significance. Use of self-injury for the regulation of low-energy emotional states like depression, for self-punishment or deterrence from suicide, and for sensory stimulation, was associated with suicide ideation and attempts, as was the number of self-injurious behaviors engaged in. There was no significant relationship between suicide ideation/attempts and the duration and lifetime incidence of self-injury or social support. Conclusions These preliminary data suggest that while individuals might frame their self-injury as a positive or neutral thing, there remains a concerning relationship between self-injury and suicidality which exists regardless of individual feelings on self-injury. This is consistent with the theoretical perspective that self-injury can be a “gateway” through which individuals acquire capability for lethal suicidal behaviors. The data highlight that particular methods (cutting) and reasons for self-injury may be of significant concern, but this information, which might be of extreme value for clinicians, requires further investigation and validation.https://doi.org/10.1186/s13229-020-0319-8AutismSelf-injurySuicidality
spellingShingle R. L. Moseley
N. J. Gregory
P. Smith
C. Allison
S. Baron-Cohen
Links between self-injury and suicidality in autism
Molecular Autism
Autism
Self-injury
Suicidality
title Links between self-injury and suicidality in autism
title_full Links between self-injury and suicidality in autism
title_fullStr Links between self-injury and suicidality in autism
title_full_unstemmed Links between self-injury and suicidality in autism
title_short Links between self-injury and suicidality in autism
title_sort links between self injury and suicidality in autism
topic Autism
Self-injury
Suicidality
url https://doi.org/10.1186/s13229-020-0319-8
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