Understanding Suicide Risk in Autistic Adults: Comparing the Interpersonal Theory of Suicide in Autistic and Non-autistic Samples | Circa March 2020

Abstract

This study explored whether the Interpersonal Theory of suicide informs our understanding of high rates of suicidality in autistic adults. Autistic and non-autistic adults (n = 695, mean age 41.7 years, 58% female) completed an online survey of self-reported thwarted belonging, perceived burden, autistic traits, suicidal capability, trauma, and lifetime suicidality. Autistic people reported stronger feelings of perceived burden, thwarted belonging and more lifetime trauma than non-autistic people. The hypothesised interaction between burdensomeness and thwarted belonging were observed in the non-autistic group but not in the autistic group. In both groups autistic traits influenced suicidality through burdensomeness/thwarted belonging. Promoting self-worth and social inclusion are important for suicide prevention and future research should explore how these are experienced and expressed by autistic people.

Introduction

Research reports higher suicidality rates amongst adults diagnosed with an autism spectrum condition (ASC) than the general population, but research has yet to explain how the unique challenges facing autistic adults lead to suicidality (Cassidy and Rodgers 2017; Segers and Rawana 2014). A recent population study reported a nine-fold increase in death by suicide amongst autistic adults^Footnote 1 (Hirvikoski et al. 2016) and higher rates of suicide ideation have been noted in autistic samples than general population, psychotic and student samples (Cassidy et al. 2014). Autistic adults more frequently experience general population suicide risk factors, such as abuse (Storch et al. 2013) and depression (Cassidy et al. 2014), but also report greater impact of less commonly reported risk factors, such as camouflaging (masking autistic characteristics to fit in) or coping with life without required support (Cassidy et al. 2018b). However, studies to date have not applied theoretically based empirical models and so do not provide the detailed insight into suicide mechanisms required to design interventions that meet the specific needs of autistic people (Cassidy and Rodgers 2017; Franklin et al. 2017; Joiner 2005; Segers and Rawana 2014; Van Orden et al. 2010). The current study, thus, explores for the first time how a widely cited theory of suicide, the Interpersonal Theory of Suicide (Joiner 2005), applies to suicide in autistic adults and whether this is different from non-autistic adults. […]