Paper: "The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults"
This paper was published in 2022, in the journal Molecular Autism.
You can click HERE to download a PDF of the paper.
Keep reading to see a plain English summary, or you can watch one of my explanatory videos!
Why is this an important issue?
Suicide is a leading cause of premature death in autistic people, but is poorly understood. In the general population, one very popular theory, the interpersonal theory of suicide (ITS), has been helpful for identifying risk factors and suggesting ways that others can help.
The ITS suggests that feelings of thwarted belongingness (feeling alienated from others) and perceived burdensomeness (feeling like a liability) are important risk factors for suicide. The theory also suggests that if people become habituated to thoughts about death and to pain, they ‘acquire capability’ to act on suicidal desires if they experience them.
This theory could be helpful for understanding suicide in autistic people and supporting those at risk, but we don’t know if it is relevant for autistic people.
Here is a short (~5 minute) video summary. You can toggle your view by clicking the icon in the top right corner, and turn captions on and off by clicking the 'CC' button. See below for a longer video explanation!
If you would like a more detailed explanation, please click this video:
What was the purpose of this study, and what did the researchers do?
We explored whether risk factors proposed by the ITS were associated with suicidal feelings and suicide attempts in autistic people. To do this, we asked 314 autistic adults to complete an online survey which assessed their current mental health and suicidal thoughts / behaviours over the past year and their whole lifespans. They also completed some questionnaires assessing thwarted belongingness, perceived burdensomeness, and acquired capability for suicide.
What were the results of the study?
We found that perceived burdensomeness was highly associated with past-year suicide ideation, past-year suicide attempts, and lifetime suicide attempts. This means that people who felt that they were a burden were at higher risk of suicide. We also found that reduced fear of death, one aspect of acquired capability for suicide, was associated with greater likelihood of the person having attempted suicide in the last year.
We found that people who were single (not in a romantic relationship) were more likely to have been suicidal in the last year, and this seemed to be because they had greater feelings of burdensomeness and of depression.
The images below show that unfortunately, our autistic participants reported high rates of suicide ideation over the past 12 months (left image). Suicide attempts were also high in our sample (right image). Sadly this is consistent with other studies.
What are potential weaknesses in the study?
Because this study looked at a snapshot of participants’ current states, we cannot be sure whether feelings of perceived burdensomeness, thwarted belongingness and acquired capability for suicide actually existed before suicidal thoughts or behaviours.
Because we measured these feelings with questionnaires designed on neurotypical people, it is possible that we didn’t succeed in accurately measuring these states.
Finally, our sample was not representative of many minority groups within the spectrum, like non-binary and trans autistic people, or autistic people of colour.
How will these findings help autistic adults now or in the future?
These findings indicate feelings and experiences which are relevant to suicide risk in autistic people (perceived burdensomeness and reduced fear of death) - these might be important to target in interventions.
The findings also indicate that the most popular theory of suicide in the general population is not entirely relevant to autistic people, or may need adjusting, in order to better explain suicidal thoughts and behaviours, identify people at risk, and intervene to reduce that risk.
Thank you for reading!
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