Elevated Suicidal Thoughts and Behaviors and Nonsuicidal Self-Injury in Autistic Youth and Adults: A Multinational Study.

The sample was suicide-enriched and not representative of all autistic people. The data were pooled from three studies with different recruitment methods, age ranges, income reporting, and clinical settings. The study was cross-sectional and used lifetime reports, so it cannot show current risk or age changes in the same people. Declines at older ages may be artifacts of who survived, participated, or was diagnosed, not true reductions. Canadian youth relied on caregiver report, and autistic youth may not disclose suicidal thoughts or self-harm to caregivers. The C-SSRS nonsuicidal self-injury item only asked yes or no and did not distinguish self-injurious stereotypy in autism from nonsuicidal self-injury. The sample excluded people with intellectual disability and was mostly White and from Western countries, so findings may not apply to broader autism populations. Gender nonbinary and gender diverse differences were not examined. Co-occurring mental health diagnoses were not available across sites.

Do not read these high lifetime rates as typical of all autistic people. The sample was suicide-enriched, pooled from different clinical and research sources, and excluded intellectual disability, so these rates may not represent all autistic people.