Investigating Bullying as a Predictor of Suicidality in a Clinical Sample of Adolescents with Autism Spectrum Disorder.
Rachel Holden, Joanne Mueller, John McGowan and 5 others
PMID 32198982WHAT IT FOUND
Adolescents with autism who experienced bullying were nearly twice as likely to develop suicidal thoughts over five years.
This risk remained significant after adjusting for demographics and clinical factors, highlighting bullying as a key predictor of suicidality in this group.
Key findings
01Bullying at baseline was associated with a significantly higher risk of incident suicidality during follow-up.
02The association between bullying and suicidality lost statistical significance when adjusted for adaptive function (CGAS scores).
03Female sex, psychosis diagnosis, and intellectual function in the normal range remained significant predictors of suicidality even after full adjustment.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study relied on electronic health records, which are not collected for research purposes and may contain false positives or negatives for bullying and suicidality. The sample was drawn from urban and suburban clinical populations, so findings may not generalize to rural areas or non-clinical groups. Bullying was recorded as 'any report' without details on type, duration, or severity, which limits understanding of dose-response relationships. Diagnoses of co-occurring conditions like anxiety were likely under-reported due to diagnostic shadowing by ASD. The exclusion of adolescents with prior suicidality to prevent reverse causation may have led to an underestimate of bullying's impact.
Declared interests
No authors declared any conflicts of interest. The study was supported by various funders including Autistica, the Economic and Social Research Council, and the National Institute for Health Research.
The easy way to misread this
Do not conclude that bullying causes suicidality independently of adaptive function. The study found that when adaptive function was included in the model, the association between bullying and suicidality was no longer statistically significant.