Links between self-injury and suicidality in autism.
R L Moseley, N J Gregory, P Smith and 2 others
PMID 32039740WHAT IT FOUND
Autistic adults with a history of self-injury reported significantly more suicide ideation and attempts than those without, regardless of whether they viewed their self-injury as a problem.
Cutting was associated with higher suicide risk, while hitting or scratching was not.
Key findings
01Participants who self-harmed (current or historic) had significantly higher scores for suicide ideation and attempts compared to non-self-harmers.
02Self-injury involving cutting was significantly associated with higher suicide risk, whereas hitting the self, punching objects, or scratching/pinching were not.
03How participants felt about their self-injury (whether they saw it as a problem) did not predict their level of suicide ideation or attempts.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample consisted exclusively of autistic adults without intellectual disability, mostly with normal to high IQ, so findings may not apply to those with learning disabilities. Diagnoses were self-reported and not independently verified. The study did not control for psychiatric comorbidities (like anxiety and depression) when analyzing the link between self-injury and suicide, so the independent effect of self-injury is unclear. The sample was heavily skewed towards women (73% female), limiting generalizability to autistic men. Self-injury and suicide data were collected at different time points (up to 6 months apart). The study was cross-sectional, so it cannot prove that self-injury causes increased suicide risk, only that they are associated.
Declared interests
The study was supported by non-U.S. government funding. No specific commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that autistic patients who do not view their self-injury as a problem are at lower risk for suicide. The study found no link between how a patient feels about their self-harm and their suicide ideation or attempts. Also, do not generalize these findings to autistic individuals with intellectual disability, as they were not included in this sample.