Non-suicidal self-injury and its relation to suicide through acquired capability: investigating this causal mechanism in a mainly late-diagnosed autistic sample.

The study was cross-sectional, so it cannot show that NSSI caused acquired capability or suicide attempts; capability could have followed attempts. Autism diagnoses were self-reported and not clinically validated, and the comparison group's lack of autism was also self-reported. The groups differed greatly in age and life stage: autistic participants averaged 41.9 years and non-autistic participants averaged 21.3 years, and sex distributions differed. Both samples were convenience samples. The autistic group was recruited online and was mainly late-diagnosed, highly educated, and skewed toward cisgender women, with only 15 participants diagnosed at or below age 7. The non-autistic group was mainly undergraduates. Ethnicity data were missing for the non-autistic group. The measures of pain and acquired capability were brief self-report tools, and the authors say the pain-related variables may not have captured real-world pain tolerance well. Analyses of specific NSSI methods were run separately for each group and could not directly compare autistic and non-autistic participants. Sample sizes varied slightly across some specific-method analyses because some autistic participants did not complete all pain and habituation items.

The supplied text does not provide a funding or conflict-of-interest declaration. The publication types note research support from a non-U.S. government source.

Do not conclude that non-suicidal self-injury causes suicide attempts, or that acquired capability is the reason. The data are cross-sectional and self-reported, so NSSI, capability, and attempts were measured at the same time and could have influenced one another in either direction.