Type, content, and triggers for self-injurious thoughts and behaviors in autistic youth and their disclosure to caregivers.
Jessica M Schwartzman, Alex Rubin, Kathryn R Fox and 2 others
PMID 39723692WHAT IT FOUND
In autistic youth seeking therapy, half did not tell caregivers about suicidal thoughts.
Common triggers were sadness and bullying for suicide risk, but anger was the top trigger for self-harm. Clinicians must screen directly, as many patients cannot identify what causes their distress.
Key findings
01Half of the youth who experienced suicidal thoughts did not disclose this to a caregiver.
02Sadness and bullying were the most common reported triggers for suicidal thoughts, whereas anger was the most common trigger for non-suicidal self-injury.
03Nearly one third of youth were unable to identify a trigger for their suicidal thoughts or behaviors.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was treatment-seeking, so rates of suicide risk and self-harm are likely higher than in the general autistic population. The study was cross-sectional, so it cannot determine causality or how triggers change over time. Many youth could not identify triggers for their suicidal thoughts, limiting the ability to link specific stressors to specific outcomes. Information on co-occurring psychiatric disorders was not collected. The study did not ask why youth did or did not disclose their thoughts to caregivers.
Declared interests
One author received partial salary support from the clinic where the data were collected. The authors declared no other conflicts of interest.
The easy way to misread this
Do not assume that a lack of reported triggers means a lack of risk. Nearly one third of youth could not identify what caused their suicidal thoughts, which may reflect difficulty with introspection or communication rather than an absence of precipitating factors.