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Understanding Suicide Risk in Autistic Adults: Comparing the Interpersonal Theory of Suicide in Autistic and Non-autistic Samples

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Abstract

This study explored whether the Interpersonal Theory of suicide informs our understanding of high rates of suicidality in autistic adults. Autistic and non-autistic adults (n = 695, mean age 41.7 years, 58% female) completed an online survey of self-reported thwarted belonging, perceived burden, autistic traits, suicidal capability, trauma, and lifetime suicidality. Autistic people reported stronger feelings of perceived burden, thwarted belonging and more lifetime trauma than non-autistic people. The hypothesised interaction between burdensomeness and thwarted belonging were observed in the non-autistic group but not in the autistic group. In both groups autistic traits influenced suicidality through burdensomeness/thwarted belonging. Promoting self-worth and social inclusion are important for suicide prevention and future research should explore how these are experienced and expressed by autistic people.

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Notes

  1. This study refers to adults without intellectual disability who are reported to be at greatest risk of suicidal behaviour (Hirvikoski et al. 2016).

  2. The ‘other’ gender group were not included as n = 2.

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Acknowledgments

This research has been compiled with the kind support of the Coventry steering group who assisted in selecting and devising the materials for this study. This study also acknowledges the kind support of Paula Smith, database manager at the Autism Research Centre, University of Cambridge for assisting with contacting participants registered in the Cambridge Autism Research Database. We would also like to thank Autistica for advertising their study via their Discover network and thank all the participants for taking part. This study has been undertaken as a component of PhD study with financial support from Coventry University. Mirabel Pelton is grateful for the generous support of a grant from Funds for Women Graduates [Ref: GA-00109]. Sarah Cassidy was supported by the Economic and Social Research Council [grant number: ES/N000501/2], Autistica, the International Society for Autism Research and the Slifka-Ritvo Foundation during the course of this research. Simon Baron-Cohen was funded by the Autism Research Trust, the Wellcome Trust, the Templeton World Charitable Foundation, and the NIHR Biomedical Research Centre in Cambridge, during the period of this work. He also received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 777394. The JU receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA and AUTISM SPEAKS, Autistica, SFARI. His research was also supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England at Cambridgeshire and Peterborough NHS Foundation Trust. Hayley Crawford is supported by the NIHR Applied Research Centre West Midlands. The views expressed are those of the author(s) and not necessarily those of the NHS, NIHR or Department of Health and Social Care

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Authors and Affiliations

  1. Centre for Intelligent Healthcare, Coventry University, Priory Street, Coventry, CV1 5FB, UK

    Mirabel K. Pelton & Hayley Crawford

  2. School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK

    Mirabel K. Pelton & Hayley Crawford

  3. CMHWR and Mental Health and Wellbeing Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, CV4 7HL, UK

    Hayley Crawford

  4. Faculty of Health and Life Sciences, Coventry University, Priory Street, Coventry, CV1 5FB, UK

    Ashley E. Robertson & Sarah Cassidy

  5. Population Health Sciences Institute, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Queen Victoria Road, Newcastle, NE1 4LP, UK

    Jacqui Rodgers

  6. Autism Research Centre, University of Cambridge, Cambridge, UK

    Simon Baron-Cohen

  7. Cambridge Lifetime Asperger Syndrome Service (CLASS), Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK

    Simon Baron-Cohen

  8. School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK

    Sarah Cassidy

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  1. Mirabel K. Pelton
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  2. Hayley Crawford
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  3. Ashley E. Robertson
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  4. Jacqui Rodgers
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  5. Simon Baron-Cohen
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  6. Sarah Cassidy
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Contributions

This project was conceived by SC and MP. MP designed the detailed protocol, gathered the data, designed and undertook the data analysis and wrote the main draft. SC, JR, HC, AR and SB-C provided feedback on that draft. All co-authors have reviewed and approved of the manuscript prior to submission.

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Correspondence to Mirabel K. Pelton or Sarah Cassidy.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of Coventry University (ref p61841) and with the 1964 Helsinki declaration and its later amendments or comparable ethical approval standards. Informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.

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Appendix

Appendix

Original wording instructions of the Interpersonal Needs Questionnaire:

The following questions ask you to think about yourself and other people. Please respond to each question by using your own current beliefs and experiences, NOT what you think is true in general, or what might be true for other people. Please base your responses on how you’ve been feeling recently. Use the rating scale to find the number that best matches how you feel and circle that number. There are no right or wrong answers: we are interested in what you think and feel.

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Pelton, M.K., Crawford, H., Robertson, A.E. et al. Understanding Suicide Risk in Autistic Adults: Comparing the Interpersonal Theory of Suicide in Autistic and Non-autistic Samples. J Autism Dev Disord 50, 3620–3637 (2020). https://doi.org/10.1007/s10803-020-04393-8

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