A Comparative Study of Suicidality and Its Association with Emotion Regulation Impairment in Large ASD and US Census-Mat
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S.I.: SUICIDALITY AND SELF-HARM IN AUTISM
A Comparative Study of Suicidality and Its Association with Emotion Regulation Impairment in Large ASD and US Census‑Matched Samples Caitlin M. Conner1 · Josh Golt1 · Giulia Righi2,3,4 · Rebecca Shaffer5,6 · Matthew Siegel7 · Carla A. Mazefsky1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Evidence suggests increased rates of suicidality in autism spectrum disorder (ASD), but the research has rarely used comparison samples and the role of emotion dysregulation has not been considered. We compared the prevalence of parent-reported suicidality ideation and considered the role of emotion dysregulation in 330 psychiatric inpatient youth with ASD, 1169 community youth with ASD surveyed online, and 1000 youth representative of the US census. The prevalence of suicidal ideation was three and five times higher in the community and inpatient ASD samples, respectively, compared to the general US sample. In the ASD groups, greater emotion dysregulation was associated with suicidal ideation. Implications include consideration of emotion regulation as a potential mechanism and treatment target for suicidality in ASD. Keywords Suicidality · Emotion regulation · ASD · Autism · Reactivity · Dysphoria Suicide is the second leading cause of death among US youth and young adults (Stone et al. 2018), and suicide rates have increased 31% for male adolescents and 100% for female adolescents from 2007 to 2015 (Centers for Disease Control 2017). Suicidal ideation is especially common among adolescents (Nock et al. 2010). In recent years, attention has been drawn to whether individuals with autism spectrum disorder (ASD) experience heightened risk for suicidality, though studies with larger comparative samples Portions of these data were presented at the 2019 International Meeting for Autism Research in Montreal, CA. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10803-020-04370-1) contains supplementary material, which is available to authorized users.
and examinations of potential mechanisms and associated characteristics are lacking.
Rates of Suicidality in ASD Extant research suggests that the prevalence of suicidality is heightened in ASD. In two reviews published in 2014, prevalence rates of suicidality ranged from 10 to 50% (Richa et al. 2014; Segers and Rawana 2014). Several studies of adults with ASD have noted elevated rates of suicidal ideation, suicidal behaviors, or suicide attempts. Among a diagnostic clinic sample of adults who were recently diagnosed with ASD, 66% reported a history of suicidal ideation and 35% reported a suicide plan or suicide attempt (Cassidy
* Carla A. Mazefsky [email protected] 1
2
Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Webster Hall Suite 300, Pittsburgh, PA 15213, USA Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
3
Emma Pendleton Bradley Ho
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