Advancing Our Understanding of Self-harm, Suicidal Thoughts and Behaviours in Autism

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EDITORIAL

Advancing Our Understanding of Self‑harm, Suicidal Thoughts and Behaviours in Autism Sarah A. Cassidy1   · Ashley Robertson2,4 · Ellen Townsend1 · Rory C. O’Connor2 · Jacqui Rodgers3

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Until recently, self-harm, suicidal thoughts and behaviours have not received extensive attention in autism research (Cassidy 2020; Cassidy and Rodgers 2017). The extant research evidence indicates high rates of self-harm in autistic people, but this work has primarily focused on self-harm in the context of challenging and/or repetitive behaviour associated with intellectual disability (Minshawi et al. 2014). Although extremely important work, this research does not explore whether autistic people who self-harm also experience intent to end one’s life, or whether self-harm increases risk of subsequent suicidal behaviours (as in the general population; Rebeiro et al. 2016). More recent research has explored self-harm and suicidality, as defined in the general population, in autistic people. Early work showed that 66% of adults recently diagnosed with Asperger Syndrome had contemplated suicide in their lifetime, and 35% had planned or attempted suicide (Cassidy et al. 2014). Autistic adults are also significantly more likely to experience non-suicidal self-injury (NSSI) compared to the general population, and NSSI is associated with increased risk of suicidality in this group (Cassidy et al. 2018b; Maddox et al. 2017; Moseley et al. 2019, 2020). Large-scale population studies have followed, showing that autistic people are significantly more likely to die by self-harm and suicide compared to those in the general population (Hirvikoski et al. 2016; Hwang et al. 2019; Kirby et al. 2019). Importantly, the majority of available research has focused on prevalence (Hedley and Uljarevic 2018). This has * Sarah A. Cassidy [email protected] 1



School of Psychology, University of Nottingham, Nottingham NG7 2RD, UK

2



Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK

3

Population Health Sciences Institute, Newcastle University, Newcastle, UK

4

School of Psychology, University of Glasgow, Glasgow, UK



been instrumental in raising awareness of these critical life and death issues in the autistic community. However, there is relatively little research into why autistic people are at increased risk of self-harm and suicide, to inform treatment and prevention strategies (Cassidy 2020; Cassidy and Rodgers 2017). To make progress, it is crucial for different stakeholders to listen and learn from one another. This includes autism researchers, self-harm and suicide researchers, autistic people, and those who support them. Members of the guest editorial board for this special issue have developed international forums involving these stakeholder groups to support these efforts, including an international priority setting exercise which identified the top 10 autism community priorities for suicid