An Exploratory Analysis of Predictors of Youth Suicide-Related Behaviors in Autism Spectrum Disorder: Implications for P
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S.I. : SUICIDALITY AND SELF-HARM IN AUTISM
An Exploratory Analysis of Predictors of Youth Suicide‑Related Behaviors in Autism Spectrum Disorder: Implications for Prevention Science Christina G. McDonnell1 · Elizabeth A. DeLucia1 · Elizabeth P. Hayden2 · Evdokia Anagnostou3,4 · Rob Nicolson2,5 · Elizabeth Kelley6 · Stelios Georgiades7 · Xudong Liu6 · Ryan A. Stevenson2
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Although autism spectrum disorder (ASD) is associated with significant mental health concerns, little is known about suicidality, particularly among youth. To address this critical gap in the literature, the current study examined the predictive validity of (1) demographics, (2) core autism symptoms, (3) cognitive abilities and adaptive behavior, (4) comorbid psychopathology, and (5) medical problems, for suicide-related behaviors among autistic youth (N = 481; Mage = 11.56 years). As indices of suicide-related behaviors, parents reported on whether the child had ever (1) talked about killing themselves, and (2) engaged in deliberate self-harm or attempted suicide. These two suicide-related outcomes had distinct clinical correlates, including child age, parental education, restricted and repetitive behaviors, IQ and adaptive behavior, affective and conduct problems, and medical concerns. Keywords Autism spectrum disorder · Suicidality · Psychopathology · Prevention
Introduction Autism spectrum disorder (ASD) is associated with a range of comorbid mental health concerns, such as depression, anxiety, and behavioral problems, among others (Hollocks et al. 2019; Menezes et al. 2018; van Steensel and Heeman 2017). Despite encouraging developments in our ability to identify and reduce comorbid mental health concerns in ASD (Weston et al. 2016), our understanding of suicidality * Christina G. McDonnell [email protected]; [email protected] 1
Virginia Tech Department of Psychology, Williams Hall, Blacksburg, VA 24060, USA
2
Western University, London, Canada
3
Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
4
Department of Paediatrics, University of Toronto, Toronto, Canada
5
Children’s Health Research Institute, London, ON, Canada
6
Queen’s University, Kingston, CA, Canada
7
McMaster University, Hamilton, CA, Canada
in ASD is limited (Cassidy and Rodgers 2017). This is problematic given that autistic individuals1 may be at heightened risk for suicidality due to core aspects of the disorder (e.g., difficulties with social relationships and communication) and common comorbid difficulties (e.g., high rates of depression, anxiety, and loneliness) that may potentiate suicidal ideation and behavior. Indeed, prior work supports a high prevalence of suicidality in ASD, with systematic reviews demonstrating that between 7 and 66% of autistic individuals report suicidal thoughts and/or behaviors (Hedley and Uljarević 2018; Segers and Rawana 2014). Suicidality among autistic adults has been the primary focus of the scant research to d
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