Parent-Reported Rates and Clinical Correlates of Suicidality in Children with Autism Spectrum Disorder: A Longitudinal S
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S.I. : SUICIDALITY AND SELF-HARM IN AUTISM
Parent‑Reported Rates and Clinical Correlates of Suicidality in Children with Autism Spectrum Disorder: A Longitudinal Study Michelle C. Hunsche1 · Sonja Saqui1 · Pat Mirenda1 · Anat Zaidman‑Zait1,2 · Teresa Bennett3 · Eric Duku3 · Mayada Elsabbagh4 · Stelios Georgiades3 · Isabel M. Smith5 · Peter Szatmari6 · Wendy J. Ungar6 · Tracy Vaillancourt7 · Charlotte Waddell9 · Lonnie Zwaigenbaum8 · Connor M. Kerns1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This study investigated rates of suicidal ideation (SI) and suicidal and/or self-injurious behaviour (SSIB) reported by parents on the Child Behavior Checklist for 178 children with ASD over four annual assessments (ages 7–11 years). Analyses examined the frequency and persistence of SI and SSIB, and the association of SI and SSIB at any time point with child characteristics and internalizing and externalizing problems at age 7. SI occurred in 9.6% of children and was associated with fewer ASD symptoms and better adaptive functioning at age 7. SSIB occurred in 14.6% and was associated with poorer adaptive functioning and more externalizing behaviour at age 7. Internalizing problems were not associated with SI or SSIB at any time point. SI and SSIB rarely co-occurred (4%). Keywords Autism spectrum disorder · Suicide · Internalizing symptoms · Externalizing symptoms Suicide is the second leading cause of death in youth aged 10–24 years in Canada (Statistics Canada 2012). Recent research suggests that youth with autism spectrum disorder (ASD), a neurodevelopment disorder that affects approximately 1% of the population (Statistics Canada 2012), are more likely than the general population to attempt and die by suicide. In a nationwide population-based study of insurance records in Taiwan, adolescents and young adults with ASD (n = 5618, ages 12–29) were nearly six times more likely to attempt suicide, and to attempt suicide at a significantly * Connor M. Kerns [email protected] 1
University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada
2
Tel Aviv University, Tel Aviv, Israel
3
McMaster University, Vancouver, BC, Canada
4
McGill University, Montreal, QC, Canada
5
Dalhousie University, Halifax, NS, Canada
6
University of Toronto, Toronto, ON, Canada
7
University of Ottawa, Ottawa, ON, Canada
8
University of Alberta, Edmonton, AB, Canada
9
Simon Fraser University, Burnaby, BC, Canada
younger age, than adolescents and young adults without ASD (n = 22,472; Chen et al. 2017). A study examining hospital records of a population-based cohort of individuals with ASD in Sweden reported that adults with ASD without intellectual disability were 7.5 times more likely, and adults with ASD and intellectual disability were 2.5 times more likely, to die by suicide than individuals in the general population (Hirvikoski et al. 2016). In another study that analyzed medical registry data collected over 20 years in a representative statewide population in the USA,
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