Top

Journal of Autism and Developmental Disorders

Gepubliceerd in:

14-01-2020 | 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

Auteurs: Caitlin M. Conner, Josh Golt, Giulia Righi, Rebecca Shaffer, Matthew Siegel, Carla A. Mazefsky

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 10/2020

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.

vorige artikel An Exploratory Analysis of Predictors of Youth Suicide-Related Behaviors in Autism Spectrum Disorder: Implications for Prevention Science

volgende artikel Prevalence and Risk-Markers of Self-Harm in Autistic Children and Adults

Alleen toegankelijk voor geautoriseerde gebruikers

Achenbach T, Rescorla LA (2001) Manual for the ASEBA school-age forms and profiles. University of Vermont Research Center for Children, Youth, and Families, Burlington, VT

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004.CrossRefPubMed

Berthoz, S., & Hill, E. L. (2005). The validity of using self-reports to assess emotion regulation abilities in adults with autism spectrum disorder. European Psychiatry, 20, 291–298. https://doi.org/10.1016/j.eurpsy.2004.06.013.CrossRefPubMed

Bird, G., & Cook, R. (2013). Mixed emotions: The contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry, 3(7), e285–e288. https://doi.org/10.1038/tp.2013.61.CrossRefPubMedPubMedCentral

Blakeley-Smith, A., Reaven, J., Ridge, K., & Hepburn, S. (2012). Parent–child agreement of anxiety symptoms in youth with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(2), 707–716. https://doi.org/10.1016/j.rasd.2011.07.020.CrossRef

Cai, R. Y., Richdale, A. L., Foley, K.-R. R., Trollor, J., & Uljarević, M. (2018a). Brief report: Cross-sectional interactions between expressive suppression and cognitive reappraisal and its relationship with depressive symptoms in autism spectrum disorder. Research in Autism Spectrum Disorders, 45, 1–8. https://doi.org/10.1016/j.rasd.2017.10.002.CrossRef

Cai, R. Y., Richdale, A., Uljarevic, M., Dissanayake, C., & Samson, A. C. (2018b). Emotion regulation in autism spectrum disorder: Where we are and where we need to go. Autism Research, 11(7), 962–978. https://doi.org/10.1002/aur.1968.CrossRefPubMed

Cassidy, S., Bradley, P., Robinson, J., Allison, C., McHugh, M., & Baron-Cohen, S. (2014). Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic: A clinical cohort study. The Lancet Psychiatry, 1(2), 142–147. https://doi.org/10.1016/S2215-0366(14)70248-2.CrossRefPubMed

Cassidy, S. A., Bradley, L., Bowen, E., Wigham, S., & Rodgers, J. (2018a). Measurement properties of tools used to assess depression in adults with and without autism spectrum conditions: A systematic review. Autism Research, 62, 56–70. https://doi.org/10.1002/aur.1922.CrossRef

Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018b). Risk markers for suicidality in autistic adults. Molecular Autism, 9(1), 1–14. https://doi.org/10.1186/s13229-018-0226-4.CrossRef

Centers for Disease Control (2017) QuickStats: Suicide Rates for teens aged 15–19 years, by sex—United States 1975–2015. Morbidity and Mortality Weekly Report, 66(30), 816. https://doi.org/10.15585/mmwr.mm6630a6

Conner, C. M., Golt, J., Righi, G., Shaffer, R. C., Siegel, M., & Mazefsky, C. A. (in preparation). The influence of emotion dysregulation on outcomes in ASD: Comparison of inpatient ASD, community ASD, and US census-matched youth samples.

Conner, C. M., White, S. W., Beck, K. B., Golt, J., Smith, I. C., & Mazefsky, C. A. (2019). Improving emotion regulation ability in autism: The Emotional Awareness and Skills Enhancement (EASE) program. Autism, 23(5), 1273–1287. https://doi.org/10.1177/1362361318810709.CrossRefPubMed

Daniels, A. M., Rosenberg, R. E., Anderson, C., Law, J. K., Marvin, A. R., & Law, P. A. (2012). Verification of parent-report of child autism spectrum disorder diagnosis to a web-based autism registry. Journal of Autism and Developmental Disorders, 42(2), 257–265. https://doi.org/10.1007/s10803-011-1236-7.CrossRefPubMed

Davey, S., Halberstadt, J., Bell, E., & Collings, S. (2018). A scoping review of suicidality and alexithymia: The need to consider interoception. Journal of Affective Disorders. https://doi.org/10.1016/j.jad.2018.06.027.CrossRefPubMedPubMedCentral

Demirkaya, S. K., Tutkunkardaş, M. D., & Mukaddes, N. M. (2016). Assessment of suicidality in children and adolescents with diagnosis of high functioning autism spectrum disorder in a Turkish clinical sample. Neuropsychiatric Disease and Treatment, 12, 2921–2926. https://doi.org/10.2147/NDT.S118304.CrossRef

Duerden, E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari, P., et al. (2012). Risk factors associated with self-injurious behaviors in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(11), 2460–2470. https://doi.org/10.1007/s10803-012-1497-9.CrossRefPubMed

Goodwin, M. S., Mazefsky, C. A., Ioannidis, S., Erdogmus, D., & Siegel, M. (2019). Predicting aggression to others in youth with autism using a wearable biosensor. Autism Research, 12(8), 1286–1296. https://doi.org/10.1002/aur.2151.CrossRefPubMedPubMedCentral

Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(5), 271–299.CrossRef

Gross, J. J., & Thompson, R. A. (2006). Emotion regulation: Conceptual foundations. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 3–26). New York: Guilford Press.

Hatkevich, C., Penner, F., & Sharp, C. (2019). Difficulties in emotion regulation and suicide ideation and attempt in adolescent inpatients. Psychiatry Research, 271, 230–238. https://doi.org/10.1016/j.psychres.2018.11.038.CrossRefPubMed

Hayes, A. F. (2015). The PROCESS macro for SPSS and SAS.

Hedley, D., Uljarević, M., Wilmot, M., Richdale, A., & Dissanayake, C. (2017). Brief report: Social support, depression and suicidal ideation in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(11), 3669–3677. https://doi.org/10.1007/s10803-017-3274-2.CrossRefPubMed

Hedley, D., Uljarević, M., Wilmot, M., Richdale, A., & Dissanayake, C. (2018). Understanding depression and thoughts of self-harm in autism: A potential mechanism involving loneliness. Research in Autism Spectrum Disorders, 46, 1–7. https://doi.org/10.1016/j.rasd.2017.11.003.CrossRef

Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P., & Bölte, S. (2016). Premature mortality in autism spectrum disorder. The British Journal of Psychiatry, 208(3), 232–238.CrossRef

Horowitz, L. M., Thurm, A., Farmer, C., Mazefsky, C., Lanzillo, E., Bridge, J. A., et al. (2018). Talking about death or suicide: Prevalence and clinical correlates in youth with autism spectrum disorder in the psychiatric inpatient setting. Journal of Autism and Developmental Disorders, 48(11), 3702–3710. https://doi.org/10.1007/s10803-017-3180-7.

Joiner, T. E. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.

Joshi, G., Wozniak, J., Fitzgerald, M., Faraone, S., Fried, R., Galdo, M., et al. (2018). High risk for severe emotional dysregulation in psychiatrically referred youth with autism spectrum disorder: A controlled study. Journal of Autism and Developmental Disorders, 48, 3101–3115. https://doi.org/10.1007/s10803-018-3542-9.

Kato, K., Mikami, K., Akama, F., Yamada, K., Maehara, M., Kimoto, K., et al. (2013). Clinical features of suicide attempts in adults with autism spectrum disorders. General Hospital Psychiatry, 35(1), 50–53. https://doi.org/10.1016/j.genhosppsych.2012.09.006.

Khor, A. S., Melvin, G. A., Reid, S. C., & Gray, K. M. (2014). Coping, daily hassles and behavior and emotional problems in adolescents with high-functioning autism/Asperger’s disorder. Journal of Autism and Developmental Disorders, 44, 593–608. https://doi.org/10.1007/s10803-013-1912-x.CrossRefPubMed

Kirby, A. V. (2019). Suicide and autism spectrum disorder: Associated health conditions. In INSAR 2019 pre-meeting on mental health, Montreal.

Kirby, A. V., Bakian, A. V., Zhang, Y., Bilder, D. A., Keeshin, B. R., & Coon, H. (2019). A 20-year study of suicide death in a statewide autism population. Autism Research, 12, 658–666. https://doi.org/10.1002/aur.2076.CrossRefPubMedPubMedCentral

Kleiman, E. M., & Liu, R. T. (2013). Social support as a protective factor in suicide: Findings from two nationally representative samples. Journal of Affective Disorders, 150(2), 540–545. https://doi.org/10.1016/j.jad.2013.01.033.CrossRefPubMedPubMedCentral

Lai, J. K. Y., Rhee, E., & Nicolas, D. (2017). Suicidality in autism spectrum disorder: A commentary. Advances in Neurodevelopmental Disorders, 1(3), 190–195. https://doi.org/10.1007/s41252-017-0018-4.CrossRef

Lee, H., Marvin, A. R., Watson, T., Piggot, J., Law, J. K., Law, P. A., et al. (2010). Accuracy of phenotyping of autistic children based on internet implemented parent report. American Journal of Medical Genetics, Part B: Neuropsychiatric Genetics, 153(6), 1119–1126. https://doi.org/10.1002/ajmg.b.31103.

Lerner, M. D., Calhoun, C. D., Mikami, A. Y., & De Los, R. A. (2012). Understanding parent–child social informant discrepancy in youth with high functioning autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(12), 2680–2692. https://doi.org/10.1007/s10803-012-1525-9.CrossRefPubMed

Lipkin, P. H., Rybczynski, S., Ryan, T., & Wilcox, H. (2019). Screening for suicide risk in children with autism and related disabilities in a pediatric autism center. Montreal: In International meeting for autism research.

Loevaas, M. E. S., Sund, A. M., Lydersen, S., Neumer, S.-P., Martinsen, K., Holen, S., et al. (2019). Does the transdiagnostic EMOTION intervention improve emotion regulation skills in children? Journal of Child and Family Studies, 28(3), 805–813. https://doi.org/10.1007/s10826-018-01324-1.

Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism Diagnostic Observation Schedule-2. Los Angeles: Western Psychological Services.

Maddox, B. B., Trubanova, A., & White, S. W. (2017). Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder. Autism, 21(4), 412–422. https://doi.org/10.1177/1362361316644731.CrossRefPubMed

Mayes, S. D., Gorman, A. A., Hillwig-Garcia, J., & Syed, E. (2013). Suicide ideation and attempts in children with autism. Research in Autism Spectrum Disorders, 7(1), 109–119. https://doi.org/10.1016/j.rasd.2012.07.009.CrossRef

Mazefsky, C. A., Yu, L., & Pilkonis, P. A. (2020). Psychometric properties of the Emotion Dysregulation Inventory in a nationally representative sample of youth. Journal of Clinical Child and Adolescent Psychiatry. https://doi.org/10.1080/15374416.2019.1703710CrossRef

Mazefsky, C. A., Kao, J., & Oswald, D. P. (2011). Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 164–174. https://doi.org/10.1016/j.rasd.2010.03.006.CrossRefPubMedPubMedCentral

Mazefsky, C. A., Borue, X., Day, T. N., & Minshew, N. J. (2014). Emotion regulation patterns in adolescents with high functioning autism spectrum disorder: Comparison to typically developing adolescents and association with psychiatric symptoms. Autism Research, 7(3), 344–354. https://doi.org/10.1002/aur.1366.CrossRefPubMedPubMedCentral

Mazefsky, C. A., Day, T. N., Siegel, M., White, S. W., Yu, L., & Pilkonis, P. A. (2018a). Development of the Emotion Dysregulation Inventory: A PROMIS®ing method for creating sensitive and unbiased questionnaires for autism spectrum disorder. Journal of Autism and Developmental Disorders, 48(11), 3736–3746. https://doi.org/10.1007/s10803-016-2907-1.CrossRefPubMedPubMedCentral

Mazefsky, C. A., Yu, L., White, S. W., Siegel, M., & Pilkonis, P. A. (2018b). The Emotion Dysregulation Inventory: Psychometric properties and Item Response Theory calibration in an autism spectrum disorder sample. Autism Research, 11(6), 928–941. https://doi.org/10.1002/aur.1947.CrossRefPubMedPubMedCentral

McCauley, E., Gudmundsen, G., Scholredt, K., Martell, C., Rhew, I., Hubley, S., et al. (2016). The adolescent behavioral activation program: Adapting behavioral activation as a treatment for depression in adolescence. Journal of Clinical Child and Adolescent Psychology, 45(3), 291–304. https://doi.org/10.1080/15374416.2014.979933.CrossRefPubMed

McMakin, D. L., Siegle, G. J., & Shirk, S. R. (2011). Positive Affect Stimulation and Sustainment (PASS) module for depressed mood: A preliminary investigation of treatment-related effects. Cognitive Therapy and Research, 35(3), 217–226. https://doi.org/10.1007/s10608-010-9311-5.CrossRefPubMedPubMedCentral

Miller, A. B., McLaughlin, K. A., Busso, D. S., Brueck, S., Peverill, M., & Sheridan, M. A. (2018). Neural correlates of emotion regulation and adolescent suicidal ideation. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 3(2), 125–132. https://doi.org/10.1016/j.bpsc.CrossRef

Nock, M. K., & Mendes, W. B. (2008). Physiological arousal, distress tolerance, and social problem-solving deficits among adolescent self-injurers. Journal of Consulting and Clinical Psychology, 76(1), 28–38. https://doi.org/10.1037/0022-006X.76.1.28.CrossRefPubMed

Nock, M. K., Hwang, I., Sampson, N. A., & Kessler, R. C. (2010). Mental disorders, comorbidity and suicidal behavior: Results from the National Comorbidity Survey Replication. Molecular Psychiatry, 15(8), 868–876. https://doi.org/10.1038/mp.2009.29.CrossRefPubMed

Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., et al. (2013). Prevalence, correlates and treatment of lifetime suicidal behavior among adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). JAMA Psychiatry, 70(3), 1–24. https://doi.org/10.1001/2013.jamapsychiatry.55.CrossRef

O’Connor, R. C. (2011). The integrated motivational–volitional model of suicidal behavior. Crisis, 32(6), 295–298. https://doi.org/10.1027/0227-5910/a000120.CrossRefPubMed

O’Connor, R. C., & Nock, M. K. (2014). The psychology of suicidal behaviour. The Lancet Psychiatry, 1(1), 73–85. https://doi.org/10.1016/S2215-0366(14)70222-6.CrossRefPubMed

Raja, M., Azzoni, A., & Frustaci, A. (2011). Autism spectrum disorders and suicidality. Clinical Practice and Epidemiology in Mental Health, 7(1), 97–105. https://doi.org/10.2174/1745017901107010097.CrossRefPubMedPubMedCentral

Richa, S., Fahed, M., Khoury, E., & Mishara, B. (2014). Suicide in autism spectrum disorders. Archives of Suicide Research, 18(4), 327–339. https://doi.org/10.1080/13811118.2013.824834.CrossRefPubMed

Rutter, M., Bailey, A., & Lord, C. (2003). The Social Communication Questionnaire. Los Angeles: Western Psychological Services.

Samson, A. C., & Antonelli, Y. (2013). Humor as character strength and its relation to life satisfaction and happiness in Autism spectrum disorders. Humor, 26(3), 477–491. https://doi.org/10.1515/humor-2013-0031.CrossRef

Samson, A. C., Huber, O., & Ruch, W. (2013). Seven decades after Hans Asperger’s observations: A comprehensive study of humor in individuals with Autism Spectrum Disorders. Humor, 26(3), 441–460. https://doi.org/10.1515/humor-2013-0026.CrossRef

Samson, A. C., Hardan, A. Y., Lee, I. A., Phillips, J. M., & Gross, J. J. (2015). Maladaptive behavior in autism spectrum disorder: The role of emotion experience and emotion regulation. Journal of Autism and Developmental Disorders, 45(11), 3424–3432. https://doi.org/10.1007/s10803-015-2388-7.CrossRefPubMed

Segers, M., & Rawana, J. (2014). What do we know about suicidality in autism spectrum disorders? A systematic review. Autism Research, 7(4), 507–521. https://doi.org/10.1002/aur.1375.CrossRefPubMed

Shaffer, R. C., Wink, L. K., Ruberg, J., Pittenger, A., Adams, R., Sorter, M., et al. (2019). Emotion regulation intensive outpatient programming: Development, feasibility, and acceptability. Journal of Autism and Developmental Disorders, 49(2), 495–508. https://doi.org/10.1007/s10803-018-3727-2.

Siegel, M., Doyle, K., Chemelski, B., Payne, D., Ellsworth, B., Harmon, J., et al. (2012). Specialized inpatient psychiatry units for children with autism and developmental disorders: A United States survey. Journal of Autism and Developmental Disorders, 42(9), 1863–1869. https://doi.org/10.1007/s10803-011-1426-3.

Siegel, M., Smith, K. A., Mazefsky, C., Gabriels, R. L., Erickson, C., Kaplan, D., et al. (2015). The autism inpatient collection: Methods and preliminary sample description. Molecular Autism, 6(61), 1–10. https://doi.org/10.1186/s13229-015-0054-8.

Stone, D. M., Simon, T. R., Fowler, K. A., Kegler, S. R., Yuan, K., Holland, K. M., et al. (2018). Vital signs: Trends in state suicide rates—United States, 1999–2016 and circumstances contributing to suicide—27 States, 2015. Morbidity and Mortality Weekly Report, 67(22), 617–624. https://doi.org/10.15585/mmwr.mm6722a1.

Storch, E. A., Sulkowski, M. L., Nadeau, J., Lewin, A. B., Arnold, E. B., Mutch, P. J., et al. (2013). The phenomenology and clinical correlates of suicidal thoughts and behaviors in youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(10), 2450–2459. https://doi.org/10.1007/s10803-013-1795-x.

Stratis, E. A., & Lecavalier, L. (2017). Predictors of parent–teacher agreement in youth with autism spectrum disorder and their typically developing siblings. Journal of Autism and Developmental Disorders, 47(8), 2575–2585. https://doi.org/10.1007/s10803-017-3173-6.CrossRefPubMed

Van Eck, K., Ballard, E., Hart, S., Newcomer, A., Musci, R., & Flory, K. (2015). ADHD and suicidal ideation: The roles of emotion regulation and depressive symptoms among college students. Journal of Attention Disorders, 19(8), 703–714. https://doi.org/10.1177/1087054713518238.CrossRefPubMed

Volkaert, B., Wante, L., Vervoort, L., & Braet, C. (2018). ‘Boost Camp’, a universal school-based transdiagnostic prevention program targeting adolescent emotion regulation; evaluating the effectiveness by a clustered RCT: A protocol paper. BMC Public Health, 18(1), 1–14.CrossRef

Weiner, L., Flin, A., Causin, J., Weibel, S., & Bertschy, G. (2019). A case study of suicidality presenting as a restricted interest in autism spectrum disorder. BMC Psychiatry, 19(126), 1–5. https://doi.org/10.1186/s12888-019-2122-7.CrossRef

Weiss, J. A. (2014). Transdiagnostic case conceptualization of emotional problems in youth with ASD: An emotion regulation approach. Clinical Psychology: Science and Practice, 21, 331–350.

Weiss, J. A., Thomson, K., Burnham Riosa, P., Albaum, C., Chan, V., Maughan, A., et al. (2018). A randomized waitlist-controlled trial of cognitive behavior therapy to improve emotion regulation in children with autism. Journal of Child Psychology and Psychiatry, 59(11), 1180–1191. https://doi.org/10.1111/jcpp.12915.

Williams, J. M. G., & Williams, M. (1997). Cry of pain: Understanding suicide and self-harm. New York: Penguin Group.

Titel: A Comparative Study of Suicidality and Its Association with Emotion Regulation Impairment in Large ASD and US Census-Matched Samples
Auteurs: Caitlin M. Conner
Josh Golt
Giulia Righi
Rebecca Shaffer
Matthew Siegel
Carla A. Mazefsky
Publicatiedatum: 14-01-2020
Uitgeverij: Springer US
Gepubliceerd in: Journal of Autism and Developmental Disorders / Uitgave 10/2020
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI: https://doi.org/10.1007/s10803-020-04370-1

Andere artikelen Uitgave 10/2020

Comparing the Pragmatic Speech Profiles of Minimally Verbal and Verbally Fluent Individuals with Autism Spectrum Disorder

Original Paper

Comment on “Association Between DCC Polymorphisms and Susceptibility to Autism Spectrum Disorder”

Letter to the Editor

Chinese Validation of the Multidimensional Attitude Scale toward Persons with Disabilities (MAS): Attitudes toward Autism Spectrum Disorders

Original Paper

Suicidal Ideation and Self-inflicted Injury in Medicare Enrolled Autistic Adults With and Without Co-occurring Intellectual Disability

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

S.I. : Suicidality and Self-harm in Autism

Prevalence and Risk-Markers of Self-Harm in Autistic Children and Adults

Open Access
S.I. : Suicidality and Self-harm in Autism