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

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). …