Transcript Slide 1

ABSTRACT
Suicide is a major public health problem in the United
States. Despite research indicating high rates of
depression in autism spectrum disorders (ASD), little is
known about suicidality in this population. A systematic
literature review was conducted to provide a more
thorough understanding of suicidality in ASD from
childhood through adulthood. The purpose of the review
was to provide information about the current state of
evidence on the topic, and to identify key areas for future
research. Results indicated that the evidence base is
small, but that individuals with ASD are at a higher risk for
suicidality than those without ASD and suicidal ideation is
more common in individuals with ASD than are suicide
attempts. Adolescents and young adults are at greatest
risk for suicidality in comparison to children and older
adults, and high functioning individuals with ASD are at a
higher risk for suicidality than lower functioning individuals.
Finally, bullying and relationship difficulties were significant
triggers for both suicidal ideation and suicide attempts in
some studies.
INTRODUCTION
Individuals with autism spectrum disorder (ASD) have
impairments in social communication/interactions and
repetitive/restricted behavior. However, co-occurring
cognitive and psychiatric difficulties are also common.
Many of these co-occurring problems are specific risk
factors for suicidality in the general population. These
include:
•Depression
•Executive functioning & problem-solving difficulties
•Impulsivity
•Behavioral problems/aggression
•Mood dysregulation
Thus, individuals with ASD may be at particular risk
for suicidal ideation (SI) and suicide attempts (SA).
METHOD
A systematic review of the literature was conducted using
pre-defined search procedures and inclusion/exclusion
criteria. Only 20 studies met inclusion criteria, and only 5
studies specifically addressed ASD and suicide. Based on
available evidence, some preliminary findings emerged.
ASD and Suicidality Across the Lifespan
Valerie M. Vorderstrasse, PsyD & Micah O. Mazurek, PhD
University of Missouri
CONCLUSIONS
RESULTS
Studies Addressing Suicidality in Individuals with ASD
Author (year)
Kato et al.
(2012)
Mayes et al.
(2013)
Ages
Prevalence
Associated Factors
21-45 Sample (n=587)
•7% had ASD
Hospitalized for SA
Method: Chart review
•Male
•Early adulthood
•Living alone
•Impulsivity
•Relationship difficulties
1-16
Method
Sample
ASD (n=791)
TD (n=186)
Depression (n=35)
Method:
Parent report
Mikami et al. 14-19 Sample (n=94)
(2009)
Hospitalized for SA
Method:
Chart review
Raja et al.
(2011)
21-39 Sample (n=26)
Psychiatric patients
with ASD
Method:
Chart review
Shtayermann 16-22 Sample (n=10)
(2007)
Youth with ASD
Method:
Self-report
questionnaires
•14% of ASD
Group had
SI/SA
•0.5% of TD
Group had
SI/SA
•Adolescence
•Behavioral problems
•Mood dysregulation
•Relationship difficulties
•Bullying
•12.8% had
ASD
•Male
•Lack of social support
•Restricted thinking
•Relationship difficulties
•Bullying
•31% had SI
•3.8% had SA
•7.6% suicide
•Male
•Early adulthood
•Psychosis
•Isolation
•Social failures
•50% had SI
•Higher IQ
•Early adulthood
•Depression
•Bullying
Summary of findings:
• Individuals with ASD are at risk for suicidality.
• Suicidal ideation is more common than suicide
attempts.
• Adolescents and young adults are at greatest
risk for suicidality
• High functioning individuals with ASD are at a
higher risk for suicidality than lower functioning
individuals.
• Bullying and relationship difficulties are
significant triggers for suicidal ideation and
attempts.
Implications for practice:
There is a clear need for:
• Regular screening for suicidality in individuals
with ASD
• Bullying prevention efforts
• Preparing youth with ASD for life transitions
Future Research:
• Large-scale longitudinal studies are needed to
further examine prevalence and predictors of
suicidality in individuals with ASD
• More research is needed to better understand
how to assess, prevent, and treat suicidality in
ASD.
• ASD-specific measures are needed to assess
suicidality
SELECTED REFERENCES
Kato, K., Katsunaka, M., Akama, F., Yamada, K., Maehara, M., Kimoto, K. et al.
(2012). Clinical features of suicide attempts in adults with autism spectrum
disorders. General Hospital Psychiatry, 1-4.
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, 109-119.
Mikami, K., Inomata, S., Hayakawa, N., Ohnishi, Y., Enseki, Y., Akitoshi, O. et
al. (2009). Frequency and clinical features of pervasive developmental disorder in
adolescent suicide attempts. General Hospital Psychiatry, 31, 163-166.
Raja, M., Azzoni, A., & Frustaci, A. (2011). AUTISM spectrum disorders and
suicidality. Clinical Practice and Epidemiology in Mental Health, 7, 97-105.
Shtayermman, O. (2007). Peer victimization in adolescents and young adults
diagnosed with Asperger’s syndrome: A link to depressive symptomatology,
anxiety symptomatology, and suicidal ideation. Issues in Comprehensive Pediatric
Nursing, 30, 87-107.