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Molecular Autism
Published in: Molecular Autism 1/2022

Open Access 01-12-2022 | Suicide | Research

The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults

Authors: R. L. Moseley, N. J. Gregory, P. Smith, C. Allison, S. Cassidy, S. Baron-Cohen

Published in: Molecular Autism | Issue 1/2022

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Abstract

Background

While there are known risk factors for suicidality in autistic adults, these are often unconnected from theoretical frameworks that might explain why risk is elevated and guide clinical interventions. The present study investigated the relevance of constructs from the Interpersonal Theory of Suicide (ITS), including perceived burdensomeness, thwarted belongingness and acquired capability for suicide, and explored mechanisms through which certain risk factors (relationship status, age at diagnosis) might elevate suicide risk.

Methods

Autistic adults (n = 314) completed an online study including measures of depression, anxiety and constructs from the ITS. Linear and multinomial regression analysis disentangled contributions of ITS variables from effects of depression and anxiety for past-year suicide ideation, past-year and lifetime suicide attempts. Mediation analyses examined associations between risk factors and these suicide outcomes via mechanisms proposed by the ITS.

Results

Past-year suicide ideation was associated with burdensomeness, mental rehearsal of suicide plans (a facet of acquired capability), and depression. Greater feelings of burdensomeness, and reduced fear of death, marked out participants who had attempted suicide in comparison to those who had experienced suicide ideation in the past year. Relationship status was indirectly associated with past-year suicide ideation via the mediators of depression and burdensomeness, and was associated with past-year attempts via its effect on ideation. Age at diagnosis was unrelated to any variables.

Limitations

Cross-sectional research is insensitive to causality and temporal dynamics, which is likely why interaction hypotheses from the ITS were unsupported. Normative measures may be invalid in autistic samples. There was no control group. The autistic sample was unrepresentative of the whole population, particularly autistic people with intellectual disabilities, ethnic/racial minorities, and gender minorities.

Conclusions

Perceived burdensomeness and acquired capability appear potentially important to suicide in autistic people, and may mediate the effects of some risk factors. Future research should explore the temporal dynamics of suicide trajectories in longitudinal, prospective designs.
Appendix
Available only for authorised users
Footnotes
1
Bereaved individuals (n = 4) might be considered to constitute quite a different psychological profile than those who were divorced or separated, but were included in the ‘single’ category for simplicity. Analyses were checked without these individuals: the results did not change significantly.
 
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Metadata
Title
The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults
Authors
R. L. Moseley
N. J. Gregory
P. Smith
C. Allison
S. Cassidy
S. Baron-Cohen
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Molecular Autism / Issue 1/2022
Electronic ISSN: 2040-2392
DOI
https://doi.org/10.1186/s13229-022-00495-5

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