Summary: A new study reports children who have difficulties with social communication have an increased risk of sucidiality and self harm behaviors by the age of 16 than those who do not face such difficulties.
Children who have difficulties with social communication have a higher risk of self-harm with suicidal intent by the age of 16 years compared to those without, reports a new study published in the May 2018 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). The study was designed to understand whether characteristics of Autism Spectrum Disorders in childhood are linked with suicidal thoughts, plans and self-harm at 16 years.
Children with autism spectrum disorders often have difficulties in social communication and recent research suggests that suicidality is under-recognized in this population. However, until now, community-based studies on suicidal thoughts and behaviors among children with symptoms of Autism have been limited. Factors that could explain the risk of suicide in this population, such as depression, have also not been studied.
Researchers analysed data on 5,031 adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC), to assess whether there were any associations between Autism-like traits (social communication, pragmatic language, sociability, repetitive behavior) and the risk of suicidal self-harm, and suicidal thoughts and plans by the age of 16 years. Depression in early adolescence at 12 years of age was considered as a possible explanatory mechanism.
“Our study suggests that children who have difficulties with social communication are at higher risk for suicidal ideation and behavior in late adolescence,” said Dr. Iryna Culpin, Senior Research Associate in the Bristol Medical School (PHS). “Depressive symptoms in early adolescence partially explain this association.
The researchers found that children with difficulties in social communication had a higher risk of suicidal self-harm, suicidal thoughts and suicide plans by the age of 16 years as compared to those without such difficulties. There was no evidence for an association between a diagnosis of Autism Spectrum Disorders and suicidal behaviors, but the sample was not large enough to definitively rule out such an association.
The team found that approximately a third of the association between social communication difficulties and suicidal self-harm was explained by depression in early adolescence.
“Future studies should focus on identifying other changeable mechanisms to develop preventative interventions for autistic people,” Dr. Culpin concluded.
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Original Research: Open access research for “Autistic Traits and Suicidal Thoughts, Plans, and Self-Harm in Late Adolescence: Population-Based Cohort Study” by Iryna Culpin, PhD, Becky Mars, PhD, Rebecca M. Pearson, PhD, Jean Golding, DSc, Jon Heron, PhD, Isidora Bubak, MD, Peter Carpenter, FRCPsych, Cecilia Magnusson, PhD, David Gunnell, DSc, and Dheeraj Rai, PhD in Journal of the American Academy of Child and Adolescent Psychiatry. Published March 14 2018.
Autistic Traits and Suicidal Thoughts, Plans, and Self-Harm in Late Adolescence: Population-Based Cohort Study
To examine the hypothesis that autism spectrum disorders (ASD) diagnosis and traits in childhood are associated with suicidal thoughts, plans and self-harm at 16 years, and that any observed associations are explained by depression at 12 years.
We examined associations between ASD diagnosis and 4 dichotomized ASD traits (social communication, pragmatic language, repetitive behavior, and sociability) with suicidal and nonsuicidal self-harm, suicidal thoughts, and suicidal plans at age 16 years in 5,031 members of the United Kingdom−based birth cohort study the Avon Longitudinal Study of Parents and Children. We assessed whether any associations were explained by depressive symptoms in early adolescence measured by the Short Moods and Feelings Questionnaire at 12 years.
Children with impaired social communication had a higher risk of self-harm with suicidal intent (relative risk [RR] = 2.14, 95% CI = 1.28–3.58), suicidal thoughts (RR = 1.42, 95% CI = 1.06–1.91), and suicidal plans (RR = 1.95, 95% CI = 1.09–3.47) by age 16 years as compared to those without. There was no evidence for an association between ASD diagnosis and outcomes, although these analyses were imprecise because of small numbers. There was also no evidence of an association between other autism traits and the outcomes. Approximately 32% of the total estimated association between social communication impairment and self-harm was explained by depressive symptoms at 12 years.
Social communication impairments are an important autistic trait in relation to suicidality. Early identification and management of depression may be a preventative mechanism, and future research identifying other potentially modifiable mechanisms may lead to interventions against suicidal behavior in this high-risk group.