Summary: A new study finds that children with social communication difficulties face a higher risk of suicidal thoughts, plans, and self-harm with suicidal intent by age 16 compared with peers without those difficulties.
Source: Elsevier.
Children who struggle with social communication have an elevated risk of self-harm with suicidal intent by age 16, according to a study published in the May 2018 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). The research examined whether characteristics associated with autism spectrum disorders in childhood are linked to suicidal thoughts, plans, and self-harm in later adolescence.
Autism spectrum disorders (ASD) commonly include challenges with social communication. Emerging evidence indicates that suicidality may be under-recognized among autistic individuals, but community-based research measuring suicidal thoughts and behaviors in young people with autistic traits has been limited. In particular, there has been a need to understand whether co-occurring mental health issues—such as adolescent depression—help explain any increased risk.
To address these questions, researchers analyzed data from 5,031 adolescents participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). They looked for associations between four autism-like traits measured in childhood—social communication, pragmatic language, sociability, and repetitive behavior—and the risk of suicidal and non-suicidal self-harm, suicidal thoughts, and suicide plans by age 16. The study also evaluated whether depressive symptoms measured at age 12 contributed to any observed links.
“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 at the Bristol Medical School (PHS). “Depressive symptoms in early adolescence partially explain this association.”
Key findings from the study include higher risks for adolescents who displayed impaired social communication in childhood. Compared with youth without social communication difficulties, those with impairment had greater 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
- Suicide plans (RR = 1.95; 95% CI = 1.09–3.47).
The study did not find clear evidence linking an actual clinical diagnosis of ASD with suicidal outcomes, but these analyses were less precise because relatively few participants had a formal diagnosis. Likewise, other measured autism traits (pragmatic language, sociability, repetitive behavior) were not associated with suicidal outcomes in this sample.
Importantly, the researchers estimated that roughly one third (about 32%) of the association between childhood social communication difficulties and self-harm by age 16 could be explained by depressive symptoms at age 12. This suggests that early adolescent depression is a meaningful, though partial, mediator of later suicidal behavior in this group.
Dr. Culpin emphasized the clinical implications: early detection of social communication challenges and timely assessment for depression could help identify young people at elevated risk. “Early identification and management of depression may be a preventative mechanism,” she noted, adding that future research should seek other modifiable factors that could inform targeted interventions to reduce suicidal behavior among autistic or autism-trait populations.
Source: Elsevier.
Publisher: Organized by NeuroscienceNews.com.
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Original Research: Open access research titled “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, published in the Journal of the American Academy of Child and Adolescent Psychiatry on March 14, 2018.
doi: 10.1016/j.jaac.2018.01.023
MLA: Elsevier. “Communication Difficulties Linked to Increased Risk of Self Harm and Suicidal Behavior.” NeuroscienceNews. NeuroscienceNews, 1 May 2018.
APA: Elsevier (2018, May 1). Communication Difficulties Linked to Increased Risk of Self Harm and Suicidal Behavior. NeuroscienceNews. Retrieved May 1, 2018.
Chicago: Elsevier. “Communication Difficulties Linked to Increased Risk of Self Harm and Suicidal Behavior.” NeuroscienceNews. (accessed May 1, 2018).
Abstract
Autistic Traits and Suicidal Thoughts, Plans, and Self-Harm in Late Adolescence: Population-Based Cohort Study
Objective
This study tested the hypothesis that an autism spectrum disorder diagnosis and specific autistic traits in childhood are associated with suicidal thoughts, plans, and self-harm at age 16, and that depressive symptoms at age 12 explain any observed associations.
Method
Researchers examined associations between ASD diagnosis and four dichotomized ASD traits—social communication, pragmatic language, repetitive behavior, and sociability—and outcomes at 16 years (suicidal and nonsuicidal self-harm, suicidal thoughts, and suicide plans) in 5,031 members of the UK birth cohort ALSPAC. Depressive symptoms at 12 years were measured with the Short Moods and Feelings Questionnaire to assess mediation.
Results
Impaired social communication in childhood was associated with higher risks of self-harm with suicidal intent (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, compared with peers without social communication difficulties. Analyses examining diagnosed ASD were imprecise due to small numbers and did not show clear associations. Other autistic traits showed no evidence of association with the outcomes. Approximately 32% of the link between social communication impairment and self-harm was explained by depressive symptoms at 12 years.
Conclusion
Social communication impairment appears to be a key autistic trait related to suicidality in adolescence. Early detection and treatment of depression may reduce this risk, and additional studies should identify other potentially modifiable mechanisms to guide preventive interventions for affected young people.