Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder
Abstract
Recent studies have examined non-suicidal self-injury in community and clinical samples, but there is no published research on non-suicidal self-injury in individuals with autism spectrum disorder. This lack of research is surprising, since individuals with autism spectrum disorder have high rates of risk factors for non-suicidal self-injury, including depression and poor emotion regulation skills. Using an online survey, we examined non-suicidal self-injury methods, frequency, severity, functions, and initial motivations in adults with autism spectrum disorder ( n = 42). We also compared their non-suicidal self-injury characteristics to those of a gender-matched group of adults without autism spectrum disorder ( n = 42). Of the participants with autism spectrum disorder, 50% reported a history of non-suicidal self-injury. This proportion is higher than non-suicidal self-injury rates previously reported for college students, adult community samples, and adolescents with autism spectrum disorder, which suggests that adults with autism spectrum disorder have increased risk for engaging in non-suicidal self-injury. Women with autism spectrum disorder were significantly more likely to endorse non-suicidal self-injury, relative to men with autism spectrum disorder. A history of non-suicidal self-injury was not related to current depression or emotion dysregulation for the participants with autism spectrum disorder. Non-suicidal self-injury characteristics among the adults with autism spectrum disorder were similar to non-suicidal self-injury in adults without autism spectrum disorder. These preliminary findings highlight the need for increased awareness and further research about non-suicidal self-injury within autism spectrum disorder.
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Maddox et al. found 50% of their autistic sample (n = 42) had engaged in at least one act of NSSI, indicating increased prevalence of NSSI in autistic compared with typically developing populations.
“Crucially, it highlighted the increased prevalence of NSSI in autistic as compared with typically developing populations, with 50% of the autistic sample (n = 42) having engaged in at least one act of NSSI—an inflated prevalence that motivates further study of NSSI in a larger sample of these individuals within the autism spectrum.”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [15]
Maddox et al. found no significant differences in age, depression or emotion dysregulation between autistic self-harmers and autistic non-self-harmers, but a higher proportion of autistic women than autistic men engaged in NSSI.
“These authors also compared autistic self-harmers to autistic people who did not engage in NSSI: they found no significant differences in age, depression or emotion dysregulation, but a higher proportion of autistic women than autistic men engaged in NSSI.”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [15]
Maddox et al. found no significant differences in depression and emotion dysregulation between autistic self-harmers and autistic non-self-harmers and suggested these factors are not associated with increased risk of self-injury.
“They found no significant differences between groups and so suggest that these factors are not associated with increased risk of self-injury.”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [15]
Maddox et al. delineated a different type of NSSI in autistic people without intellectual disability, resembling that seen in neurotypical populations.
“Maddox et al. [15] were recently the first to delineate a different type of NSSI, one resembling that seen in neurotypical populations, in autistic people without intellectual disability (all of whom had completed high school, the majority of whom had college qualifications).”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [15]
Maddox et al. found more similarities than differences between autistic and non-autistic self-harmers; both began self-injuring in early adolescence and did not differ in the specific NSSI they engaged in.
“They found more similarities than differences between their small groups of autistic and non-autistic (typically developing) self-harmers; both began self-injuring in early adolescence and did not differ in the specific NSSI they engaged in.”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [15]
Maddox et al. found autistic participants were more likely than non-autistic self-harmers to engage in NSSI for shocking or hurting others, in imitation of peers, or for avoiding a suicide attempt.
“The only suggested differences were that autistic participants were more likely than non-autistic self-harmers to engage in NSSI for the purpose of shocking or hurting others, in imitation of peers, or for the purpose of avoiding a suicide attempt.”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [15]
BDI and BAI scores reflect current psychological health within the last fortnight and month respectively, so results using them must be interpreted with caution.
“(We included measures of anxiety and depression in this analysis to specifically test the assertion that autistic self-harmers and non-self-harmers do not differ significantly in depression [15], but results must be interpreted with caution as these measures reflect current psychological health within the last fortnight and month respectively.”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [15]
Only one study has ever explored NSSI in a small sample of autistic adults using a validated instrument but did not explore associations with suicidality.
“However, to our knowledge, only one study has ever explored NSSI in a small sample of autistic adults using a validated instrument but did not explore associations with suicidality [10].”
From Risk markers for suicidality in autistic adults (2018) · cites this paper as [10]
The rate of NSSI in ASC was elevated (50%) compared to college students (17%) and adult community samples (23%), but the phenomenology of NSSI was broadly similar between those with and without ASC.
“The rate of NSSI in ASC was elevated (50%) compared to college students (17%) and adult community samples (23%), but the phenomenology of NSSI was broadly similar between those with and without ASC [10].”
From Risk markers for suicidality in autistic adults (2018) · cites this paper as [10]
NSSI could be more prevalent in ASC than in the general population, and could potentially be a previously unexplored common risk factor for suicidality in ASC and the general population.
“Importantly, this suggests that NSSI could be more prevalent in ASC than that in the general population, and could potentially be a previously unexplored common risk factor for suicidality in ASC and the general population.”
From Risk markers for suicidality in autistic adults (2018) · cites this paper as [10]
The current study is the first to use measures of suicidality (SBQ-R) and NSSI (NSSI-AT) that have good evidence of validity, albeit not yet in autistic adults.
“This study is the first to use measures of suicidality (SBQ-R) and NSSI (NSSI-AT) that have good evidence of validity, albeit not yet in autistic adults [7, 10].”
From Risk markers for suicidality in autistic adults (2018) · cites this paper as [10]
The rate of NSSI in the ASC group (63.6%) was significantly higher than in the general population group (29.8%).
“The rate of NSSI in the ASC group (63.6%) was significantly higher than the general population group (29.8%), and similar to the rate reported in previous research [10] (50%), which also utilised the NSSI-AT in autistic adults.”
From Risk markers for suicidality in autistic adults (2018) · cites this paper as [10]
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802 · see citing works
Gratz, K. L., & Roemer, L. (2004) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/b:joba.0000007455.08539.94 · Cited by 8,942 · cited 2× · see citing works
“A 36-item scale that measures a person’s typical emotion dysregulation, the Difficulties in Emotion Regulation Scale (DERS) has been used in college samples, clinical samples, and in treatment outcome research (Gratz and Roemer, 2004).”
MethodThe functions of deliberate self-injury: a review of the evidence
Klonsky, E. D. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.08.002 · Cited by 1,979 · see citing works
Swannell, S. V., Martin, G. E., Page, A., Hasking, P., & St John, N. J. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12070 · Cited by 1,624 · see citing works
Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts
NOCK, M., JOINERJR, T., GORDON, K., LLOYDRICHARDSON, E., & PRINSTEIN, M. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2006.05.010 · Cited by 1,617 · see citing works
A Functional Approach to the Assessment of Self-Mutilative Behavior.
Nock, M. K., & Prinstein, M. J. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.5.885 · Cited by 1,564 · see citing works
Nock, M. K. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.121208.131258 · Cited by 1,550 · see citing works
Why Do People Hurt Themselves?
Nock, M. K. (2009) · Current Directions in Psychological Science · doi:10.1111/j.1467-8721.2009.01613.x · Cited by 1,245 · see citing works
The health status of adults on the autism spectrum
Croen, L. A., Zerbo, O., Qian, Y., Massolo, M. L., Rich, S., Sidney, S., & Kripke, C. (2015) · Autism · doi:10.1177/1362361315577517 · Cited by 1,110 · see citing works
Premature mortality in autism spectrum disorder
Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P., & Bölte, S. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.160192 · Cited by 1,011 · see citing works
Self-injurious behaviors in a college population
Whitlock, J., Eckenrode, J., & Silverman, D. (2006) · PEDIATRICS · doi:10.1542/peds.2005-2543 · Cited by 874 · see citing works
Lam, K. S. L., & Aman, M. G. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0213-z · Cited by 793 · see citing works
Klonsky, E. D. (2011) · Psychological Medicine · doi:10.1017/s0033291710002497 · Cited by 753 · see citing works
Mandy, W., Chilvers, R., Chowdhury, U., Salter, G., Seigal, A., & Skuse, D. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1356-0 · Cited by 715 · see citing works
The Coming of Age of Self-Mutilation
Favazza, A. R. (1998) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199805000-00001 · Cited by 712 · see citing works
Jacobson, C. M., & Gould, M. S. (2007) · Archives of Suicide Research · doi:10.1080/13811110701247602 · Cited by 694 · see citing works
Annotation: Repetitive Behaviour in Autism: A Review of Psychological Research
Turner, M. (1999) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00502 · Cited by 688 · see citing works
McClintock, K., Hall, S., & Oliver, C. (2003) · Journal of Intellectual Disability Research · doi:10.1046/j.1365-2788.2003.00517.x · Cited by 675 · see citing works
Asarnow, J. R., Porta, G., Spirito, A., Emslie, G., Clarke, G., Wagner, K. D., Vitiello, B., Keller, M., Birmaher, B., McCracken, J., et al. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.04.003 · Cited by 632 · see citing works
Halladay, A. K., Bishop, S. L., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., Messinger, D. S., Pelphrey, K. A., Sanders, S., Singer, A., et al. (2015) · Molecular Autism · doi:10.1186/s13229-015-0019-y · Cited by 582 · see citing works
Lecavalier, L. (2006) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0147-5 · Cited by 569 · see citing works
Nonsuicidal Self-injury in a College Population: General Trends and Sex Differences
Whitlock, J. L., Muehlenkamp, J. J., Purington, A., Eckenrode, J. J., Barreira, P. J., Abrams, G. B., Marchell, T. C., Kress, V. E. W., Girard, K., Chin, C., et al. (2011) · Journal of American College Health · doi:10.1080/07448481.2010.529626 · Cited by 434 · see citing works
Cassidy, S., Bradley, P., Robinson, J., Allison, C., McHugh, M., & Baron-Cohen, S. (2014) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)70248-2 · Cited by 432 · cited 1× · see citing works
“Although there has been recent attention to increased rates of suicidal ideation and attempts in adults with ASD (e.g. Cassidy et al., 2014; Croen et al., 2015), no published reports on NSSI in this population could be found.”
BackgroundRepetitive Behavior Profiles in Asperger Syndrome and High-Functioning Autism
South, M., Ozonoff, S., & McMahon, W. M. (2005) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-004-1992-8 · Cited by 423 · see citing works
Klonsky, E. D. (2009) · Psychiatry Research · doi:10.1016/j.psychres.2008.02.008 · Cited by 404 · see citing works
Age-Related Differences in Restricted Repetitive Behaviors in Autism Spectrum Disorders
Esbensen, A. J., Seltzer, M. M., Lam, K. S. L., & Bodfish, J. W. (2008) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-008-0599-x · Cited by 373 · see citing works
Gratz, K. L., & Roemer, L. (2008) · Cognitive Behaviour Therapy · doi:10.1080/16506070701819524 · Cited by 366 · cited 1× · see citing works
“The lack of a relationship between NSSI and depression symptoms or emotion regulation difficulties in the ASD group is inconsistent with the general NSSI literature (Gratz and Roemer, 2008; Wilcox et al., 2012).”
ResultHartley, S. L., & Sikora, D. M. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0810-8 · Cited by 355 · see citing works
Emotion dysregulation and the Core features of autism Spectrum disorder
Samson, A. C., Phillips, J. M., Parker, K. J., Shah, S., Gross, J. J., & Hardan, A. Y. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-2022-5 · Cited by 338 · see citing works
Nonsuicidal Self-Injury Disorder: An Empirical Investigation in Adolescent Psychiatric Patients
Glenn, C. R., & Klonsky, E. D. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.794699 · Cited by 337 · see citing works
Autism Symptoms and Internalizing Psychopathology in Girls and Boys with Autism Spectrum Disorders
Solomon, M., Miller, M., Taylor, S. L., Hinshaw, S. P., & Carter, C. S. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1215-z · Cited by 326 · see citing works
Mazefsky, C. A., & White, S. W. (2014) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2013.07.002 · Cited by 323 · see citing works
Self-citationRisk factors for self‐injurious behaviours among 222 young children with autistic disorders
Baghdadli, A., Pascal, C., Grisi, S., & Aussilloux, C. (2003) · Journal of Intellectual Disability Research · doi:10.1046/j.1365-2788.2003.00507.x · Cited by 307 · see citing works
Adrian, M., Zeman, J., Erdley, C., Lisa, L., & Sim, L. (2011) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-010-9465-3 · Cited by 301 · see citing works
Prospective Prediction of Nonsuicidal Self-Injury: A 1-Year Longitudinal Study in Young Adults
Glenn, C. R., & Klonsky, E. D. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.04.005 · Cited by 211 · see citing works
Longitudinal predictors of past-year non-suicidal self-injury and motives among college students
Wilcox, H. C., Arria, A. M., Caldeira, K. M., Vincent, K. B., Pinchevsky, G. M., & O’Grady, K. E. (2011) · Psychological Medicine · doi:10.1017/s0033291711001814 · Cited by 201 · see citing works
Duerden, E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari, P., & Roberts, S. W. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1497-9 · Cited by 198 · see citing works
Special Feature the Inner Experience of the Borderline Self-Mutilator
Leibenluft, E., Gardner, D. L., & Cowdry, R. W. (1987) · Journal of Personality Disorders · doi:10.1521/pedi.1987.1.4.317 · Cited by 192 · see citing works
The association between self-injurious behaviors and autism spectrum disorders
Minshawi, N., Hurwitz, S., Fodstad, J., Biebl, S., Morris, D., & McDougle, C. (2014) · Psychology Research and Behavior Management · doi:10.2147/prbm.s44635 · Cited by 188 · see citing works
Whitlock, J., Exner-Cortens, D., & Purington, A. (2014) · Psychological Assessment · doi:10.1037/a0036611 · Cited by 157 · see citing works
Epidemiology and phenomenology of nonsuicidal self-injury.
Rodham, K., & Hawton, K. E. (2009) · American Psychological Association eBooks · doi:10.1037/11875-003 · Cited by 130 · see citing works
Non-suicidal self-injury disorder in a community sample of adults
Andover, M. S. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.06.001 · Cited by 112 · see citing works
Dickstein, D. P., Puzia, M., Cushman, G. K., Weissman, A. B., Wegbreit, E., Kim, K. L., Nock, M. K., & Spirito, A. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12385 · Cited by 66 · see citing works
Definition, Classification, and Taxonomy
Fee, V. E., & Matson, J. L. (1992) · Springer eBooks · doi:10.1007/978-1-4613-9130-2_1 · Cited by 42 · see citing works
Kim, K. L., Galvan, T., Puzia, M., Cushman, G. K., Seymour, K. E., Vanmali, R., Jones, R. N., Spirito, A., & Dickstein, D. P. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12110 · Cited by 32 · see citing works
Understanding Nonsuicidal Self-Injury
Moore, J., & Bauer, R. (2022) · Journal of Christian Nursing · doi:10.1097/cnj.0000000000000939 · Cited by 28 · see citing works
Behavioral Assessment and Treatment of Self-Injurious Behavior in Autism
Minshawi, N. F. (2008) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2008.06.012 · Cited by 20 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Risk markers for suicidality in autistic adults
Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018) · Molecular Autism · doi:10.1186/s13229-018-0226-4 · Cited by 621 · see citing works
Camm-Crosbie, L., Bradley, L., Shaw, R., Baron-Cohen, S., & Cassidy, S. (2019) · Autism · doi:10.1177/1362361318816053 · Cited by 415 · see citing works
The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study
Steenfeldt-Kristensen, C., Jones, C. A., & Richards, C. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04443-1 · Cited by 150 · see citing works
Updated Systematic Review of Suicide in Autism: 2018–2024
Brown, C. M., Newell, V., Sahin, E., & Hedley, D. (2024) · Current Developmental Disorders Reports · doi:10.1007/s40474-024-00308-9 · Cited by 130 · see citing works
Newell, V., Phillips, L., Jones, C., Townsend, E., Richards, C., & Cassidy, S. (2023) · Molecular Autism · doi:10.1186/s13229-023-00544-7 · Cited by 143 · see citing works
Gender differences in restricted and repetitive behaviors and interests in youth with autism
Antezana, L., Factor, R. S., Condy, E. E., Strege, M. V., Scarpa, A., & Richey, J. A. (2018) · Autism Research · doi:10.1002/aur.2049 · Cited by 112 · see citing works
Cassidy, S. A., Bradley, L., Bowen, E., Wigham, S., & Rodgers, J. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.05.002 · Cited by 104 · see citing works
“However, there is only one study on non-suicidal selfinjury (NSSI) in autistic adults (Maddox et al. 2017).”
BackgroundSummers, J., Shahrami, A., Cali, S., D’Mello, C., Kako, M., Palikucin-Reljin, A., Savage, M., Shaw, O., & Lunsky, Y. (2017) · Brain Sciences · doi:10.3390/brainsci7110140 · Cited by 106 · see citing works
Moseley, R. L., Gregory, N. J., Smith, P., Allison, C., & Baron-Cohen, S. (2019) · Molecular Autism · doi:10.1186/s13229-019-0267-3 · Cited by 97 · see citing works
Pelton, M., Crawford, H., Robertson, A., Rodgers, J., Baron‐Cohen, S., & Cassidy, S. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04393-8 · Cited by 103 · see citing works
Beck, K. B., Conner, C. M., Breitenfeldt, K. E., Northrup, J. B., White, S. W., & Mazefsky, C. A. (2020) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2020.02.003 · Cited by 95 · see citing works
Self-citationConner, C. M., Golt, J., Righi, G., Shaffer, R., Siegel, M., & Mazefsky, C. A. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04370-1 · Cited by 77 · see citing works
Rattaz, C., Michelon, C. P., Münir, K., & Baghdadli, A. (2018) · Journal of Intellectual Disability Research · doi:10.1111/jir.12503 · Cited by 77 · see citing works
Unrelenting Depression and Suicidality in Women with Autistic Traits
South, M., Beck, J. S., Lundwall, R. A., Christensen, M., Cutrer‐Párraga, E. A., Gabrielsen, T. P., Cox, J. C., & Lundwall, R. A. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04324-2 · Cited by 76 · see citing works
Links between self-injury and suicidality in autism
Moseley, R. L., Gregory, N. J., Smith, P., Allison, C., & Baron-Cohen, S. (2020) · Molecular Autism · doi:10.1186/s13229-020-0319-8 · Cited by 76 · see citing works
Psychotherapeutic interventions specifically developed for NSSI in adolescence: A systematic review
Calvo, N., García-González, S., Pérez-Galbarro, C., Regales-Peco, C., Lugo‐Marín, J., Ramos‐Quiroga, J. A., & Ferrer, M. (2022) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2022.02.009 · Cited by 75 · see citing works
McQuaid, G. A., Pelphrey, K. A., Bookheimer, S. Y., Dapretto, M., Webb, S. J., Bernier, R., McPartland, J. C., Horn, J. D. V., & Wallace, G. L. (2021) · Autism · doi:10.1177/1362361321995620 · Cited by 77 · see citing works
Perseverations of the academy: a survey of wearable technologies applied to autism intervention
Williams, R. M., & Gilbert, J. E. (2020) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2020.102485 · Cited by 74 · see citing works
Advancing Our Understanding of Self-harm, Suicidal Thoughts and Behaviours in Autism
Cassidy, S. A., Robertson, A., Townsend, E., O’Connor, R. C., & Rodgers, J. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04643-9 · Cited by 68 · see citing works
Hand, B. N., Benevides, T. W., & Carretta, H. J. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04345-x · Cited by 66 · see citing works
Bemmouna, D., Coutelle, R., Weibel, S., & Weiner, L. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05317-w · Cited by 64 · see citing works
Shalev, I., Warrier, V., Greenberg, D. M., Smith, P. L., Allison, C. L., Baron‐Cohen, S., Eran, A., & Uzefovsky, F. (2022) · Autism Research · doi:10.1002/aur.2794 · Cited by 62 · see citing works
Cannabinoid use and self-injurious behaviours: A systematic review and meta-analysis
Escelsior, A., Murri, M. B., Corsini, G. P., Serafini, G., Aguglia, A., Zampogna, D., Cattedra, S., Nebbia, J., Trabucco, A., Prestía, D., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.020 · Cited by 63 · see citing works
Autistic adults’ experience of restricted repetitive behaviours
Collis, E., Gavin, J., Russell, A., & Brosnan, M. (2022) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2021.101895 · Cited by 54 · see citing works
Schwartzman, J. M., Muscatello, R. A., & Corbett, B. A. (2023) · Autism · doi:10.1177/13623613231162154 · Cited by 50 · see citing works
Tint, A., Weiss, J. A., & Lunsky, Y. (2017) · Autism Research · doi:10.1002/aur.1806 · Cited by 48 · see citing works
Prevalence and Risk-Markers of Self-Harm in Autistic Children and Adults
Licence, L., Oliver, C., Moss, J., & Richards, C. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04260-1 · Cited by 45 · see citing works
A pilot study of dialectical behaviour therapy skills training for autistic adults
Ritschel, L., Guy, L., & Maddox, B. (2021) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465821000370 · Cited by 33 · see citing works
Self-citationWaisman-Nitzan, M., Schreuer, N., & Gal, E. (2020) · Research in Autism · doi:10.1016/j.rasd.2020.101643 · Cited by 42 · see citing works
Oliphant, R. Y. K., Smith, E. M., & Grahame, V. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04422-6 · Cited by 40 · see citing works
McVey, A. J., Schiltz, H. K., Coffman, M., Antezana, L., & Magnus, B. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05018-4 · Cited by 37 · see citing works
Toward a unifying theory of dysregulated behaviors
Bresin, K. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101885 · Cited by 38 · see citing works
McFayden, T. C., Antezana, L., Albright, J., Muskett, A., & Scarpa, A. (2019) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-019-00183-w · Cited by 37 · see citing works
Repetitive behaviors in Autism Spectrum Disorder: Associations with depression and anxiety symptoms
Muskett, A., Capriola-Hall, N. N., Radtke, S. R., Factor, R. S., & Scarpa, A. (2019) · Research in Autism · doi:10.1016/j.rasd.2019.101449 · Cited by 35 · see citing works
Capriola-Hall, N. N., Brewe, A. M., Golt, J., & White, S. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04549-6 · Cited by 31 · see citing works
Self-citationAutism in Later Life: What Is Known and What Is Needed?
Sonido, M. T., Arnold, S. R. C., Higgins, J. M., & Hwang, Y. I. (2020) · Current Developmental Disorders Reports · doi:10.1007/s40474-020-00192-z · Cited by 31 · see citing works
Moseley, R. L., Gregory, N. J., Smith, P. L., Allison, C. L., Cassidy, S., & Baron‐Cohen, S. (2022) · Molecular Autism · doi:10.1186/s13229-022-00495-5 · Cited by 34 · see citing works
Stewart, G. R., Corbett, A., Ballard, C. G., Creese, B., Aarsland, D., Hampshire, A., Charlton, R. A., & Happe, F. G. E. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05595-y · Cited by 33 · see citing works
Moseley, R. L., Gregory, N. J., Smith, P. L., Allison, C. L., Cassidy, S., & Baron‐Cohen, S. (2022) · Molecular Autism · doi:10.1186/s13229-022-00522-5 · Cited by 30 · see citing works
Junker, A., Bjørngaard, J. H., & Bjerkeset, O. (2017) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-017-0161-8 · Cited by 25 · see citing works
Prevalence and Predictors of Non-Suicidal Self-Injury among Children with Autism Spectrum Disorder
Akram, B., Batool, M., Rafi, Z., & Akram, A. (2017) · Pakistan Journal of Medical Sciences · doi:10.12669/pjms.335.12931 · Cited by 29 · see citing works
Sampson, K. N., Upthegrove, R., Abu-Akel, A. M., Haque, S. M., Wood, S. J., & Reniers, R. L. E. P. (2020) · Psychological Medicine · doi:10.1017/s0033291720000124 · Cited by 29 · see citing works
McQuaid, G. A., Strang, J. F., & Jack, A. (2024) · Autism in Adulthood · doi:10.1089/aut.2023.0034 · Cited by 34 · see citing works
Bemmouna, D., Lagzouli, A., & Weiner, L. (2023) · Molecular Autism · doi:10.1186/s13229-023-00580-3 · Cited by 26 · see citing works
Apicella, M., Pontillo, M., Maglio, G., Vincenzo, C. D., Santa, G. D., Andracchio, E., & Vicari, S. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1605508 · Cited by 26 · see citing works
Rodgers, J., Goodwin, J., Nielsen, E., Bhattarai, N., Heslop, P., Kharatikoopaei, E., O’Connor, R. C., Ogundimu, E. O., Ramsay, S. E., Steele, K., et al. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01264-8 · Cited by 26 · see citing works
Hunsche, M. C., Saqui, S., Mirenda, P., Zaidman‐Zait, A., Bennett, T. A., Duku, E., Elsabbagh, M., Georgiades, S., Smith, I. M., Szatmári, P., et al. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04373-y · Cited by 25 · see citing works
Eddy, C. M. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.797952 · Cited by 28 · see citing works
Celia, T., Freysteinson, W. M., Fredland, N., & Bowyer, P. (2019) · Journal of Advanced Nursing · doi:10.1111/jan.14213 · Cited by 22 · see citing works
Autistic adults’ subjective experiences of hoarding and self-injurious behaviors
Goldfarb, Y., Zafrani, O., Hedley, D., Yaari, M., & Gal, E. (2021) · Autism · doi:10.1177/1362361321992640 · Cited by 21 · see citing works
Self-harm and Mental Health Characteristics of Prisoners with elevated rates of autistic traits
Chaplin, E., McCarthy, J. M., Allely, C. S., Forrester, A., Underwood, L., Hayward, H., Sabet, J., Young, S., Mills, R., Asherson, P. J., et al. (2021) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2021.103987 · Cited by 21 · see citing works
Vandewalle, K., & Melia, Y. (2020) · Research in Autism · doi:10.1016/j.rasd.2020.101713 · Cited by 21 · see citing works
González, M., Zeidan, J., Lai, J., Yusuf, A., Wright, N., Steiman, M., Karpur, A., Shih, A. J., Elsabbagh, M., & Shikako‐Thomas, K. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08672-1 · Cited by 20 · see citing works
Nyrenius, J., Wærn, M., Eberhard, J., Ghaziuddin, M., Gillberg, C., & Billstedt, E. (2023) · BJPsych Open · doi:10.1192/bjo.2023.553 · Cited by 39 · see citing works
Bemmouna, D., & Weiner, L. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1238116 · Cited by 20 · see citing works
Fındık, O. T. P., Erdoğdu, A. B., Fadıloğlu, E., & Arman, A. R. (2021) · Child Psychiatry and Human Development · doi:10.1007/s10578-021-01125-6 · Cited by 17 · see citing works
Aging on the Autism Spectrum: Self-care Practices and Reported Impact on Well-Being
Waldron, D. A., Coyle, C. E., & Kramer, J. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05229-9 · Cited by 19 · see citing works
Ferguson, E. F., Spackman, E. K., Cai, R. Y., Hardan, A. Y., & Uljarević, M. (2024) · Autism Research · doi:10.1002/aur.3269 · Cited by 19 · see citing works
Autism and self‐harm: A population‐based and discordant sibling study of young individuals
Stark, I., Rai, D., Lundberg, M., Culpin, I., Nordström, S. I., Ohlis, A., & Magnusson, C. (2022) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13479 · Cited by 19 · see citing works
Wang, W., & Wang, X. (2023) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2023.152407 · Cited by 19 · see citing works
Anxiety and Depression from Adolescence to Old Age in Autism Spectrum Disorder
Uljarević, M., Hedley, D., Cai, R., Hardan, A., & South, M. (2020) · Encyclopedia of Autism Spectrum Disorders · doi:10.1007/978-1-4614-6435-8_102432-1 · Cited by 1 · see citing works
Guo, Z., Liu, Y., Wang, C., Li, S., Yu, L., Wu, W., You, X., Zhang, Y., Teng, Z., & Zeng, Y. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1126615 · Cited by 17 · see citing works
Blay, M., Duarte, M., Dessouli, M.-A., Durpoix, A., Rüfenacht, E., Weibel, S., Speranza, M., & Perroud, N. A. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1260138 · Cited by 21 · see citing works
Micai, M., Ciaramella, A., Salvitti, T., Fulceri, F., Fatta, L. M., Poustka, L., Diehm, R., Iskrov, G., Stefanov, R., Guillon, Q., et al. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05038-0 · Cited by 16 · see citing works
Marsden, S. J. E., Eastham, R., & Kaley, A. (2024) · Autism · doi:10.1177/13623613241271931 · Cited by 16 · see citing works
Structural models of genome-wide covariance identify multiple common dimensions in autism
de Hoyos, L., Barendse, M. T., Schlag, F., van Donkelaar, M. M. J., Verhoef, E., Shapland, C. Y., Klassmann, A., Buitelaar, J. K., Verhulst, B., Fisher, S. E., et al. (2024) · Nature Communications · doi:10.1038/s41467-024-46128-8 · Cited by 12 · see citing works
Soto, E. F., Orantes, D., Russo, N. N., & Antshel, K. M. (2024) · Autism · doi:10.1177/13623613241236228 · Cited by 14 · see citing works
Coping Strategies Used by Aging Parental Caregivers of Adults With Autism Spectrum Disorder
Marsack‐Topolewski, C. N., & Wilson, K. P. (2020) · Families in Society The Journal of Contemporary Social Services · doi:10.1177/1044389420913121 · Cited by 14 · see citing works
Aggression and Non-Suicidal Self-Injury among Depressed Youths: The Mediating Effect of Resilience
Zhang, L., Chen, M., Benxian, Y. A. O., & Zhang, Y. (2021) · Iranian Journal of Public Health · doi:10.18502/ijph.v50i2.5342 · Cited by 14 · see citing works
Beck, K. B., Conner, C. M., Breitenfeldt, K. E., Northrup, J. B., White, S. W., & Mazefsky, C. A. (2021) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2020.11.008 · Cited by 13 · see citing works
Self-citationMeasurement properties of tools used to assess self-harm in autistic and general population adults
Newell, V., Townsend, E., Richards, C., & Cassidy, S. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102412 · Cited by 13 · see citing works
Powell, T., Parker, J., Kitson, H., & Rogalewski, M. (2024) · Autism in Adulthood · doi:10.1089/aut.2023.0031 · Cited by 10 · see citing works
Sex differences in self‐harm and suicide in young autistic adults
Hull, L., Stark, I., Lundberg, M., Ahlqvist, V. H., Nordström, S. I., Ohlis, A., Hadlaczky, G., Rai, D., & Magnusson, C. (2024) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13736 · Cited by 12 · see citing works
Swierczynski, A. (2019) · SciMedicine Journal · doi:10.28991/scimedj-2019-0102-5 · Cited by 16 · see citing works
Carlier, S., Vorlet, P., dos Reis, C. S., & Malamateniou, C. (2022) · Journal of medical imaging and radiation sciences · doi:10.1016/j.jmir.2022.11.002 · Cited by 11 · see citing works
Bottema‐Beutel, K., McKinnon, R., Mohiuddin, S. S., Crowley, S., & Kim, S. Y. (2024) · Autism · doi:10.1177/13623613241229159 · Cited by 12 · see citing works
Empathic Disequilibrium as a Predictor of Nonsuicidal Self-Injury in Autistic and Nonautistic People
Moseley, R. L., Shalev, I., Gregory, N. J., & Uzefovsky, F. (2024) · Autism in Adulthood · doi:10.1089/aut.2023.0134 · Cited by 11 · see citing works
Jørgensen, M. S., Sharp, C., Bo, S., Møhl, B., Kongerslev, M., Møller, L., Vestergaard, M. D., Storebø, O. J., Poulsen, S., Beck, E., et al. (2024) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-024-00272-1 · Cited by 14 · see citing works
Ferguson, E. F., Russell, K. M., Licona, S., Cai, R. Y., Frazier, T. W., Vivanti, G., Gengoux, G. W., Hardan, A. Y., & Uljarević, M. (2024) · Autism Research · doi:10.1002/aur.3289 · Cited by 11 · see citing works
Pérez-Arqueros, M., Jamett-Cuevas, V., Pulgar-Vera, V., Santander-Gonzalez, R., Pemau, A., & Álvarez-Cabrera, P. L. (2025) · Research in Autism · doi:10.1016/j.reia.2025.202540 · Cited by 11 · see citing works
Meta-Synthesis of Autistic Adults’ First-Person Perspectives About Mental Health-Related Services
Andoni, L., Eisenhower, A., Gudknecht, J., & Levitt, H. M. (2026) · Autism in Adulthood · doi:10.1089/aut.2023.0167 · Cited by 11 · see citing works
Hedley, D., Williams, Z. J., Deady, M., Batterham, P. J., Bury, S. M., Brown, C. M., Robinson, J., Trollor, J. N., Uljarević, M., & Stokes, M. A. (2024) · Autism · doi:10.1177/13623613241289493 · Cited by 10 · see citing works
Shields, M. C., Akobirshoev, I., Dembo, R. S., & Mitra, M. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201800318 · Cited by 10 · see citing works
Self-harm and suicidality experiences of autistic and non-autistic adults in midlife and old age
Roper, S., Charlton, R. A., Happe, F. G. E., & Stewart, G. R. (2025) · Molecular Autism · doi:10.1186/s13229-025-00693-x · Cited by 9 · see citing works
Suicide and Autism: A Lifespan Perspective
Hedley, D., Hayward, S. M., Clarke, A., Uljarević, M., & Stokes, M. A. (2022) · Springer eBooks · doi:10.1007/978-3-030-98697-1_3 · Cited by 9 · see citing works
The neuropathology of Self-Injurious Behavior: Studies using animal models
Devine, D. P. (2024) · Brain Research · doi:10.1016/j.brainres.2024.149172 · Cited by 8 · see citing works
Figueiredo, T., Bernardes, C., & Serra-Pinheiro, M. A. (2023) · Current Psychology · doi:10.1007/s12144-021-02299-x · Cited by 6 · see citing works
Lacroix, A., Tzang, C.-C., Yu, J., Jacob, B. K., Alexandrovsky, M., Winge-Breen, A., Rodak, T., & Lai, M. (2025) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2025.101229 · Cited by 6 · see citing works
Boylu, M. E., Taşdemir, İ., Doğan, M., & Özcanlı, T. (2024) · Journal of Forensic Sciences · doi:10.1111/1556-4029.15586 · Cited by 6 · see citing works
Costache, M. E., Gioia, F., Vanello, N., Greco, A., Capobianco, A., Weibel, S., & Weiner, L. (2025) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-025-00288-1 · Cited by 5 · see citing works
Pathogenicity of Endocrine Dysregulation in AutismPreprint
Swierczynski, A. (2018) · Preprints.org · doi:10.20944/preprints201805.0359.v1 · Cited by 4 · see citing works
Newell, V., Richards, C., & Cassidy, S. (2025) · Autism · doi:10.1177/13623613251348555 · Cited by 4 · see citing works
Addressing suicidality in autistic youth: Implications for school mental health professionals
Rodriguez, G., Holmberg, D. R., Fredrick, A., & Stadelman, S. (2024) · Psychology in the Schools · doi:10.1002/pits.23273 · Cited by 4 · see citing works
Dudas, R. B., & Cheney, L. B. (2025) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20230049 · Cited by 4 · see citing works
Antezana, L., Conner, C. M., Eldeeb, S. M., Turecki, S. C., Siegel, M. S., Karim, H. T., & Mazefsky, C. A. (2025) · Psychological Medicine · doi:10.1017/s0033291725000637 · Cited by 4 · see citing works
Woods, R., & Waldock, K. E. (2020) · Springer eBooks · doi:10.1007/978-1-4614-6435-8_102297-2 · Cited by 4 · see citing works
Emotion Awareness and Skills Enhancement (EASE) Program
Mazefsky, C. A., White, S. W., Beck, K. B., & Conner, C. M. (2021) · Springer eBooks · doi:10.1007/978-3-319-91280-6_102186 · Cited by 4 · see citing works
Self-citationGender Differences in the Timing of Identification among Children with Autism
Malhi, P., & SINGHI, P. D. (2023) · Journal of the Scientific Society · doi:10.4103/jss.jss_218_22 · Cited by 3 · see citing works
Antezana, L., Conner, C. M., Feldman, J., Manna, L. L., Ionadi, A., Su, D. J., Eldeeb, S. M., Gastgeb, H. Z., Sivathasan, S., Northrup, J. B., et al. (2026) · Autism in Adulthood · doi:10.1177/25739581261423792 · Cited by 3 · see citing works
Experiences of equine assisted therapy for females with autism spectrum disorders
Warner, K., Keville, S., Hockley, J., & Ludlow, A. (2022) · Advances in Autism · doi:10.1108/aia-10-2021-0040 · Cited by 3 · see citing works
- Authors
- Maddox, B. B., Trubanova, A., & White, S. W.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Virginia Tech, USA
- Virginia Tech (US)
- Corresponding author
- Maddox, Brenna B
- Venue
- Autism
- Publisher
- SAGE Publications
- Published
- 2016-05-12
- Volume
- 21
- Issue
- 4
- Pages
- 412-422
- ISSN
- 1362-3613 (ISSN-L)
- 1461-7005
- OpenAlex
- W2380785725
- Cited by
- 154
- References
- 48
- Citations by year
- 2026: 7 · 2025: 23 · 2024: 26 · 2023: 21 · 2022: 14 · 2021: 18 · 2020: 23 · 2019: 11 · 2018: 7 · 2017: 4
- FWCI
- 9.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Autism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Virginia Tech Graduate Research Development Program (N/A)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- non-suicidal self-injury, autism spectrum disorder, autistic adults, self-injury methods, functions of self-injury, gender differences, depression, emotional dysregulation, risk factors
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Adult, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Self-Injurious Behavior, Young Adult
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