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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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In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“(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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
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Metadata
- 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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