Suicidal Risk Behaviors in Adolescents With Rare Neurodevelopmental Disorders: The Role of Sex, Autistic Traits, and Mental Health Difficulties

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

About the autistic author marker

Orm, S., Wood, J., Corbett, B., & Fjermestad, K. (2023). Suicidal Risk Behaviors in Adolescents With Rare Neurodevelopmental Disorders: The Role of Sex, Autistic Traits, and Mental Health Difficulties. Journal of Pediatric Psychology, 48(10), 852-860. https://doi.org/10.1093/jpepsy/jsad051

Publication date: 8 Aug 2023 Added to AutiHub: 20 Sep 2026 Type: Article Article language: English

This publication is integrated into AutiHub through:

Authors

Publication authors
4
Publication authors identified as autistic
1 / 4 (25.0%)

Abstract

Abstract Objective Autistic traits are associated with mental health difficulties and risk of suicidal risk behaviors among adolescents. Little is known about how autistic traits affect the mental health of adolescents with rare neurodevelopmental disorders (RNDs). The aim of this study was to investigate the relationship between autistic traits, mental health difficulties, and suicidal risk behaviors in adolescents with RNDs. Methods Parents (N = 93) completed the Child Behavior Checklist, Social Communication Questionnaire, and Social Responsiveness Scale about their adolescent (Mage = 13.1, SD = 2.3, 62.4% females) with an RND (e.g., sex chromosome aneuploidies, Fragile X syndrome, 22q11.2 deletion syndrome). The data were analyzed with hierarchical logistic regression analysis. Results The prevalence of suicidal risk behaviors (16.1%) was similar to that reported among autistic youth and was higher among boys than girls. More autistic traits were associated with suicidal risk behaviors in bivariate analysis. In multivariate analysis, more anxiety/depressive symptoms were associated with more suicidal risk behaviors and externalizing problems associated with suicidal risk behaviors beyond autistic traits and anxiety/depressive symptoms. Conclusion Adolescents with RNDs are at risk of suicidal risk behaviors, especially those with higher levels of autistic traits, anxiety/depressive symptoms, and externalizing problems. Assessment of autistic traits, mental health difficulties, and suicide risk may be indicated for adolescents with RNDs to determine if corresponding intervention is needed.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:01.

Cited references
56
With a DOI
52
Without a DOI, from raw bibliography text
4
2 / 56 (3.6%) cited references include at least one author identified as autistic.
References with data to complete
1 / 56 (1.8%)
References with detected author names
56 / 56 (100.0%)
Without detected author names
0
Without a structured title
1
Without a stable identifier
4
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
481
From DOI or external metadata
481
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
61 / 481 (12.7%) names are linked to an author already present in AutiHub. 420 / 481 (87.3%) names are not yet linked.
Names linked to a person identified as autistic
2 / 481 (0.4%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 2 / 61 (3.3%). Distinct people identified as autistic: 2 / 460 (0.4%).
  1. Cynthia M Farquhar , Emma W Kofa , Jean R Slutsky (2002). Clinicians' attitudes to clinical practice guidelines: a systematic review . Medical Journal of Australia, 177(9), 502-506. AMPCo.
    Crossref OpenAlex OpenCitations
  2. Achenbach (2001). Manual for the ASEBA school-age forms & profiles: An integrated system of multi-informant assessment . Manual for the ASEBA school-age forms & profiles: An integrated system of multi-informant assessment.
    Type: Other
    Crossref
  3. Caroline Richards , Christopher Jones , Laura Groves , Jo Moss , Chris Oliver (2015). Prevalence of autism spectrum disorder phenomenology in genetic disorders: a systematic review and meta-analysis . The Lancet Psychiatry, 2(10), 909-916. Elsevier BV.
    Crossref OpenAlex OpenCitations
  4. Christina Gross , Anne Hoffmann , Gary J. Bassell , Elizabeth Berry‐Kravis (2015). Therapeutic Strategies in Fragile X Syndrome: From Bench to Bedside and Back . Neurotherapeutics, 12(3), 584-608. Elsevier BV.
    Crossref OpenAlex OpenCitations
  5. Molly Adrian , Adam Bryant Miller , Elizabeth McCauley , Ann Vander Stoep (2016). Suicidal ideation in early to middle adolescence: sex‐specific trajectories and predictors . Journal of Child Psychology and Psychiatry, 57(5), 645-653. Wiley.
    Crossref OpenAlex OpenCitations
  6. on behalf of the Simons VIP consortium , LeeAnne Green Snyder , Debra D’Angelo , Qixuan Chen , Raphael Bernier , Robin P. Goin-Kochel et al. (2016). Autism Spectrum Disorder, Developmental and Psychiatric Features in 16p11.2 Duplication . Journal of Autism and Developmental Disorders, 46(8), 2734-2748. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  7. Jeffrey Wood , Kenneth D. Gadow (2010). Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clinical Psychology: Science and Practice, 17(4), 281-292. American Psychological Association (APA).
    Crossref OpenAlex OpenCitations
  8. Madison Aitken , Doug P. VanderLaan , Lori Wasserman , Sonja Stojanovski , Kenneth J. Zucker (2016). Self-Harm and Suicidality in Children Referred for Gender Dysphoria . Journal of the American Academy of Child & Adolescent Psychiatry, 55(6), 513-520. Elsevier BV.
    Crossref OpenAlex OpenCitations
  9. Maria Niarchou , Samuel J. R. A. Chawner , Joanne L. Doherty , Anne M. Maillard , Sebastien Jacquemont , Wendy K. Chung et al. (2019). Psychiatric disorders in children with 16p11.2 deletion and duplication . Translational Psychiatry, 9(1). Springer Science and Business Media LLC.
    OpenCitations
  10. John N. Constantino , Sandra A. Davis , Richard D. Todd , Matthew K. Schindler , Maggie M. Gross , Susan L. Brophy et al. (2003). Validation of a Brief Quantitative Measure of Autistic Traits: Comparison of the Social Responsiveness Scale with the Autism Diagnostic Interview-Revised . Journal of Autism and Developmental Disorders, 33(4), 427-433. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  11. Asit B. Biswas , Frederick Furniss (2016). Cognitive phenotype and psychiatric disorder in 22q11.2 deletion syndrome: A review . Research in Developmental Disabilities, 53-54, 242-257. Elsevier BV.
    Crossref OpenAlex OpenCitations
  12. Jayawant N. Mandrekar (2010). Receiver Operating Characteristic Curve in Diagnostic Test Assessment . Journal of Thoracic Oncology, 5(9), 1315-1316. Elsevier BV.
    Crossref OpenAlex OpenCitations
  13. Anders Bojesen , Svend Juul , Niels Birkebæk , Claus H. Gravholt (2004). Increased Mortality in Klinefelter Syndrome . The Journal of Clinical Endocrinology & Metabolism, 89(8), 3830-3834. The Endocrine Society.
    Crossref OpenAlex OpenCitations
  14. Matthew K. Nock , Jennifer Greif Green , Irving Hwang , Katie A. McLaughlin , Nancy A. Sampson , Alan M. Zaslavsky et al. (2013). Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents . JAMA Psychiatry, 70(3), 300. American Medical Association (AMA).
    Crossref OpenAlex OpenCitations
  15. J. J. Carballo , C. Llorente , L. Kehrmann , I. Flamarique , A. Zuddas , D. Purper-Ouakil et al. (2020). Psychosocial risk factors for suicidality in children and adolescents . European Child & Adolescent Psychiatry, 29(6), 759-776. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  16. Joshua Zadro , Mary O’Keeffe , Christopher Maher (2019). Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review . BMJ Open, 9(10), e032329. BMJ.
    Crossref OpenAlex OpenCitations
  17. SUSIE CHANDLER , Tony Charman , Gillian Baird , Emily Simonoff , TOM LOUCAS , DAVID MELDRUM et al. (2007). Validation of the Social Communication Questionnaire in a Population Cohort of Children With Autism Spectrum Disorders . Journal of the American Academy of Child & Adolescent Psychiatry, 46(10), 1324-1332. Elsevier BV.
    Crossref OpenAlex OpenCitations
  18. Sarah Cassidy , Sheena K. Au‐Yeung , Ashley Robertson , Heather Cogger-Ward , Gareth Richards , Carrie T. Allison et al. (2022). Autism and autistic traits in those who died by suicide in England . The British Journal of Psychiatry, 221(5), 683-691. Royal College of Psychiatrists.
    Crossref OpenAlex OpenCitations
  19. Steven K Dobscha , Martha Gerrity , Kathryn Corson , Alison Bahr , Nancy M Cuilwik (2003). Measuring adherence to depression treatment guidelines in a VA primary care clinic . General Hospital Psychiatry, 25(4), 230-237. Elsevier BV.
    Crossref OpenAlex OpenCitations
  20. Christine B. Cha , Peter J. Franz , Eleonora M. Guzmán , Catherine R. Glenn , Evan M. Kleiman , Matthew K. Nock (2018). Annual Research Review: Suicide among youth – epidemiology, (potential) etiology, and treatment . Journal of Child Psychology and Psychiatry, 59(4), 460-482. Wiley.
    Crossref OpenAlex OpenCitations
  21. Kristian A. Groth , Anne Skakkebæk , Christian Høst , Claus Højbjerg Gravholt , Anders Bojesen (2013). Klinefelter Syndrome—A Clinical Update . The Journal of Clinical Endocrinology & Metabolism, 98(1), 20-30. The Endocrine Society.
    Crossref OpenAlex OpenCitations
  22. Krister Fjermestad , Stian Orm *Autistic author. Learn more… , Wendy K. Silverman , Hugo Cogo-Moreira (2022). Short report: COVID-19-related anxiety is associated with mental health problems among adults with rare disorders . Research in Developmental Disabilities, 123, 104181. Elsevier BV.
    Crossref OpenAlex OpenCitations
  23. Tamar Green , Doron Gothelf , Bronwyn Glaser , Martin Debbane , Amos Frisch , Moshe Kotler et al. (2009). Psychiatric Disorders and Intellectual Functioning Throughout Development in Velocardiofacial (22q11.2 Deletion) Syndrome . Journal of the American Academy of Child & Adolescent Psychiatry, 48(11), 1060-1068. Elsevier BV.
    Crossref OpenAlex OpenCitations
  24. Ying‐Yeh Chen , Yi‐Lung Chen , Susan Shur‐Fen Gau (2020). Suicidality in Children with Elevated Autistic Traits . Autism Research, 13(10), 1811-1821. Wiley.
    Type: Article DOI: 10.1002/aur.2333 OpenAlex: https://openalex.org/W3041429040
    Crossref OpenAlex OpenCitations
  25. Rachel L. Doyle , Paula J. Fite (2024). Informant Discrepancies in Suicidality Screening Tools Among School Age Youth . Child Psychiatry & Human Development, 55(2), 394-404. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  26. Christina C. Emeh , Amori Yee Mikami , Bethany A. Teachman (2018). Explicit and Implicit Positive Illusory Bias in Children With ADHD . Journal of Attention Disorders, 22(10), 994-1001. SAGE Publications.
    Crossref OpenAlex OpenCitations
  27. Kairi Kõlves , Cecilie Fitzgerald , Merete Nordentoft , Stephen James Wood , Annette Erlangsen (2021). Assessment of Suicidal Behaviors Among Individuals With Autism Spectrum Disorder in Denmark . JAMA Network Open, 4(1), e2033565. American Medical Association (AMA).
    Crossref OpenAlex OpenCitations
  28. Iryna Culpin , Becky Mars , Rebecca M. Pearson , Jean Golding , Jon Heron , Isidora Bubak et al. (2018). Autistic Traits and Suicidal Thoughts, Plans, and Self-Harm in Late Adolescence: Population-Based Cohort Study . Journal of the American Academy of Child & Adolescent Psychiatry, 57(5), 313-320.e6. Elsevier BV.
    Crossref OpenAlex OpenCitations
  29. V. Soto‐Sanz , P. Castellví , J. A. Piqueras , J. Rodríguez‐Marín , T. Rodríguez‐Jiménez , A. Miranda‐Mendizábal et al. (2019). Internalizing and externalizing symptoms and suicidal behaviour in young people: a systematic review and meta‐analysis of longitudinal studies . Acta Psychiatrica Scandinavica, 140(1), 5-19. Wiley.
    Crossref OpenAlex OpenCitations
  30. Martin Pinquart , Daniela Teubert (2012). Academic, Physical, and Social Functioning of Children and Adolescents With Chronic Physical Illness: A Meta-analysis . Journal of Pediatric Psychology, 37(4), 376-389. Oxford University Press (OUP).
    Crossref OpenAlex OpenCitations
  31. David H. Demmer , Merrilyn Hooley , Jade Sheen , Jane A. McGillivray , Jarrad A. G. Lum (2017). Sex Differences in the Prevalence of Oppositional Defiant Disorder During Middle Childhood: a Meta-Analysis . Journal of Abnormal Child Psychology, 45(2), 313-325. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  32. Jessica Schwartzman , Blythe Corbett (2020). Higher depressive symptoms in early adolescents with Autism Spectrum Disorder by self- and parent-report compared to typically-developing peers . Research in Autism Spectrum Disorders, 77, 101613. Elsevier BV.
    Crossref OpenAlex OpenCitations
  33. Masha Y. Ivanova , Thomas M. Achenbach , Levent Dumenci , Leslie A. Rescorla , Fredrik Almqvist , Sheila Weintraub et al. (2007). Testing the 8-Syndrome Structure of the Child Behavior Checklist in 30 Societies . Journal of Clinical Child & Adolescent Psychology, 36(3), 405-417. Informa UK Limited.
    Crossref OpenAlex OpenCitations
  34. Andrea Miranda-Mendizabal , Pere Castellví , Oleguer Parés-Badell , Itxaso Alayo , José Almenara , Iciar Alonso et al. (2019). Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies . International Journal of Public Health, 64(2), 265-283. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  35. Katie A. McLaughlin , Kevin King (2015). Developmental Trajectories of Anxiety and Depression in Early Adolescence . Journal of Abnormal Child Psychology, 43(2), 311-323. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  36. M. Pinquart , Y. Shen (2011). Behavior Problems in Children and Adolescents With Chronic Physical Illness: A Meta-Analysis . Journal of Pediatric Psychology, 36(9), 1003-1016. Oxford University Press (OUP).
    Crossref OpenAlex OpenCitations
  37. Sharon A. Kidd , Ave Lachiewicz , Deborah Barbouth , Robin K. Blitz , Carol Delahunty , Dianne McBrien et al. (2014). Fragile X Syndrome: A Review of Associated Medical Problems . Pediatrics, 134(5), 995-1005. American Academy of Pediatrics (AAP).
    Crossref OpenAlex OpenCitations
  38. EURODIS—Rare Diseases Europe (2023). 2024020920492860200_jsad051-B18
    Type: Other
    Crossref
  39. Valérie La Buissonnière Ariza , Sophie C. Schneider , Sandra L. Cepeda , Jeffrey Wood , Philip C. Kendall , Brent J. Small et al. (2022). Predictors of Suicidal Thoughts in Children with Autism Spectrum Disorder and Anxiety or Obsessive-Compulsive Disorder: The Unique Contribution of Externalizing Behaviors . Child Psychiatry & Human Development, 53(2), 223-236. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  40. Sólveig Óskarsdóttir , Erik Boot , Terrence Blaine Crowley , Joanne C.Y. Loo , Jill M. Arganbright , Marco Armando et al. (2023). Updated clinical practice recommendations for managing children with 22q11.2 deletion syndrome . Genetics in Medicine, 25(3), 100338. Elsevier BV.
    Crossref OpenAlex OpenCitations
  41. Matthew Gittus , Jiehan Chong , Anthea Sutton , Albert C. M. Ong , James Fotheringham (2023). Barriers and facilitators to the implementation of guidelines in rare diseases: a systematic review . Orphanet Journal of Rare Diseases, 18(1), 140. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  42. Tara L. Wenger , Judith S. Miller , Lauren M. DePolo , Ashley de Marchena , Caitlin C. Clements , Beverly S. Emanuel et al. (2016). 22q11.2 duplication syndrome: elevated rate of autism spectrum disorder and need for medical screening . Molecular Autism, 7(1), 27. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  43. Claus H Gravholt , Niels H Andersen , Gerard S Conway , Olaf M Dekkers , Mitchell E Geffner , Karen O Klein et al. (2017). Clinical practice guidelines for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner Syndrome Meeting . European Journal of Endocrinology, 177(3), G1-G70. Oxford University Press (OUP).
    Crossref OpenAlex OpenCitations
  44. Mirabel Pelton , Hayley Crawford , Ashley Robertson , Jacqui Rodgers , Simon Baron-Cohen , Sarah Cassidy (2020). Understanding Suicide Risk in Autistic Adults: Comparing the Interpersonal Theory of Suicide in Autistic and Non-autistic Samples . Journal of Autism and Developmental Disorders, 50(10), 3620-3637. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  45. Tatja Hirvikoski , M. Boman , Qian Chen , B. M. D'Onofrio , E. Mittendorfer-Rutz , P. Lichtenstein et al. (2020). Individual risk and familial liability for suicide attempt and suicide in autism: a population-based study . Psychological Medicine, 50(9), 1463-1474. Cambridge University Press (CUP).
    Crossref OpenAlex OpenCitations
  46. Louise K. Hoeffding , Betina B. Trabjerg , Line Olsen , Wiktor Mazin , Thomas Sparsø , Anders Vangkilde et al. (2017). Risk of Psychiatric Disorders Among Individuals With the 22q11.2 Deletion or Duplication . JAMA Psychiatry, 74(3), 282. American Medical Association (AMA).
    Crossref OpenAlex OpenCitations
  47. Lori Shore , John W. Toumbourou , Andrew J. Lewis , Peter Kremer (2018). Review: Longitudinal trajectories of child and adolescent depressive symptoms and their predictors – a systematic review and meta‐analysis . Child and Adolescent Mental Health, 23(2), 107-120. Wiley.
    Crossref OpenAlex OpenCitations
  48. Anna R. Van Meter , Guillermo Perez Algorta , Eric A. Youngstrom , Yana Lechtman , Jen K. Youngstrom , Norah C. Feeny et al. (2018). Assessing for suicidal behavior in youth using the Achenbach System of Empirically Based Assessment . European Child & Adolescent Psychiatry, 27(2), 159-169. Springer Science and Business Media LLC.
    Crossref OpenAlex OpenCitations
  49. Joiner (2005). Why people die by suicide . Why people die by suicide.
    Type: Other
    Crossref
  50. Marian Reiff , Meeta Kumar , Batsirai Bvunzawabaya , Soumya Madabhushi , Alaina Spiegel , Benjamin Bolnick et al. (2019). I CARE: Development and Evaluation of a Campus Gatekeeper Training Program for Mental Health Promotion and Suicide Prevention . Journal of College Student Psychotherapy, 33(2), 107-130. Informa UK Limited.
    Crossref OpenAlex OpenCitations
  51. Maria Niarchou , Samuel J. R. A. Chawner , Joanne L. Doherty , Anne M. Maillard , Sebastien Jacquemont , Wendy K. Chung et al. (2019). Psychiatric disorders in children with 16p11.2 deletion and duplication . Translational Psychiatry, 9(1), 8. Springer Science and Business Media LLC.
    Crossref OpenAlex
  52. L. O'Halloran , P. Coey , Colin Wilson (2022). Suicidality in autistic youth: A systematic review and meta-analysis . Clinical Psychology Review, 93, 102144. Elsevier BV.
    Crossref OpenAlex OpenCitations
  53. Neda Motamedi , Bibiana Susaimanickam , Amir Riahinezhada (2021). Depression With Suicidal and Homicidal Ideation in Turner Syndrome . The Primary Care Companion For CNS Disorders, 23(5), 37444. Physicians Postgraduate Press, Inc.
    Crossref OpenAlex OpenCitations
  54. Rutter (2003). The Social Communication Questionnaire: Manual . The Social Communication Questionnaire: Manual.
    Type: Other
    Crossref
  55. John N. Constantino (2013). Social Responsiveness Scale . In Social responsiveness scale (pp. 2919-2929). Springer New York.
    OpenAlex