(Re)thinking about self-harm and autism: Findings from an online qualitative study on self-harm in autistic adults

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Marsden, S. J. E., Eastham, R., & Kaley, A. (2024). (Re)thinking about self-harm and autism: Findings from an online qualitative study on self-harm in autistic adults. Autism, 29(1), 247-258. https://doi.org/10.1177/13623613241271931

Publication date: 4 Sep 2024 Added to AutiHub: 22 Oct 2026 Type: Article Article language: English
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Authors

Publication authors
3
Publication authors identified as autistic
1 / 3 (33.3%)
  1. Sarah J. E. Marsden *
  2. Rachael Eastham
  3. Alexandra Kaley

Abstract

Autistic people experience a higher prevalence of self-harming behaviours than do the general population. Self-harm remains a stigmatised topic, and until recently, self-harming behaviours in autism were considered to be limited to self-injurious behaviours experienced by intellectually impaired autistic children and not to be experienced by cognitively able autistic adults. Because of the belief held by many professionals that many mental health-related problems are inherently part of autism and immune to treatment or help, many autistic people are left unable to access the help and support that they desperately need. This study adopts an online qualitative methodology to explore this under-researched phenomenon, thematically analysing online forum posts from autistic adults to determine what forms of self-harm are described, what precipitates the self-harm and how forum users support each other. The findings reveal that self-harming behaviours are nuanced and complex, highlighting the connections between sensory overload, meltdowns, stimming and impulsive repetitive blunt trauma seen as autistic self-injurious behaviours. When seeking help, barriers include navigating misdiagnoses of other mental illnesses and being misunderstood or disbelieved by professionals. Online forum users offer help in the form of emotional empathy, as well as practical solutions, providing an example of valuable peer support. Lay abstract There is a higher prevalence of self-harming behaviours within the autistic community than is experienced by the general population, in addition to co-occurring mental health conditions such as anxiety and depression. To date, research has focused on quantifying and categorising the numbers of autistic people self-harming, what types of harming they are engaging in and what functions the harming performs. Autism research has historically focused on the opinions and experiences of parents, carers and clinicians, with a belief that autistic people are unable to present their own experiences and thoughts accurately. This study adopted a qualitative method to develop themes arising from online forum discussions, using the words of autistic adults talking about how they experience and understand their self-harming behaviours. The analysis discovered that self-harming behaviours are used by autistic people as a way of coping with anxiety and depression and to relieve the build up of stress and sensory or mental overload that can otherwise lead to a meltdown. Repetitive behaviours such as stimming are also used to relieve the buildup of sensory over-stimulation and anxiety, but both stimming and meltdowns can also be self-harming behaviours if they cause tissue damage, and are believed to be childhood presentations which are stigmatised if expressed by an autistic adult. Many autistic adults find it hard to get help with self-harming behaviours because they are not taken seriously by professionals, as it is seen as part of autism and cannot be helped, or the professionals do not have enough knowledge of autism.

Bibliography cited by this reference

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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: 23 Oct 2026 08:00.

Cited references
69
With a DOI
58
Without a DOI, from raw bibliography text
9
14 / 69 (20.3%) cited references include at least one author identified as autistic.
References with data to complete
7 / 69 (10.1%)
References with detected author names
63 / 69 (91.3%)
Without detected author names
6
Without a structured title
7
Without a stable identifier
9
References with raw author names still to review
6
References with external metadata lookup issues
1
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
170
From DOI or external metadata
170
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
17
86 / 170 (50.6%) names are linked to an author already present in AutiHub. 84 / 170 (49.4%) names are not yet linked.
Names linked to a person identified as autistic
20 / 170 (11.8%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 20 / 86 (23.3%). Distinct people identified as autistic: 14 / 135 (10.4%).
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