Links between self-injury and suicidality in autism

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Moseley, R., Gregory, N., Smith, P., Allison, C., & Baron-Cohen, S. (2020). Links between self-injury and suicidality in autism. Molecular Autism, 11(1), 14-14. https://doi.org/10.1186/s13229-020-0319-8

Publication date: 10 Feb 2020 Added to AutiHub: 6 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
5
Publication authors identified as autistic
1 / 5 (20.0%)
  1. Rachel Moseley *
  2. Nicola Gregory
  3. Paula Smith
  4. Carrie Allison
  5. Simon Baron-Cohen

Abstract

BACKGROUND: Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism, motivate investigating the link between self-injury, suicide ideation, and attempts which has been reported in typically developing individuals. METHOD: One hundred three autistic participants completed the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Suicide Behaviors Questionnaire (SBQ-R), and the Interpersonal Social Evaluation List (ISEL-12) across two online studies. Logistic regression was conducted to predict self-harming status via responses to questions on suicidality, and to predict whether certain self-injurious behaviors, including cutting, were especially associated with suicide ideation and attempts. Non-parametric correlation analysis examined relationships between suicide ideation/attempts and other variables that might characterize self-harmers especially at risk of suicidality. These included perceived access to social support, purposes or reasons for self-injury, the number of different self-injurious behaviors engaged in, the duration and lifetime incidence of self-injury, and the individual's feelings about their self-injury. RESULTS: While self-injuring status was significantly predicted by responses to a question on suicide ideation and attempts, there was no relationship between suicide ideation/attempts and a participant's personal feelings about their self-injury. The method of cutting was also predicted by suicide ideation and attempts, though other methods common in autistic people were at borderline significance. Use of self-injury for the regulation of low-energy emotional states like depression, for self-punishment or deterrence from suicide, and for sensory stimulation, was associated with suicide ideation and attempts, as was the number of self-injurious behaviors engaged in. There was no significant relationship between suicide ideation/attempts and the duration and lifetime incidence of self-injury or social support. CONCLUSIONS: These preliminary data suggest that while individuals might frame their self-injury as a positive or neutral thing, there remains a concerning relationship between self-injury and suicidality which exists regardless of individual feelings on self-injury. This is consistent with the theoretical perspective that self-injury can be a "gateway" through which individuals acquire capability for lethal suicidal behaviors. The data highlight that particular methods (cutting) and reasons for self-injury may be of significant concern, but this information, which might be of extreme value for clinicians, requires further investigation and validation.

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Cited references
133
Total cited references integrated for this publication.
Cited references with an identified autistic author
1 / 133 (0.8%)
Cited author occurrences identified as autistic
1 / 608 (0.2%)
Among occurrences linked to AutiHub author records: 1 / 79 (1.3%). Distinct cited authors identified as autistic: 1 / 548 (0.2%).
Cited author occurrences linked to AutiHub author records
79 / 608 (13.0%)
Distinct linked cited authors: 59 / 548 (10.8%)
Linked cited-author occurrences not identified as autistic
78 / 79 (98.7%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 78 / 608 (12.8%). Distinct linked cited authors not identified as autistic: 58 / 59 (98.3%).
2 cited bibliography entries could not be fully enriched from DOI metadata.
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