Mécanismes potentiels sous-jacents à la suicidalité chez les personnes autistes présentant un trouble du déficit de l'attention avec hyperactivité : mise à l'épreuve d'hypothèses issues de la théorie interpersonnelle du suicide

Titre original en anglais : Potential Mechanisms Underlying Suicidality in Autistic People with Attention Deficit/Hyperactivity Disorder: Testing Hypotheses from the Interpersonal Theory of Suicide

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Moseley, R., Gregory, N., Smith, P., Allison, C., Cassidy, S., & Baron-Cohen, S. (2023). Potential Mechanisms Underlying Suicidality in Autistic People with Attention Deficit/Hyperactivity Disorder: Testing Hypotheses from the Interpersonal Theory of Suicide. Autism in Adulthood, 6(1), 9-24. https://doi.org/10.1089/aut.2022.0042

Date de publication: 15/06/2023 Ajout dans AutiHub: 06/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
6
Auteur·ices de la publication identifié·es comme autistes
1 / 6 (16,7 %)
  1. Rachel Moseley *
  2. Nicola Gregory
  3. Paula Smith
  1. Carrie Allison
  2. Sarah Cassidy
  3. Simon Baron-Cohen

Résumé

Contexte : Les personnes autistes présentant un trouble déficitaire de l’attention avec hyperactivité (TDAH) concomitant semblent présenter un risque accru de suicide. Afin de comprendre pourquoi, nous avons exploré deux mécanismes explicatifs issus de la théorie interpersonnelle du suicide : premièrement, le TDAH concomitant pourrait être associé à un risque plus élevé par l’intermédiaire d’un sentiment d’appartenance contrarié et d’une charge perçue plus importants et, deuxièmement, les caractéristiques hyperactives/impulsives pourraient entraîner un risque supplémentaire par leur association avec des événements douloureux et provocateurs, qui seraient susceptibles de créer une « capacité » de suicide. Méthodes : Des adultes autistes (n = 314) ont répondu à une enquête en ligne comprenant des mesures du sentiment d’appartenance contrarié, de la charge perçue, des événements douloureux et provocateurs, de la capacité acquise de suicide et des caractéristiques du TDAH. En créant un indice global de TDAH probable, nous avons examiné les associations entre le TDAH probable, les idées suicidaires et les tentatives de suicide au cours de la vie par l’intermédiaire des médiateurs parallèles que sont le sentiment d’appartenance contrarié, la charge perçue, l’anxiété et la dépression. Dans plusieurs modèles, nous avons ensuite examiné les caractéristiques hyperactives, impulsives et inattentives comme prédicteurs de l’exposition à des événements douloureux et provocateurs et de la capacité de suicide subséquente, et avons examiné si ces deux variables, séquentiellement ou individuellement, médiatisaient une association avec les tentatives de suicide au cours de la vie. Résultats : Le TDAH probable était associé aux idées suicidaires au cours de l’année passée par l’intermédiaire d’une dépression et d’une charge perçue plus importantes, lesquelles médiatisaient également son association avec un plus grand nombre de tentatives de suicide. Les caractéristiques hyperactives et impulsives étaient associées à l’exposition à des événements douloureux et provocateurs et, par ce biais, à la capacité acquise de suicide. Les deux caractéristiques étaient associées à un nombre plus élevé de tentatives de suicide par l’intermédiaire de ces deux médiateurs de façon séquentielle, et par l’intermédiaire de l’exposition aux seuls événements douloureux et provocateurs. Conclusions : Ces données suggèrent que la suicidalité chez les personnes autistes avec TDAH peut être partiellement liée à la charge perçue et à la capacité acquise de suicide après l’exposition à des événements douloureux et provocateurs. Toutefois, comme nous avons observé une voie vers la suicidalité associée aux seuls événements douloureux et provocateurs, il est probable qu’il existe également d’autres mécanismes explicatifs de l’influence des événements traumatiques sur le risque de suicide.

Background: Autistic people with co-occurring attention deficit/hyperactivity disorder (ADHD) appear to be at heightened risk of suicide. To understand why, we explored two explanatory mechanisms from the interpersonal theory of suicide: first, that co-occurring ADHD might be associated with greater risk through greater thwarted belongingness and perceived burdensomeness and, secondly, that hyperactive/impulsive features might incur additional risk through their association with painful and provocative events, which are suggested to create “capability” for suicide. Methods: Autistic adults (n = 314) completed an online survey including measures of thwarted belongingness, perceived burdensomeness, painful and provocative events, acquired capability for suicide, and ADHD features. Creating an overall index of likely ADHD, we examined associations between likely ADHD, suicide ideation, and lifetime suicide attempts through the parallel mediators of thwarted belongingness, perceived burdensomeness, anxiety, and depression. In several models, we then examined hyperactive, impulsive, and inattentive features as predictors of exposure to painful and provocative events and subsequent capability for suicide, and examined whether these two variables, sequentially or individually, mediated an association with lifetime suicide attempts. Results: Likely ADHD was associated with past-year suicide ideation through greater depression and perceived burdensomeness, which also mediated its association with more suicide attempts. Hyperactive and impulsive features were associated with exposure to painful and provocative events and through this acquired suicide capability. Both features were associated with more numerous suicide attempts through these two mediators sequentially, and through exposure to painful and provocative events alone. Conclusions: These data suggest that suicidality in autistic people with ADHD may be partially related to perceived burdensomeness and to acquired suicide capability after exposure to painful and provocative events. However, as we observed a pathway to suicidality associated with painful and provocative events alone, it is likely that there are also other explanatory mechanisms for the influence of traumatic events on suicide risk.

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Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:31.

Références citées
125
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
5 / 125 (4,0 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
9 / 809 (1,1 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 9 / 117 (7,7 %). Auteurices cité·es distinct·es identifié·es comme autistes : 7 / 712 (1,0 %).
Occurrences citées rattachées à la base AutiHub
117 / 809 (14,5 %)
Auteurices cité·es distinct·es rattaché·es : 81 / 712 (11,4 %)
Occurrences rattachées, non identifiées comme autistes
108 / 117 (92,3 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 108 / 809 (13,3 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 74 / 81 (91,4 %).
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