Automutilation non suicidaire et sa relation avec le suicide par l'intermédiaire de la capacité acquise : investigation de ce mécanisme causal dans un échantillon autiste principalement diagnostiqué tardivement

Titre original en anglais : Non-suicidal self-injury and its relation to suicide through acquired capability: investigating this causal mechanism in a mainly late-diagnosed autistic sample

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Moseley, R., Gregory, N., Smith, P., Allison, C., Cassidy, S., & Baron-Cohen, S. (2022). Non-suicidal self-injury and its relation to suicide through acquired capability: investigating this causal mechanism in a mainly late-diagnosed autistic sample. Molecular Autism, 13(1), 45-45. https://doi.org/10.1186/s13229-022-00522-5

Date de publication: 12/11/2022 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 : L'automutilation non suicidaire (NSSI) a été associée à un risque plus élevé de tentatives de suicide chez les personnes autistes et non autistes. Dans la population générale, la NSSI peut conférer une capacité acquise au suicide en érodant la peur et l'évitement de la douleur et de la mort. La présente étude visait à explorer la capacité acquise en tant que médiateur de l'augmentation du risque de suicide conférée par la NSSI chez des adultes autistes et non autistes. MÉTHODES : Des adultes autistes et non autistes (n = 314, n = 312) ont répondu à une enquête en ligne portant sur les tentatives de suicide au cours de la vie, l'expérience de la NSSI et la capacité acquise au suicide. Nous avons exploré les relations entre l'incidence de la NSSI au cours de la vie et les tentatives de suicide au cours de la vie par l'intermédiaire de trois facettes de la capacité acquise (tolérance à la douleur, peur réduite de la mort et répétition mentale du suicide). Chez les participants s'automutilant (224 autistes et 156 non autistes), nous avons exploré si certains types et caractéristiques de NSSI pouvaient être particulièrement associés à la capacité et, par son intermédiaire, au suicide : à savoir le fait de se griffer, de se couper et de se frapper soi-même, ainsi que le recours à un plus grand nombre de formes de NSSI. RÉSULTATS : Bien qu'une fréquence plus élevée de NSSI ait été associée aux trois facettes de la capacité acquise, seule la peur réduite de la mort et la répétition mentale du suicide ont médiatisé une relation indirecte avec les tentatives de suicide au cours de la vie. La NSSI a également prédit directement un plus grand nombre de tentatives de suicide. Les personnes autistes tendaient vers une peur réduite de la mort et une répétition mentale du suicide, quel que soit leur statut de NSSI. Parmi les participants autistes et non autistes s'automutilant, le fait de se couper et un nombre accru de comportements de NSSI étaient associés aux tentatives de suicide au cours de la vie, directement et indirectement par l'intermédiaire de la capacité acquise. Dans les deux groupes, le fait de se frapper soi-même était associé aux tentatives de suicide au cours de la vie uniquement par l'intermédiaire de la capacité acquise. LIMITES : Notre méthodologie transversale ne permet pas de tirer des conclusions quant à la directionnalité. Bien que nous ayons contrôlé l'âge, nos échantillons étaient mal appariés, le groupe autiste étant en moyenne deux fois plus âgé. L'échantillon autiste, majoritairement diagnostiqué tardivement, féminin et hautement qualifié, n'était pas représentatif de l'ensemble de la communauté autiste. CONCLUSIONS : Nos données suggèrent que la capacité acquise, telle que mesurée ici, constitue une explication incomplète de l'association entre la NSSI et le risque de suicide. Une construction plus large comportant des facettes stables et transitoires pourrait offrir un pouvoir explicatif supérieur, mais il est probable que d'autres variables expliquent cette association ou fournissent des moyens supplémentaires par lesquels elle survient.

BACKGROUND: Non-suicidal self-injury (NSSI) has been linked with a higher risk of suicide attempts in autistic and non-autistic people. In the general population, NSSI may confer acquired capability for suicide by eroding one's fear and avoidance of pain and death. The present study aimed to explore acquired capability as the mediator of increased suicide risk conferred by NSSI in autistic and non-autistic adults. METHODS: Autistic and non-autistic adults (n = 314, n = 312) completed an online survey exploring lifetime suicide attempts, experience with NSSI, and acquired capability for suicide. We explored relationships between lifetime incidence of NSSI and lifetime suicide attempts via three facets of acquired capability (pain tolerance, reduced fear of death, and mental rehearsal of suicide). In self-harming participants (224 autistic and 156 non-autistic), we explored whether particular types and features of NSSI might be especially associated with capability and through that with suicide: namely engagement in scratching, cutting, and self-hitting, and engaging in more numerous forms of NSSI. RESULTS: While a higher frequency of NSSI was associated with all three facets of acquired capability, only reduced fear of death and mental rehearsal of suicide mediated an indirect relationship with lifetime suicide attempts. NSSI also directly predicted more numerous suicide attempts. Autistic people tended towards reduced fear of death and mental rehearsal regardless of NSSI status. Among self-harming autistic and non-autistic participants, cutting and an increased number of NSSI behaviours were associated with lifetime suicide attempts directly and indirectly via acquired capability. In both groups, self-hitting was associated with lifetime suicide attempts only via acquired capability. LIMITATIONS: Our cross-sectional methodology negates inferences of directionality. While we controlled for age, our samples were poorly matched, with the autistic group two times older on average. The autistic sample, predominantly late-diagnosed, female and highly qualified, were unrepresentative of the whole autistic community. CONCLUSIONS: Our data suggest that acquired capability, as measured herein, is an incomplete explanation for the association between NSSI and suicide risk. A broader construct with stable and transient facets may offer greater explanatory power, but it is probable that other variables explain or provide additional means through which this association arises.

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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
132
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
5 / 132 (3,8 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
5 / 593 (0,8 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 5 / 87 (5,7 %). Auteurices cité·es distinct·es identifié·es comme autistes : 2 / 493 (0,4 %).
Occurrences citées rattachées à la base AutiHub
87 / 593 (14,7 %)
Auteurices cité·es distinct·es rattaché·es : 60 / 493 (12,2 %)
Occurrences rattachées, non identifiées comme autistes
82 / 87 (94,3 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 82 / 593 (13,8 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 58 / 60 (96,7 %).
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