Un « choix », une « addiction », une manière de « sortir de l'égarement » : exploration de l'automutilation chez des personnes autistes sans déficience intellectuelle

Titre original en anglais : A ‘choice’, an ‘addiction’, a way ‘out of the lost’: exploring self-injury in autistic people without intellectual disability

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Moseley, R., Gregory, N., Smith, P., Allison, C., & Baron-Cohen, S. (2019). A ‘choice’, an ‘addiction’, a way ‘out of the lost’: exploring self-injury in autistic people without intellectual disability. Molecular Autism, 10(1), 18-18. https://doi.org/10.1186/s13229-019-0267-3

Date de publication: 11/04/2019 Ajout dans AutiHub: 06/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
5
Auteur·ices de la publication identifié·es comme autistes
1 / 5 (20,0 %)
  1. Rachel Moseley *
  2. Nicola Gregory
  3. Paula Smith
  4. Carrie Allison
  5. Simon Baron-Cohen

Résumé

Contexte : L'automutilation non suicidaire (NSSI) décrit un phénomène dans lequel des individus s'infligent délibérément de la douleur et des lésions tissulaires corporelles. Les comportements auto-agressifs sont particulièrement fréquents dans l'ensemble du spectre de l'autisme, mais les caractéristiques et les fonctions de l'automutilation chez les personnes autistes sans déficience intellectuelle, ainsi que les facteurs de risque qui pourraient être utiles en pratique clinique dans ce groupe, sont peu compris. Méthodes : Cent trois adultes autistes ayant répondu à une annonce en ligne ont été classés comme pratiquant actuellement l'automutilation, l'ayant pratiquée par le passé ou ne pratiquant pas l'automutilation, conformément à leurs réponses au Non-Suicidal Self-Injury Assessment Tool (NSSI-AT). Une régression multinomiale visait à prédire la catégorisation des participants conformément aux scores obtenus à des tests de traits autistiques, d'alexithymie, de dépression, d'anxiété, de mentalisation et de sensibilité sensorielle. Une régression linéaire a examiné les relations entre ces prédicteurs et l'étendue, la fréquence, la survenue au cours de la vie et les fonctions de la NSSI. Une analyse qualitative a exploré les interventions thérapeutiques que les participants avaient trouvées utiles, ainsi que ce qu'ils souhaitaient que les gens comprennent au sujet de l'automutilation. Résultats : Les participants pratiquant actuellement l'automutilation, l'ayant pratiquée par le passé et ne pratiquant pas l'automutilation ne différaient pas en termes d'âge, d'âge au diagnostic, de ratio hommes-femmes, de niveau d'emploi ou d'éducation (la majorité étant qualifiée au moins au niveau d'une licence). La fonction la plus fréquente de la NSSI était la régulation d'états affectifs de faible énergie (dépression, dissociation), suivie de la régulation d'états de forte énergie tels que la colère et l'anxiété. L'alexithymie prédisait significativement la catégorisation des participants comme pratiquant actuellement l'automutilation, l'ayant pratiquée par le passé ou ne pratiquant pas l'automutilation, et prédisait le recours à la NSSI pour réguler des états de forte énergie et communiquer sa détresse aux autres. La dépression, l'anxiété et la sensibilité sensorielle différenciaient également les groupes de participants, et les différences sensorielles prédisaient aussi l'étendue des zones corporelles ciblées, l'incidence au cours de la vie et la fréquence de la NSSI. Les différences sensorielles, ainsi que la difficulté à exprimer et à identifier les émotions, sont également apparues comme problématiques dans l'analyse qualitative, dans laquelle les participants ont exprimé le besoin de compassion, de patience, d'absence de jugement et la nécessité de reconnaître la diversité entre les personnes qui s'automutilent, certains participants percevant la NSSI comme une stratégie d'adaptation pratique et non problématique. Conclusions : L'alexithymie, la dépression, l'anxiété et les différences sensorielles peuvent exposer certaines personnes autistes à un risque particulièrement élevé d'automutilation. L'étude de l'implication de ces variables et de leur utilité pour l'identification et le traitement est de grande importance, et les témoignages des participants offrent des orientations aux praticiens confrontés à la NSSI chez leurs clients autistes.

Background: Non-suicidal self-injury (NSSI) describes a phenomenon where individuals inflict deliberate pain and tissue damage to their bodies. Self-injurious behaviour is especially prevalent across the autism spectrum, but little is understood about the features and functions of self-injury for autistic individuals without intellectual disability, or about the risk factors that might be valuable for clinical usage in this group. Methods: One hundred and three autistic adults who responded to an online advertisement were classified as current, historic or non-self-harmers in accordance with responses to the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT). Multinomial regression aimed to predict categorisation of participants in accordance with scores on tests of autistic traits, alexithymia, depression, anxiety, mentalising and sensory sensitivity. Linear regression examined relationships between these predictors and the range, frequency, lifetime occurrence and functional purposes of NSSI. Qualitative analysis explored the therapeutic interventions that participants had found helpful, and what they wished people understood about self-injury. Results: Current, historic and non-self-harming participants did not differ in age, age at diagnosis, male-to-female ratio, level of employment or education (the majority qualified to at least degree level). The most common function of NSSI was the regulation of low-energy affective states (depression, dissociation), followed by the regulation of high-energy states such as anger and anxiety. Alexithymia significantly predicted the categorisation of participants as current, historic or non-self-harmers, and predicted use of NSSI for regulating high-energy states and communicating distress to others. Depression, anxiety and sensory-sensitivity also differentiated participant groups, and sensory differences also predicted the range of bodily areas targeted, lifetime incidence and frequency of NSSI. Sensory differences, difficulty expressing and identifying emotions also emerged as problematic in the qualitative analysis, where participants expressed the need for compassion, patience, non-judgement and the need to recognise diversity between self-harmers, with some participants perceiving NSSI as a practical, non-problematic coping strategy. Conclusions: Alexithymia, depression, anxiety and sensory differences may place some autistic individuals at especial risk of self-injury. Investigating the involvement of these variables and their utility for identification and treatment is of high importance, and the voices of participants offer guidance to practitioners confronted with NSSI in their autistic clients.

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Références citées
154
Nombre total de références citées intégrées pour cette publication.
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Occurrences citées rattachées à la base AutiHub
85 / 616 (13,8 %)
Auteurices cité·es distinct·es rattaché·es : 56 / 543 (10,3 %)
Occurrences rattachées, non identifiées comme autistes
85 / 85 (100,0 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 85 / 616 (13,8 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 56 / 56 (100,0 %).
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