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New research from the University of Cambridge could have important implications for safeguarding autistic people and can help clinicians in screening for trauma and monitoring suicide-related behaviour.
The study, published in Autism Research, found that autistic people are more likely to report suicide-related behaviours and psychological distress, irrespective of previous traumatic experiences. It is also the first to show that different types of traumas may be associated with various kinds of suicide-related behaviours and psychological distress.
Autistic adults have increased risks of trauma, suicide, and poor mental health compared to non-autistic adults, with one in four autistic adults attempting suicide.
The authors said that focusing on the prevention of trauma, coping strategies, and recovery from traumatic events through safeguarding and support may be critical tools for suicide prevention among autistic people.
Trauma and suicide risk in autistic people
This new study is the first to investigate how lifetime trauma is independently associated with specific outcomes – including lifetime self-harm, suicide attempts, suicide plans, having a mental health condition that impacts daily life, and regularly using substances such as alcohol as a coping mechanism – in autistic people.
The study was conducted by a team at the Autism Research Centre (ARC) at the University of Cambridge and used an anonymised, self-report survey to analyse the relationship between lifetime trauma and lifetime suicide-related behaviours and psychological distress in 424 autistic adults and 345 non-autistic adults.
The participants were international; however, the majority were from the UK. The survey was co-created with eight autistic adults to ask autistic and non-autistic people about their negative life experiences. It measured 60 life experiences across 10 domains (education, employment, finances, social services, criminal justice system, childhood victimisation, adulthood victimisation, domestic abuse, lack of social support, and mental health).
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The analysis took into account other factors such as age, sex, country of residence, education level and two or more neurodevelopmental/mental health conditions.
Trauma-focused mental healthcare in autistic people
The study shows for the first time that higher levels of trauma are associated with an increased likelihood of reporting suicide-related behaviours and psychological distress in autistic people, as is the case in the general population.
Autistic people who reported experiencing childhood victimisation were more likely to report a mental health condition that impacts daily life, as well as self-harm, suicide plans, and suicide attempts. Autistic people who reported experiencing a lack of social support were also more likely to report a mental health condition that impacts daily life, self-harm, and suicide plans.
Even after accounting for trauma, autistic people showed higher rates of suicide-related behaviours than others. This suggests that there may be unique aspects of autism – such as sensory differences or the efforts involved in camouflaging – that contribute to how trauma relates to self-harm, suicide attempts, suicide plans, and having mental health conditions that impact daily life.
Dr Elizabeth Weir, a Research Associate at the ARC in Cambridge, who supervised the project, said: “This study adds to the limited evidence that a greater number of traumatic experiences is associated with higher rates of self-reported suicide-related behaviours in autistic people. However, trauma alone does not explain the increased risk of suicidality for autistic people. Future research must address what other factors are playing a key role in these outcomes, so that we have better means of preventing suicide and supporting autistic people who are already experiencing suicidality.”
The research was supported by a grant from Autistica and the Autism Research Trust, whose legacy work is now managed by Autism Action.
