Risk markers for suicidality in autistic adults.
Risk markers for suicidality in autistic adults.
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自闭症成年人自杀的风险标记。
DOI：
10.1186/s13229-018-0226-4
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发表时间：
2018
期刊：
影响因子：
6.2
通讯作者：
Baron-Cohen S
中科院分区：
文献类型：
--
作者：
Cassidy S;Bradley L;Shaw R;Baron-Cohen S
研究表明，自闭症谱系（ASC）患者的自杀率很高，但缺乏对原因的研究。自闭症成年人的许多常见经历，例如抑郁或失业，与普通人群中已知的自杀风险标志重叠。然而，尚不清楚是否存在 ASC 特有的风险标记，需要新的定制自杀预防策略。通过与自闭症成人指导小组协商，开展了一项调查，旨在确定该群体自杀的独特风险标记。该调查测量了自杀倾向（SBQ-R）、非自杀性自残（NSSI-AT）、心理健康问题、未满足的支持需求、就业、对生活安排的满意度、自我报告的自闭症特征（AQ）、ASC诊断延迟和“伪装”ASC。 164 名自闭症成年人（65 名男性，99 名女性）和 169 名普通成年人（54 名男性，115 名女性）在线完成了这项调查。大多数自闭症成人 (72%) 在 SBQ-R 上的自杀风险得分高于推荐的精神病学临界值；显着高于一般人群 (GP) 成年人 (33%)。在对一系列人口统计数据和诊断进行统计控制后，普通人群的 ASC 诊断和自我报告的自闭症特征显着预测了自杀倾向。在患有自闭症的成年人中，非自杀性自残、伪装和未满足的支持需求数量显着预测了自杀倾向。结果证实了先前报道的 ASC 自杀率较高，并证明 ASC 诊断和一般人群中自我报告的自闭症特征是自杀的独立风险标记。这表明与自闭症和自闭症特征相关的独特因素会增加自杀风险。伪装和未满足的支持需求似乎是 ASC 特有的自杀风险标志。非自杀性自残、就业和心理健康问题似乎是普通人群共有的风险标志，这些风险标志在自闭症群体中更为普遍。讨论了理解和预防 ASC 自杀的意义。
Research has shown high rates of suicidality in autism spectrum conditions (ASC), but there is lack of research into why this is the case. Many common experiences of autistic adults, such as depression or unemployment, overlap with known risk markers for suicide in the general population. However, it is unknown whether there are risk markers unique to ASC that require new tailored suicide prevention strategies. Through consultation with a steering group of autistic adults, a survey was developed aiming to identify unique risk markers for suicidality in this group. The survey measured suicidality (SBQ-R), non-suicidal self-injury (NSSI-AT), mental health problems, unmet support needs, employment, satisfaction with living arrangements, self-reported autistic traits (AQ), delay in ASC diagnosis, and ‘camouflaging’ ASC. One hundred sixty-four autistic adults (65 male, 99 female) and 169 general population adults (54 males, 115 females) completed the survey online. A majority of autistic adults (72%) scored above the recommended psychiatric cut-off for suicide risk on the SBQ-R; significantly higher than general population (GP) adults (33%). After statistically controlling for a range of demographics and diagnoses, ASC diagnosis and self-reported autistic traits in the general population significantly predicted suicidality. In autistic adults, non-suicidal self-injury, camouflaging, and number of unmet support needs significantly predicted suicidality. Results confirm previously reported high rates of suicidality in ASC, and demonstrate that ASC diagnosis, and self-reported autistic traits in the general population are independent risk markers for suicidality. This suggests there are unique factors associated with autism and autistic traits that increase risk of suicidality. Camouflaging and unmet support needs appear to be risk markers for suicidality unique to ASC. Non-suicidal self-injury, employment, and mental health problems appear to be risk markers shared with the general population that are significantly more prevalent in the autistic community. Implications for understanding and prevention of suicide in ASC are discussed.
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