Background
People with Autism Spectrum Disorder (ASD) are at significantly increased risk of suicidal thoughts and behavior. Given that social difficulties in ASD often lead to social isolation, ...which can in turn increase the risk for depression, this study examined loneliness and social support as potential risk and protective factors associated with depression and suicidal ideation.
Method
The sample comprised 185 people (92 females) with ASD aged 14 to 80 years who were participating in a national survey.
Results
Forty‐nine percent of participants returned scores in the clinical range for depression and 36% reported recent suicidal ideation. Females, comprising almost 50% of the sample, returned higher depression scores than males, however no differences were identified between males and females in terms of suicidal ideation. Regression analyses revealed that loneliness, satisfaction with social support, and ASD traits predicted depression scores. Satisfaction with social support predicted suicidal ideation, however, it was no longer a significant predictor after the effects of depression were taken into account. Path analysis showed that ASD trait severity was independently related to depression, that the effect of number of social supports on depression was mediated by loneliness and satisfaction with social support, and that effects of loneliness and satisfaction with social support on suicidal ideation were mediated by depression. The pattern of relationships was nearly identical for males and females.
Conclusions
This study supports a model whereby loneliness and social support operate respectively as protective and risk factors for depression and suicidal ideation in ASD.
This study examined age trends in anxious and depressive symptoms, from older adolescence to old age, and explored the association between anxious and depressive symptoms with gender, ASD severity, ...and socio-economic factors. Two hundred and fifty-five individuals with ASD (151 males,
M
age
= 33.52 years,
SD
age
= 14.98) took part. More than one-third of participants reported clinically significant anxiety (38.4%) or depression (38%). A slight trend for an increase in the severity of both anxiety and depression from adolescence to middle adulthood, and then a slight decline in older adulthood was found. Female gender and higher ASD severity predicted more anxiety and depression symptoms. Our findings emphasise the need to provide timely assessment and treatment of anxiety and depression in ASD.
•This study examined mechanisms underpinning depression and thoughts of self-harm in Autism.•26% of participants met cut-off for depression, 21% reported thoughts of self-harm.•Loneliness acted on ...thoughts of self-harm indirectly through depression.•Highlights potential contribution of loneliness to depression and thoughts of self-harm in Autism.
Individuals with Autism Spectrum Disorder (ASD) are at increased risk of suicidal ideation and behavior. This study characterized the inter-relationships between loneliness, depression and thoughts of self-harm in adults with ASD.
Participants were 71 adults with ASD who completed questionnaires that provided information on loneliness, depression and thoughts of self-harm. Relationships between study variables were examined with correlations and a regression analysis. Two exploratory mediation models were then explored. Model 1 tested whether the relationship between depression and thoughts of self-harm was mediated through loneliness. Model 2 tested whether loneliness acted on thoughts of self-harm through depression.
Twenty-six percent of participants met the clinical cut-off for depression and 21% reported thoughts of self-harm. Depressive symptoms, loneliness, and thoughts of self-harm were significantly correlated. Only Model 2, that identified an indirect pathway from loneliness, through depression to thoughts of self-harm, was supported. The mediator for this model accounted for 56.7% of the total effect.
This study examined potential mechanisms underlying depression and thoughts of self-harm in ASD. These results highlight a possible contribution of loneliness to depression and thoughts of self-harm, suggesting treatment options that target loneliness may prove beneficial in improving mental health outcomes in ASD.
Purpose of the Review
There is a heightened risk of suicide in Autism Spectrum Disorder (ASD). An up-to-date systematic review was conducted for studies examining suicide in ASD that were published ...in the past 5 years.
Recent Findings
Four previous systematic reviews were identified. The most recent review included studies published between 1995 and 2014. Combining data cross studies, prevalence of suicide attempts in ASD was estimated to be 7 to 47%, and suicidal ideation was 72%.
Summary
The current review included 13 studies. Compared to previous reviews, we identified a shift to the use of larger cohorts, including one population-based study. Prevalence rates for suicidal ideation were 11 to 66% and suicidal attempts were 1 to 35%. One study reported that 0.31% of premature deaths in ASD were due to suicide, significantly higher than general population controls. Further theoretical and empirical work is needed to identify causal mechanisms underlying suicidal risk in people with ASD.
Suicide is a global health problem affecting both normative and clinical populations. Theoretical models that examine mechanisms underlying suicide risk across heterogeneous samples are needed. The ...present study explored core characteristics associated with autism spectrum disorder (ASD), a sub-population at high risk of suicide, as well as two dimensional cognitive constructs, as potential transdiagnostic predictors of suicidal ideation in a clinically diverse sample. Participants (n = 1851, 62% female) aged 18 to 89 years completed online questionnaires assessing: social communication difficulties; insistence on sameness; cognitive control; and rumination. Forty-three percent of participants reported the presence of at least one neurodevelopmental or neuropsychiatric disorder. One third of the sample reported some suicidal ideation (SI), and 40 percent met the threshold for concern for depression. All hypothesized constructs were associated with SI and depression and, with the exception of rumination, contributed significantly to SI. Participants reporting SI returned significantly higher social communication difficulties and insistence on sameness, and lower levels of cognitive control than those reporting no-SI. The study was limited by the use of a cross-sectional sample assessed with self-report measures. All diagnoses were self-reported and the study was additionally limited by the use of a single item indicator of suicidal ideation. These findings support a role for constructs associated with the ASD phenotype and associated broad cognitive domains as potential risk factors underlying suicidal ideation in a large clinically diverse sample. Our findings suggest directions for future longitudinal research studies, along with specific targets for suicide prevention and clinical practice.
Receiving a child's autism diagnosis can be stressful; as such, parent resolution contributes to the wellbeing and development of healthy parent-child relationships. In other significant childhood ...diagnoses (e.g., cerebral palsy, diabetes), the degree to which parents adjust to (a) their child's diagnosis and (b) their changes in expectations concerning their child's development and capacity (referred to as resolution to diagnosis), has been associated with improved outcomes including facilitating parent-child relationships and improved parental wellbeing. Given potential benefits to parent and child, and the heterogenous nature of autism, examining the unique factors associated with resolution to diagnosis is important. In this systematic review we identified factors that support or inhibit parental resolution to their child receiving a diagnosis of autism.
We completed a systematic review following PRISMA guidelines of peer-reviewed studies from 2017 to 2022, that investigated parental resolution or acceptance of an autism diagnosis. Papers including "acceptance" needed to encompass both accepting the diagnosis and the implications regarding the child's abilities. We searched six databases (Scopus, Web of Science, MEDLINE, PsycINFO, ProQuest), with additional papers located following review of reference lists.
Fourteen papers with 592 participants that investigated parental resolution or acceptance of an autism diagnosis, were included. We identified six common factors that facilitate or inhibit parental resolution and acceptance of an autism diagnosis including: symptom severity; religion, belief, and culture; knowledge and uncertainty; negative emotions (i.e., denial, shame, guilt); positive emotions; and support. Greater resolution was associated with improved "attunement and insightfulness" in the parent-child relationship.
The review was limited by the small number of studies meeting inclusion criteria. Second, the quality of included studies was mixed, with over half of the studies being qualitative and only one randomized control trial (RCT) identified.
Parental resolution can have an impact on parent's perception of their child's capabilities and impact the parent-child relationship. We identified six categories that aid in inhibiting or promoting resolution to diagnosis. Despite taking a broad approach on the definition of resolution, the low number of studies identified in the review indicates a need for more research in this area.
http://www.crd.york.ac.uk/PROSPERO/, PROSPERO ID: CRD42022336283.
Children with Autism Spectrum Disorder (ASD) are known to have difficulty in producing and perceiving emotional facial expressions. Their expressions are often perceived as atypical by adult ...observers. This paper focuses on data driven ways to analyze and quantify atypicality in facial expressions of children with ASD. Our objective is to uncover those characteristics of facial gestures that induce the sense of perceived atypicality in observers. Using a carefully collected motion capture database, facial expressions of children with and without ASD are compared within six basic emotion categories employing methods from information theory, time-series modeling and statistical analysis. Our experiments show that children with ASD exhibit lower complexity in facial dynamics, with the eye regions contributing more than other facial regions towards the differences between children with and without ASD. Our study also notes that children with ASD exhibit lower left-right facial symmetry, and more uniform motion intensity across facial regions.
There has been a recent shift from person-first to identity-first language to describe autism. In this study, Australian adults who reported having a diagnosis of autism (
N
= 198) rated and ranked ...autism-terms for preference and offensiveness, and explained their choice in free-text. ‘Autistic’, ‘Person on the Autism Spectrum’, and ‘Autistic Person’ were rated most preferred and least offensive overall. Ranked-means showed ‘person on the autism spectrum’ was the most preferred term overall. Six qualitative themes reflected (1) autism as core to, or (2) part of one’s identity, (3) ‘spectrum’ reflecting diversity, (4) the rejection of stigmatising and (5) medicalised language, and (6) pragmatics. These findings highlight the importance of inclusive dialogue regarding individual language preference.
Anxiety is a common problem in school-aged children with autism spectrum disorder (ASD). Cognitive behavioral therapy (CBT) and other psychosocial interventions have been developed as alternatives to ...pharmacological intervention to treat anxiety symptoms in students with ASD without co-occurring intellectual disability. This present synthesis of evidence is a systematic review and meta-analysis examining the efficacy of interventions for reducing anxiety among school-aged children with ASD. This review aims to address the question of what the relative effectiveness of interventions is for managing anxiety of school-aged children with ASD in school, family, and clinical settings. Twenty-four studies, involving 931 school-aged children with ASD (without co-occurring intellectual disability) and clinical anxiety, are summarized in this review. Overall, the effects of interventions on anxiety show a statistically significant moderate to high effect, compared to waitlist and treatment-as-usual control conditions at posttreatment. Author abstract
PDF
