Suicidal behavior in people with autism: characteristics and prevention

It is estimated that every year more than 1,000,000 people commit suicide in the world, which means 1 suicide in the world every 40 seconds and, for each completed suicide, there are another 20 people with suicide attempts. suicide. Thus, we are facing a problem that requires more prevention, care and urgent intervention measures to be adopted.

Suicidal behavior in people with autism is a matter that requires special attention since, although large-scale studies have not yet been carried out, there is research that should be taken into account in which it is suggested that some factors such as lack of social integration, unemployment and other associated psychiatric disorders could link autism and behavior suicide.

In this article we will explain in greater detail the most relevant factors associated with suicidal behavior in people with autism, including highlighting the importance of continuing to investigate in this regard in order to prevent more cases and provide greater support to those people who are suffering.

Suicidal behavior in people with autism

Autism spectrum disorders (ASD) have a neurobiological origin, affecting the functioning and configuration of the nervous system.Therefore, it causes a series of difficulties fundamentally in two areas: communication and social interaction, on the one hand, and flexibility of thought and behavior, on the other. other.

For this reason, a multidisciplinary and comprehensive approach is necessary that is oriented towards the facilitation of a series of specialized, individualized supports. and that they are based on evidence, thus being the most appropriate to help improve the quality of life of each person who has been diagnosed with ASD. It should be noted that within all this help that must be provided, special attention must be paid to addressing and preventing suicidal behavior in people with autism.

There is a remarkable percentage of people with autism who have ever thought about suicide and, nevertheless, on many occasions it is quite complex to detect signs associated with the suffering they are suffering. That is why some researchers have begun to study the risks and possible solutions to suicide.

What do we know about suicide in cases of autism?

A team led by the expert Sarah Cassidy, from the University of Nottingham, were the first to investigate, through a large clinical study scale, about suicidal thoughts and behavior in people with autism in adulthood when they had received a late diagnosis of syndrome of Asperger. These scientists observed that suicidal behavior is a very worrisome reality in people with autism due to Therefore, more research is needed in this regard that can help prevent and intervene in this type of cases.

These researchers further noted that two out of three people diagnosed with ASD may have contemplated suicide at some point in their lives because they had spent a large part of their childhood and youth without having received the necessary support or even without even understanding their condition.

Another important measure to prevent suicidal behavior in people with autism is based on early detection and early diagnosis of ASD, as well as that sufficient attention is paid to balance and mental health from childhood, prevention and intervention against bullying and provide further help if signs of bullying are detected. alarm.

• Related article: "Autism Spectrum Disorders: 10 symptoms and diagnosis"

Risk factors associated with suicidal ideation and behavior in people with autism

Some of the factors associated with suicidal ideation and behavior in people with autism include some insufficient and unmet support and help needs, unwanted loneliness, self-harm, ruminative thoughts, emotional dysregulation, isolation, psychiatric illnesses, low self-esteem and also the degree to which they could camouflage their condition.

Other risk factors for suicidal behavior in people with autism would be the following: social ostracism, bullying and/or employment and victimization, difficulties in finding employment, having experienced some adverse and even traumatic experiences in childhood, marginalization, or alienating experiences with some professionals they had to deal with and with those systems that were theoretically designed to provide support to people with autism, among others factors.

Research on risk factors associated with suicidal behavior and ASD

Experts in the field have tried to link previous knowledge about suicidal behavior in people with autism to models already information on suicide in the general population, in order to seek a deeper understanding and thus serve as a useful predictive. Among all those models, Special emphasis has been placed on the "Interpersonal Theory of Suicide" (TIS).

In the Interpersonal Theory of Suicide, an attempt has been made to distinguish suicidal ideation from suicide attempts, considering them as different phenomena. When analyzing and investigating suicidal ideation, the TIS has highlighted the great relevance of what has been called "frustrated belonging", which is considered as a state of social disconnection in conjunction with the belief of being a burden to their relatives, being a possible risk factor for the suicide.

On the other hand, according to this theory on suicide, in order for this suicidal ideation to increase until it becomes a suicide attempt, a person should have been exposed to a prolonged series of events that were intensely physically and/or emotionally painful, among which would include self-harm that could cause habituation to pain and also reduce the fear of pain and even death. In addition, mental rehearsal, in which the person imagines how to carry out suicide, could also contribute to an increased risk for suicidal behavior.

It should be noted that in a study carried out in 2022 by Monseley and his collaborators about some risk factors associated with suicidal behavior in people with autism were able to observe a lower rate of suicide attempts and deaths by suicide in those people with autism who were in some kind of relationship (married or in a relationship). what in those people with autism who were single. This shows that satisfying relationships with other people who can serve as a support and are also a source of social connection are a protective factor against suicide.

In addition, the fact of having a healthy and stable relationship with another person has been associated with having higher levels of self-esteem, being able to be less likely to suffer from some negative states characterized by a feeling of being a burden and/or by belonging frustrated; Therefore, it can be a protective factor against suicidal behavior in people with autism and also in the general population. However, it should be noted that the observed direct effect of not being in a relationship on suicidal ideation was not significant.

In an article that was published in 2021 by Kolves and his collaborators, it is suggested that there is a higher rate of suicide attempts in those diagnosed at an older age than in those cases in which the diagnosis had been given at an early age.

However, this hypothesis has not received support from all the studies carried out in this regard, although it is consistent with those investigations that have found findings of a higher incidence of psychiatric illnesses such as depression or anxiety, among others, along with social and behavioral difficulties and a greater history of self-harm in those with a diagnosis late.

Also, other research in this regard has suggested that victimization and bullying are quite frequent in people with a late diagnosis of autism, so often they perceive themselves as inadequate or poorly integrated socially. Another possible relationship between late diagnosis, poor mental health and an increased risk of suicidal behavior in people with autism could lie in the possibility that these people are more skilled at camouflaging their difficulties. The camouflage of these difficulties has come to be associated with suicidality or the suicidal experience.

• You may be interested in: "20 recommended books on Autism"

Suicide prevention guidelines for people with ASD

Now that we have seen some factors associated with suicidal behavior in people with autism (although more research is still needed) it is also important to know some guidelines for suicide prevention.

Some suicide researchers have made a distinction between measures that serve to reduce the risk of suicide and those that help increase protection against it. It is also important to take into account protective factors against suicide related to the social, local, family and, of course, individual situation of each person.

To give a few examples, the fact that there is access to healthcare and a good mental health support network is a good protective factor against suicide; while the implementation of bullying prevention measures are also protective factors against suicide. Another protective factor against suicide would be having a strong social network that serves as support in those most difficult moments in a person's life.

Next we will discuss some of the prevention measures that have the greatest proven efficacy for suicide prevention in the general population and that they could also be used against suicidal behavior in people with autism.

1. Restrict access to means or instruments that can be used for suicide

In the first place, it is important that a restriction be made of any type of means that could be used to carry out suicide within the home or any place in which a person with attempts or who has shown alarm signals is habitually. After all, a good part of the people who have developed ASD will only independently explore the context of their home.

Among these means or instruments that must be restricted, it is worth mentioning weapons, pesticides or any other type of poison, firearms or some drugs that could be used to induce suicide by overdose.

2. Educational and training plans through institutions and the media

Plans to raise awareness about suicide and its risks through educational and training plans through associations, institutions or centers specialized in suicide, as well as through campaigns and notices through the different media in order to inform the greatest number as possible of people about such an important and worrying matter that it requires more professional help and that, under no circumstances, should be treated as a taboo subject.

It is important that the population is talked about and aware of suicide to be able to provide more help to people with suicide attempts. When raising awareness about suicide it is important to highlight a few things: try to seek professional help or an association or specialized suicide center as soon as possible and keep in mind that warning signs should never be ignored. alarm.

Although it is essential in cases of suicidal ideation and attempt to seek professional help, it is important that this person have a trusted person nearby (eg. g., a relative, his partner or a trusted friend) who can provide support at all times to help him move forward and reduce the risk of future attempts.

In that case, a professional could teach you a series of skills that could be used to support the person who is at risk (eg. For example, you should not downplay or try to change the subject when someone tells you about their suicidal ideation, you should make it easier for the person who has told you about her suicidal ideation person who freely expresses her emotions and listens carefully in order to show her that we are there when she needs us, etc.).

• Related article: "Suicidology: what it is, characteristics and objectives of this science"

3. Promote the development of skills that can be used to prevent suicide

It's very important encourage help for the development of social skillss and socio-emotional in children, adolescents and even adults, since it is never too late, in order to prevent a greater number of suicide attempts. For this, training plans should be started in schools and also through associations, organizations and centers specialized in suicide, as well as within associations dedicated to the support of people with TORCH.

4. Early detection of alarm signals

Another essential measure is in the context of therapy, early detection, assessment and appropriate treatment of those displaying suicidal behavior, as well as monitoring over time in order to avoid possible relapses.

All these measures should be accompanied by social, psychological and, of course, family support, as well as a multidisciplinary collaboration of professionals, plans of sensitization and awareness, more funding, large-scale research and more resources that can help in the treatment, monitoring and evaluation of this type of situations.

In order for a good prevention plan to be carried out, the collaboration and coordination of various sectors of society is necessary, including include, the health system, education, aid from the government, law enforcement and support and dissemination through the media communication.