A Measurement Invariance Analysis of the Interpersonal Needs Questionnaire and Acquired Capability for Suicide Scale in Autistic and Non-Autistic Adults.
The INQ-10 measures burdensomeness and belonging differently in autistic adults—don’t compare their raw scores with non-autistic norms.
01Research in Context
What this study did
MPayne et al. (2020) checked if two suicide-risk questionnaires work the same way for autistic and non-autistic adults.
They gave the 10-item Interpersonal Needs Questionnaire (INQ-10) and the Acquired Capability for Suicide Scale (ACSS-FAD) to both groups.
Then they ran math tests to see if a score of "15" means the same thing in each group.
What they found
The ACSS-FAD passed the test: its scores can be compared across groups.
The INQ-10 failed: it measures burdensomeness and belonging differently in autistic adults.
So a "high" INQ-10 score in an autistic client may not signal the same risk level as in a non-autistic client.
How this fits with other research
Green et al. (2020) found a similar warning with kids: the DAS-II spatial subtest gives inflated scores for autistic children, so you should trust verbal and non-verbal scores instead.
Bhat et al. (2023) shows the opposite outcome: their motor questionnaire (DCD-Q) stayed fair across autistic and non-autistic kids, proving some tools do stay equivalent.
Together these papers teach one lesson—always check if the ruler stretches differently for neurodivergent clients before you compare numbers.
Why it matters
If you use the INQ-10 to judge suicide risk, treat autistic adults as a separate norm group. Look at within-person change or use autism-specific cut-offs instead of standard tables. This one extra step keeps you from under- or over-estimating how isolated or burdensome your client feels.
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02At a glance
03Original abstract
<b><i>Background:</i></b> Autistic adults are more likely to engage in suicidal thoughts and behaviors, but there is little research to explore the underlying reasons. It is unclear whether self-report suicide scales that have been designed for non-autistic people accurately measure suicide risk constructs in autistic people. Therefore, this study explored, for the first time, whether the measurement properties of the self-report scales of the Interpersonal Theory of Suicide are equivalent in autistic and non-autistic adults. <b><i>Methods:</i></b> In this study, responses from 342 autistic and 353 non-autistic people on the Interpersonal Needs Questionnaire-10 (INQ-10) and Acquired Capability for Suicide Scale-Fearlessness about Death (ACSS-FAD) were compared by using measurement invariance analysis. Data were gathered through an online cross-sectional survey of the self-report measures. <b><i>Results:</i></b> Results suggest that measurement properties of the INQ-10 were different in autistic people. Autistic characteristics, such as different theory of mind and preference for concrete language, may have led the scale items to load differently on the factors in the autistic group than in the non-autistic group. The measurement properties of the ACSS-FAD were invariant between autistic and non-autistic people. <b><i>Conclusions:</i></b> Scores on the INQ-10 cannot be meaningfully compared between autistic and non-autistic people due to different measurement properties. Future research could explore how autistic people experience the concepts of burdensomeness and belonging, to consider how measures could accurately capture this. This would allow researchers to explore the role of these constructs in the development of suicidal thoughts and behaviors in autistic people. Clinicians should be aware that suicide risk factors may present differently in autistic people. Scores on the ACSS-FAD can be meaningfully compared, but the negatively worded scale items may pose similar response difficulties to autistic and non-autistic people.
, 2020 · doi:10.1089/aut.2019.0055