Temperament and character as risk factor for suicide ideation and attempts in adults with autism spectrum disorders.
Depression, not personality traits, predicts suicide risk in adults with ASD.
01Research in Context
What this study did
Kovačič et al. (2020) asked if personality traits raise suicide risk in adults with autism.
They gave paper-and-pencil mood and personality tests to a small group of adults already diagnosed with ASD.
Then they checked whether temperament or character scores predicted who had thought about or attempted suicide.
What they found
Depression, not personality, was the only clear warning sign.
Once depression was counted, temperament and character added no extra power to predict suicide ideas or attempts.
How this fits with other research
Costa et al. (2020) asked the same question in a larger sample and got the same answer: depression is the key driver.
They also showed that trouble naming feelings (alexithymia) and taking antidepressants added extra risk, extending the basic finding.
Older work by Maddox et al. (2015) and Ganz et al. (2009) had linked temperament to other problems in ASD, but those studies did not control for mood.
The new result does not contradict the older ones; it simply shows that when depression is in the model, personality fades out.
Why it matters
If you screen adults with ASD, start and end with depression questions. Skip long personality inventories for suicide risk. Add a quick alexithymia check only after you have ruled out mood disorder. This saves time and keeps your risk watch list short and clear.
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02At a glance
03Original abstract
Persons with autism spectrum disorders (ASDs) are suggested to have an increased risk for suicide ideation and suicide attempts, but this topic is largely understudied. Research indicates that temperament and character traits are associated with suicidal behavior in persons without ASD, with higher scores for novelty seeking (NS), harm avoidance (HA), and self-transcedence (ST), and lower scores for self-directedness (SD) and cooperativeness (CO). Usually persons with ASD have temperament and character profiles with high HA, and low NS, reward dependence (RD), SD, and CO. The aim is to investigate whether there is a relationship between temperament and character traits and suicide ideation and attempts in adults with ASD. Seventy-four adults with ASD participated by completing self-report measures on suicide thoughts and behavior, depression, and temperament. Independent sample t-tests were conducted to compare scores between attempters versus nonattempters and between ideators versus nonideators. Regression analysis was performed to explore the predictive value of temperament and character. T-tests showed lower NS and SD, and higher HA for ideators versus nonideators, but not for attempters versus nonattempters. Regression models showed no significant relation between suicide ideation and NS, SD, HA after the latter were controlled for the significant influence of depression. Temperament and character can probably not be used for predicting suicide ideation and attempts, based on results from the current sample. Clinicians must take note of the high prevalence and risk of depression among persons with ASD, which may be under-reported. Autism Res 2020, 13: 104-111. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The aim of the current study was to uncover risk factors for suicide ideation and attempts in adults with autism, since this urgent topic is largely understudied. We initially investigated whether temperament and character could be risk factors, but found no association. However, we did find that depression might be a high predictor for suicide ideation, which could remain under-reported in adults with autism, due to impaired communication and problems with expressing emotions and thoughts.
Autism research : official journal of the International Society for Autism Research, 2020 · doi:10.1002/aur.2221