Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder.
Half of autistic adults report past non-suicidal self-injury, far above other groups, and routine-change distress may fuel it.
01Research in Context
What this study did
The team sent a short survey to adults with autism. They asked if the person had ever hurt themselves on purpose without wanting to die.
They also asked neurotypical adults the same questions. Then they compared the two groups.
What they found
Half of the autistic adults said yes, they had self-injured. That rate is much higher than in other adult groups.
The ways they hurt themselves looked the same as in non-autistic adults.
How this fits with other research
Ferguson et al. (2025) asked 1,892 autistic youth why they self-injure. The biggest reason was distress when routines changed. The adult survey shows the same risk may carry into adulthood.
Hedley et al. (2023) built a new suicide-thought screener for autistic adults. Their tool came after the 50% NSSI finding, giving clinicians a way to catch risk early.
Bennett (2016) warned that almost no one was asking autistic adults about mood or self-harm. The 2017 survey answered that call by going straight to the adults themselves.
Why it matters
If you work with autistic adults, expect that one in two may have a history of self-injury. Build questions about routine change distress into your intake. Pair the new SIDAS-M screener with your usual depression tools. Treat self-injury as a top priority, not a side note.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one question about distress when plans change to your intake form and note any self-injury history.
02At a glance
03Original abstract
Recent studies have examined non-suicidal self-injury in community and clinical samples, but there is no published research on non-suicidal self-injury in individuals with autism spectrum disorder. This lack of research is surprising, since individuals with autism spectrum disorder have high rates of risk factors for non-suicidal self-injury, including depression and poor emotion regulation skills. Using an online survey, we examined non-suicidal self-injury methods, frequency, severity, functions, and initial motivations in adults with autism spectrum disorder ( n = 42). We also compared their non-suicidal self-injury characteristics to those of a gender-matched group of adults without autism spectrum disorder ( n = 42). Of the participants with autism spectrum disorder, 50% reported a history of non-suicidal self-injury. This proportion is higher than non-suicidal self-injury rates previously reported for college students, adult community samples, and adolescents with autism spectrum disorder, which suggests that adults with autism spectrum disorder have increased risk for engaging in non-suicidal self-injury. Women with autism spectrum disorder were significantly more likely to endorse non-suicidal self-injury, relative to men with autism spectrum disorder. A history of non-suicidal self-injury was not related to current depression or emotion dysregulation for the participants with autism spectrum disorder. Non-suicidal self-injury characteristics among the adults with autism spectrum disorder were similar to non-suicidal self-injury in adults without autism spectrum disorder. These preliminary findings highlight the need for increased awareness and further research about non-suicidal self-injury within autism spectrum disorder.
Autism : the international journal of research and practice, 2017 · doi:10.1177/1362361316644731