What do we know about suicidality in autism spectrum disorders? A systematic review.
Up to half of people with ASD may think about or attempt suicide—screen all clients, watch for bullying, and ignore outdated “only boys” myths.
01Research in Context
What this study did
Segers et al. (2014) looked at every paper they could find on suicide thoughts or acts in people with autism. They found only 10 studies. The team pulled out risk factors such as being bullied, being a boy, or being from a minority group.
They did not run new tests. They simply counted what past work had said and pointed out big gaps in how we measure risk.
What they found
Across the small set, between 11% and 50% of people with ASD had some level of suicidality. The wide range shows we lack good tools to spot and count risk.
Bullying, male sex, and minority status came up again and again as red flags.
How this fits with other research
Green et al. (2020) narrowed the range. They tracked 7- to 11-year-olds and found parent-reported suicidal ideas in 9.6% and self-harm acts in 14.6%. Their numbers sit near the low end of the 2014 window, showing age and reporter matter.
Maïano et al. (2016) give teeth to the bullying link. Their meta-analysis of 17 studies shows 44% of school youth with ASD face peer victimization. This large pooled rate backs up the 2014 claim that bullying raises risk.
Kirby et al. (2024) tweak the male-risk message. They show death-by-suicide counts are similar for autistic males and females, warning us not to relax vigilance with girls. The 2014 review called male sex a risk factor, but newer data say both sexes die at like rates.
Why it matters
You now know suicidality is common in ASD, but numbers swing wildly depending on age, reporter, and measure. Screen every client, not just boys. Ask about bullying, sleep, and minority stress. Use simple, direct questions and document answers each visit.
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02At a glance
03Original abstract
Suicidality is a common and concerning issue across development, and there is a plethora of research on this topic among typically developing children and youth. Very little is known, however, about the nature of suicidality among individuals with autism spectrum disorders (ASDs). The purpose of the current study was to undertake a systematic literature review to assess the current state of the research literature to examine the prevalence of suicidality among individuals with ASD, related demographic and clinical profiles, and associated risk and protective factors. A literature search using key terms related to suicidality and ASD yielded 10 topical studies that were evaluated for the study objectives. Suicidality was present in 10.9-50% of the ASD samples identified in the systematic review. Further, several large-scale studies found that individuals with ASD comprised 7.3-15% of suicidal populations, a substantial subgroup. Risk factors were identified and included peer victimization, behavioral problems, being Black or Hispanic, being male, lower socioeconomic status, and lower level of education. Only one study reported on protective factors, and this is identified as a significant gap in the literature. Several methodological weaknesses were present in the current literature, such as lack of appropriate comparison groups and little to no use of empirically validated measures for ASD diagnosis and suicide assessment. Additional research is necessary to understand better how this unique population experiences and expresses suicidal tendencies. Recommendations for future research are discussed.
Autism research : official journal of the International Society for Autism Research, 2014 · doi:10.1002/aur.1375