BACKGROUND Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism, motivate investigating the link between self-injury, suicide ideation, and attempts which has been reported in typically developing individuals. METHOD One hundred three autistic participants completed the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Suicide Behaviors Questionnaire (SBQ-R), and the Interpersonal Social Evaluation List (ISEL-12) across two online studies. Logistic regression was conducted to predict self-harming status via responses to questions on suicidality, and to predict whether certain self-injurious behaviors, including cutting, were especially associated with suicide ideation and attempts. Non-parametric correlation analysis examined relationships between suicide ideation/attempts and other variables that might characterize self-harmers especially at risk of suicidality. These included perceived access to social support, purposes or reasons for self-injury, the number of different self-injurious behaviors engaged in, the duration and lifetime incidence of self-injury, and the individual's feelings about their self-injury. RESULTS While self-injuring status was significantly predicted by responses to a question on suicide ideation and attempts, there was no relationship between suicide ideation/attempts and a participant's personal feelings about their self-injury. The method of cutting was also predicted by suicide ideation and attempts, though other methods common in autistic people were at borderline significance. Use of self-injury for the regulation of low-energy emotional states like depression, for self-punishment or deterrence from suicide, and for sensory stimulation, was associated with suicide ideation and attempts, as was the number of self-injurious behaviors engaged in. There was no significant relationship between suicide ideation/attempts and the duration and lifetime incidence of self-injury or social support. CONCLUSIONS These preliminary data suggest that while individuals might frame their self-injury as a positive or neutral thing, there remains a concerning relationship between self-injury and suicidality which exists regardless of individual feelings on self-injury. This is consistent with the theoretical perspective that self-injury can be a "gateway" through which individuals acquire capability for lethal suicidal behaviors. The data highlight that particular methods (cutting) and reasons for self-injury may be of significant concern, but this information, which might be of extreme value for clinicians, requires further investigation and validation.

中文翻译：

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自闭症患者自残和自杀之间的联系。

背景技术 无智力障碍的自闭症患者自残的风险较高，并且似乎出于与非自闭症患者类似的原因进行自残。自闭症患者对自残的看法存在很大分歧，包括那些将其视为一种有用的应对机制的人，这促使人们研究自残、自杀意念和在典型发育个体中报告的自杀企图之间的联系。方法 103 名自闭症参与者通过两项在线研究完成了非自杀性自伤评估工具 (NSSI-AT)、自杀行为问卷 (SBQ-R) 和人际社会评估表 (ISEL-12)。进行逻辑回归是为了通过对自杀问题的回答来预测自残状态，并预测某些自残行为（包括切割）是否与自杀意念和企图特别相关。非参数相关分析检查了自杀意念/企图与可能表征自残者（尤其是有自杀风险的人）的其他变量之间的关系。这些包括感知的社会支持、自残的目的或原因、参与的不同自残行为的数量、自残的持续时间和终生发生率，以及个人对自残的感受。结果虽然自残状态可以通过对自杀意念和自杀企图问题的回答来显着预测，但自杀意念/企图与参与者对其自残的个人感受之间没有关系。自杀意念和自杀尝试也预测了切割方法，尽管自闭症患者中常见的其他方法具有边缘意义。使用自残来调节抑郁等低能量情绪状态、自我惩罚或威慑自杀以及感官刺激，与自杀意念和自杀企图有关，自杀的自残行为数量也与自杀意念和自杀企图有关。自杀意念/自杀企图与自残或社会支持的持续时间和终生发生率之间没有显着关系。结论 这些初步数据表明，虽然个人可能将自残视为积极或中性的事情，但自残和自杀之间仍然存在着令人担忧的关系，无论个人对自残的感受如何，这种关系都存在。这与自残可以成为个体获得致命自杀行为能力的“门户”的理论观点是一致的。数据强调，特定的自伤方法（切割）和原因可能值得关注，但这些信息对于临床医生可能具有极高的价值，需要进一步调查和验证。