For typically developing adolescents, being bullied is associated with increased risk of suicidality. Although adolescents with autism spectrum disorder (ASD) are at increased risk of both bullying and suicidality, there is very little research that examines the extent to which an experience of being bullied may increase suicidality within this specific population. To address this, we conducted a retrospective cohort study to investigate the longitudinal association between experiencing bullying and suicidality in a clinical population of 680 adolescents with ASD. Electronic health records of adolescents (13–17 years), using mental health services in South London, with a diagnosis of ASD were analyzed. Natural language processing was employed to identify mentions of bullying and suicidality in the free text fields of adolescents' clinical records. Cox regression analysis was employed to investigate the longitudinal relationship between bullying and suicidality outcomes. Reported experience of bullying in the first month of clinical contact was associated with an increased risk suicidality over the follow‐up period (hazard ratio = 1.82; 95% confidence interval = 1.28–2.59). In addition, female gender, psychosis, affective disorder diagnoses, and higher intellectual ability were all associated with suicidality at follow‐up. This study is the first to demonstrate the strength of longitudinal associations between bullying and suicidality in a clinical population of adolescents with ASD, using automated approaches to detect key life events within clinical records. Our findings provide support for identifying and dealing with bullying in schools, and for antibullying strategy's incorporation into wider suicide prevention programs for young people with ASD. Autism Res 2020, 13: 988‐997. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.

中文翻译：

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在患有自闭症谱系障碍的青少年临床样本中调查欺凌作为自杀倾向的预测因素。

对于正常发育的青少年来说，被欺负会增加自杀风险。尽管患有自闭症谱系障碍 (ASD) 的青少年遭受欺凌和自杀的风险都在增加，但很少有研究调查在这个特定人群中被欺凌的经历可能会增加自杀的程度。为了解决这个问题，我们进行了一项回顾性队列研究，以调查 680 名 ASD 青少年临床人群中遭受欺凌和自杀之间的纵向关联。分析了在伦敦南部使用心理健康服务并诊断为 ASD 的青少年（13-17 岁）的电子健康记录。自然语言处理被用来识别在青少年的自由文本字段中提到的欺凌和自杀行为。临床记录。Cox 回归分析被用来调查欺凌和自杀结果之间的纵向关系。在临床接触的第一个月报告的欺凌经历与随访期间自杀风险的增加有关（风险比 = 1.82；95% 置信区间 = 1.28-2.59）。此外，女性、精神病、情感障碍诊断和较高的智力都与随访时的自杀倾向有关。本研究首次证明了 ASD 青少年临床人群中欺凌与自杀之间的纵向关联强度，使用自动化方法检测临床记录中的关键生活事件。我们的研究结果为识别和处理校园欺凌提供了支持，自闭症水库2020年，13：988-997。© 2020 作者。国际孤独症研究协会出版的《孤独症研究》由 Wiley Periodicals, Inc. 出版。