Abstract

Objectives

Higher prevalence of suicidality has been reported in individuals with ASD. This study aimed to (1) Estimate the prevalence of suicidal ideation (SI) in epidemiologically-ascertained, population-based, samples of children with ASD or Autism Spectrum Screening Questionnaire (ASSQ) Screen Positivity (ASP); (2) Determine whether ASD/ASP is an independent risk factor for SI, controlling for known SI risk factors; and, (3) Develop an explanatory model for SI in children with ASD/ASP.

Methods

Participants came from three epidemiologically-ascertained samples of school-aged Korean children (n = 14,423; 3,702; 4,837). ASSQ ≥ 14 was the cutoff for ASP. A subsample (n = 86) was confirmed to have ASD. SI was based on parents’ endorsement of items on the Behavioral Assessment System for Children-2-Parent Report Scale-Children. Logistic regressions were used to assess associations between SI and ASD/ASP, controlling for demographics, peer victimization, behavior problems, and depression. To develop an explanatory model for SI within ASD/ASP, the associations between SI and child characteristics (comorbid conditions, ASD symptoms, IQ, adaptive function) were tested.

Results

SI was higher in children with ASD (14%) and ASP (16.6–27.4%) than ASSQ Screen Negative (ASN) peers (3.4–6.9%). ASD/ASP was strongly predictive of SI (ORs: 2.87–5.67), after controlling for known SI risk factors compared to ASN. Within the ASD and ASP groups, anxiety was the strongest predictor of SI.

Conclusions

SI prevalence was higher in non-clinical samples of children with ASD and ASP, relative to ASN peers. These results underscore the need for routine screening for SI in children with ASD and social difficulties, particularly those with high anxiety.

• Highlights

• Population-based, epidemiologically-ascertained, school-aged children

• ASD and ASP are independent risk factors for SI in school-aged children

• Anxiety is an independent risk factor for SI in children with ASD or ASP

中文翻译：

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患有自闭症谱系障碍的韩国学龄儿童的三个人群样本中家长报告的自杀意念和自闭症谱系筛查问卷的筛查阳性率

摘要

目标

据报道，自闭症谱系障碍患者自杀倾向较高。本研究的目的是 (1) 估计在流行病学确定的、基于人群的自闭症谱系障碍儿童样本中自杀意念 (SI) 的患病率或自闭症谱系筛查问卷 (ASSQ) 筛查阳性率 (ASP)；(2) 控制已知的 SI 危险因素，确定 ASD/ASP 是否是 SI 的独立危险因素；(3) 开发 ASD/ASP 儿童 SI 的解释模型。

方法

参与者来自三个流行病学确定的韩国学龄儿童样本（n  = 14,423；3,702；4,837）。ASSQ ≥ 14 是 ASP 的截止值。子样本 ( n  = 86) 被确认患有自闭症谱系障碍 (ASD)。SI 是基于家长对儿童行为评估系统 - 2 家长报告量表 - 儿童项目的认可。使用逻辑回归来评估 SI 和 ASD/ASP 之间的关联，并控制人口统计、同伴受害、行为问题和抑郁。为了开发 ASD/ASP 内 SI 的解释模型，测试了 SI 与儿童特征（共病、ASD 症状、智商、适应功能）之间的关联。

结果

患有 ASD (14%) 和 ASP (16.6–27.4%) 的儿童的 SI 高于 ASSQ 筛查阴性 (ASN) 的同龄人 (3.4–6.9%)。与 ASN 相比，在控制了已知的 SI 风险因素后，ASD/ASP 对 SI 有很强的预测能力（OR：2.87-5.67）。在 ASD 和 ASP 组中，焦虑是 SI 最强的预测因子。

结论

相对于 ASN 儿童，自闭症谱系障碍 (ASD) 和 ASP 儿童的非临床样本中 SI 患病率较高。这些结果强调了对患有自闭症谱系障碍和社交困难的儿童（尤其是高度焦虑的儿童）进行常规 SI 筛查的必要性。

• 强调

• 基于人口、流行病学确定的学龄儿童

• ASD 和 ASP 是学龄儿童 SI 的独立危险因素

• 焦虑是 ASD 或 ASP 儿童发生 SI 的独立危险因素