School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
The International Centre, University of Bedfordshire, Luton, UK.
Mol Autism. 2021 Jun 21;12(1):46. doi: 10.1186/s13229-021-00449-3.
Autistic people and those with high autistic traits are at high risk of experiencing suicidality. Yet, there are no suicidality assessment tools developed or validated for these groups.
A widely used and validated suicidality assessment tool developed for the general population (SBQ-R), was adapted using feedback from autistic adults, to create the Suicidal Behaviours Questionnaire-Autism Spectrum Conditions (SBQ-ASC). The adapted tool was refined through nine interviews, and an online survey with 251 autistic adults, to establish clarity and relevance of the items. Subsequently, 308 autistic, 113 possibly autistic, and 268 non-autistic adults completed the adapted tool online, alongside self-report measures of autistic traits (AQ), camouflaging autistic traits (CAT-Q), depression (PHQ-9), anxiety (ASA-A), thwarted belongingness and perceived burdensomeness (INQ-15), lifetime non-suicidal self-injury, and the original version of the suicidality assessment tool (SBQ-R). Analyses explored the appropriateness and measurement properties of the adapted tool between the groups.
There was evidence in support of content validity, structural validity, internal consistency, convergent and divergent validity, test-retest validity, sensitivity and specificity (for distinguishing those with or without lifetime experience of suicide attempt), and hypothesis testing of the adapted tool (SBQ-ASC) in each group. The structure of the SBQ-ASC was equivalent between autistic and possibly autistic adults, regardless of gender, or use of visual aids to help quantify abstract rating scales.
The samples involved in the development and validation of the adapted tool were largely female, and largely diagnosed as autistic in adulthood, which limits the generalisability of results to the wider autistic population. The SBQ-ASC has been developed for use in research and is not recommended to assess risk of future suicide attempts and/or self-harm. The SBQ-ASC has been designed with and for autistic and possibly autistic adults, and is not appropriate to compare to non-autistic adults given measurement differences between these groups.
The SBQ-ASC is a brief self-report suicidality assessment tool, developed and validated with and for autistic adults, without co-occurring intellectual disability. The SBQ-ASC is appropriate for use in research to identify suicidal thoughts and behaviours in autistic and possibly autistic people, and model associations with risk and protective factors.
自闭症患者和高自闭症特质人群自杀风险较高。然而，目前还没有为这些人群开发或验证的自杀评估工具。
本研究使用了一种广泛使用且经过验证的用于一般人群的自杀评估工具（SBQ-R），通过自闭症成年人的反馈进行了改编，创建了自闭症谱系条件自杀行为问卷（SBQ-ASC）。通过九次访谈和一项包含 251 名自闭症成年人的在线调查，对改编后的工具进行了细化，以确定项目的清晰度和相关性。随后，308 名自闭症患者、113 名可能患有自闭症的患者和 268 名非自闭症患者在线完成了改编后的工具，同时还填写了自闭症特质问卷（AQ）、自闭症特质掩饰问卷（CAT-Q）、抑郁量表（PHQ-9）、焦虑量表（ASA-A）、归属感受挫和负担感量表（INQ-15）、非自杀性自伤量表和原始自杀评估工具（SBQ-R）。分析探讨了该工具在各组之间的适宜性和测量特性。
在每个组中，改编后的工具都有内容有效性、结构有效性、内部一致性、收敛和发散有效性、重测信度、灵敏度和特异性（用于区分有或没有自杀尝试的终生经历）和假设检验的证据。SBQ-ASC 的结构在自闭症和可能患有自闭症的成年人中是等效的，无论性别如何，或者是否使用视觉辅助工具来帮助量化抽象评分量表。
参与改编工具开发和验证的样本主要是女性，且主要在成年后被诊断为自闭症，这限制了研究结果在更广泛的自闭症人群中的普遍性。SBQ-ASC 是为研究开发的，不建议用于评估未来自杀企图和/或自残的风险。SBQ-ASC 是专为自闭症和可能患有自闭症的成年人设计和使用的，与非自闭症成年人相比，由于这些群体之间存在测量差异，因此不适合进行比较。
SBQ-ASC 是一种简短的自我报告自杀评估工具，由自闭症成年人开发和验证，没有共患智力障碍。SBQ-ASC 适用于研究中识别自闭症和可能患有自闭症的人群中的自杀想法和行为，并建立与风险和保护因素的关联。
