Arch Suicide Res. 2022 Jul-Sep;26(3):1232-1249. doi: 10.1080/13811118.2020.1868367. Epub 2021 Nov 2.
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.
Participants came from three epidemiologically-ascertained samples of school-aged Korean children ( = 14,423; 3,702; 4,837). ASSQ ≥ 14 was the cutoff for ASP. A subsample ( = 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.
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.
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. HighlightsPopulation-based, epidemiologically-ascertained, school-aged childrenASD and ASP are independent risk factors for SI in school-aged childrenAnxiety is an independent risk factor for SI in children with ASD or ASP.
自闭症谱系障碍（ASD）患者的自杀意念发生率较高。本研究旨在：（1）评估在基于人群的流行病学样本中，自闭症或自闭症筛查问卷（ASSQ）筛查阳性（ASP）的儿童自杀意念（SI）的发生率；（2）确定 ASD/ASP 是否为 SI 的独立风险因素，控制已知的 SI 风险因素；以及，（3）为 ASD/ASP 儿童的 SI 建立解释模型。
参与者来自三个基于人群的韩国学龄儿童流行病学样本（ = 14423；3702；4837）。ASSQ≥14 为 ASP 的截断值。一个亚组（ = 86）被确认为 ASD。SI 基于父母对儿童行为评估系统-2-父母报告量表-儿童的项目的认可。使用逻辑回归评估 SI 与 ASD/ASP 之间的关联，控制人口统计学、同伴受害、行为问题和抑郁。为了在 ASD/ASP 内建立 SI 的解释模型，测试了 SI 与儿童特征（合并症、ASD 症状、智商、适应功能）之间的关联。
与 ASSQ 筛查阴性（ASN）同伴（3.4-6.9%）相比，ASD（14%）和 ASP（16.6-27.4%）儿童的 SI 发生率更高。与 ASN 相比，在控制了已知的 SI 风险因素后，ASD/ASP 强烈预测了 SI（OR：2.87-5.67）。在 ASD 和 ASP 组中，焦虑是 SI 的最强预测因素。
与 ASN 同伴相比，非临床 ASD 和 ASP 儿童样本中 SI 的发生率更高。这些结果强调了在 ASD 和有社交困难的儿童中，特别是那些有高焦虑的儿童中，常规筛查 SI 的必要性。
