Marsden Sarah Je, Eastham Rachael, Kaley Alexandra
Lancaster University, UK.
University of Essex, UK.
Autism. 2025 Jan;29(1):247-258. doi: 10.1177/13623613241271931. Epub 2024 Sep 4.
There is a higher prevalence of self-harming behaviours within the autistic community than is experienced by the general population, in addition to co-occurring mental health conditions such as anxiety and depression. To date, research has focused on quantifying and categorising the numbers of autistic people self-harming, what types of harming they are engaging in and what functions the harming performs. Autism research has historically focused on the opinions and experiences of parents, carers and clinicians, with a belief that autistic people are unable to present their own experiences and thoughts accurately. This study adopted a qualitative method to develop themes arising from online forum discussions, using the words of autistic adults talking about how they experience and understand their self-harming behaviours. The analysis discovered that self-harming behaviours are used by autistic people as a way of coping with anxiety and depression and to relieve the build up of stress and sensory or mental overload that can otherwise lead to a meltdown. Repetitive behaviours such as stimming are also used to relieve the buildup of sensory over-stimulation and anxiety, but both stimming and meltdowns can also be self-harming behaviours if they cause tissue damage, and are believed to be childhood presentations which are stigmatised if expressed by an autistic adult. Many autistic adults find it hard to get help with self-harming behaviours because they are not taken seriously by professionals, as it is seen as part of autism and cannot be helped, or the professionals do not have enough knowledge of autism.
与普通人群相比，自闭症群体中自我伤害行为的发生率更高，此外还存在焦虑和抑郁等并发心理健康问题。迄今为止，研究主要集中在对自闭症患者自我伤害的人数进行量化和分类，他们进行何种类型的伤害行为以及这些行为起到什么作用。自闭症研究历来侧重于家长、护理人员和临床医生的观点和经验，认为自闭症患者无法准确表达自己的经历和想法。本研究采用定性方法，从在线论坛讨论中提炼主题，使用成年自闭症患者讲述他们如何体验和理解自己的自我伤害行为的话语。分析发现，自闭症患者将自我伤害行为作为应对焦虑和抑郁的一种方式，以及缓解可能导致情绪崩溃的压力、感官或精神负荷的积累。诸如刺激行为等重复性行为也被用来缓解感官过度刺激和焦虑的积累，但如果刺激行为和情绪崩溃导致组织损伤，它们也可能是自我伤害行为，并且被认为是童年时期的表现，如果由成年自闭症患者表现出来会受到污名化。许多成年自闭症患者发现很难获得针对自我伤害行为的帮助，因为专业人员不重视这些行为，认为这是自闭症的一部分且无法得到帮助，或者专业人员对自闭症的了解不足。
