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Many women, men with autism harm themselves

by  /  1 July 2016

Adults with autism deliberately hurt themselves much more often than other adults do, an online survey suggests1. This behavior, which may provide a physical outlet for emotional pain, crops up twice as often in women with autism as in men with the condition.

The findings support anecdotal reports that teens and young adults with autism are unusually likely to engage in self-harm — behaviors that include cutting, nail-biting and pinching. Teens with autism are also 28 times more likely than their peers to attempt suicide.

The new study focuses on non-suicidal self-harm in 42 adults with autism and 42 young adults who do not have autism, but have a history of self-harm.

Despite the study’s small size, its results serve as a clarion call for studies of self-injury in people with autism, says senior researcher Susan White, director of the Psychosocial Interventions Laboratory at Virginia Tech in Blacksburg, Virginia. Such studies could provide detailed information about the motivations and types of self-harm in people with autism.

The participants, ranging from 18 to 56 years old, answered an online questionnaire called the Non-Suicidal Self-Injury Assessment Tool, which assesses self-care, self-harm and emotion regulation. They also completed the Severity Measure for Depression.

The two-part survey was designed to pick up on carefully calculated actions — such as cutting into the skin or drinking hazardous chemicals — that reflect emotional angst, rather than repetitive, rhythmic behaviors such as head-banging or biting that often accompany intellectual impairment or sensory difficulties, White says. One question, for example, asks whether self-injury is a calming remedy for anxiety, an outlet for uncomfortable feelings or a way to call for help without having to muster the courage to speak up.

The study found that half of the 42 adults with autism engage in deliberate self-harm. Studies estimate that 5 to 17 percent of adults in the general population show these behaviors2.

The finding may reflect the elevated rates of depression and emotional issues in adults with autism, White says. “It makes sense that something that goes along with depression and emotional dysregulation, like self-injury, might also be more common,” she says.

Emotional pain:

Women with autism are more likely than men with the condition to harm themselves, the survey found. Of the 18 women with autism in the study, 13 reported that they engage in self-harm, compared with 8 of the 24 men with the condition.

The findings also suggest that self-harm arises from emotional pain, rather than being a manifestation of the repetitive behaviors associated with autism, says White. People with autism and those in the control group both indicated that they have difficulties expressing anger and other strong emotions in a healthy way.

“It seems that non-suicidal self-injury gives voice to their pain,” White says.

The study’s online format limits the researchers’ ability to follow up on hints about the causes of self-harm, says Connie Kasari, professor of psychology at the Center for Autism Research and Treatment at the University of California, Los Angeles, who was not involved in the study.

But the issue of non-suicidal self-injury deserves “more exploration, probably in assessed participants, rather than an online survey, to better characterize participants,” Kasari says.

White’s group plans to conduct larger studies and interview people with autism to find the causes.

Meanwhile, White says, clinicians should watch for signs of self-harm in teens and adults with autism, as well as probing family members to detect these behaviors. “Non-suicidal self-injury isn’t a thing you treat — it’s a thing that calls for help,” White says.

  1. Maddox B.B. et al. Autism Epub ahead of print (2016) PubMed
  2. Swannell S.V. et al. Suicide Life Threat. Behav. 44, 273–303 (2014) PubMed

8 responses to “Many women, men with autism harm themselves”

  1. Not a happy article, I realize. But think of it as a call to action. We must do better for our children on the spectrum. They feel emotions deeply even if they cannot always put words to their feelings. Everyone wants and DESERVES to feel included, valued, purposeful, and loved. The world must do better. The pain is real, so the support and opportunities must be real!

  2. Tom Hubbard says:

    Forgive me if I’m overlooking an article or articles that Spectrum News may have written on this topic already, but it would be great to read more about why the researchers — at least in this case– are making an assumption that the neurological roots of self-harm among more highly-functioning persons with autism are different from those that may influence self-injury among persons with autism who have serious sensory and communications issues or may be categorized as Intellectually Disabled. I think we are learning more all the time that autistic people with serious impairments have an emotional life just like higher-functioning persons and just like typical people —— which may or may not contribute to self-injury.

    • Planet Autism says:

      It sounds like you assume the sensory and communication issues “high-functioning” autistics have are much less, or non-existent compared to “low-functioning” autistics. I can assure you they are just as severe. Research has identified that there is no difference of severity of sensory difficulties between low and high functioning autistics. There can be non-verbal low-functioning and high-functioning autistics and there are a plethora of communication difficulties in high-functioning autism but way less sympathy or understanding for this. NTs assume that if someone sounds coherent and of normal IQ they are able to communicate in a “normal” way. They have no idea.

  3. Planet Autism says:

    Know why this is? Because autistic females are masking so much and the pressures on females in society to be empathetic, sociable and accommodating are far, far greater than they are on men – that means autistic men can get away with their presentation more and females are trying desperately to live up and punishing themselves for failing.

  4. William Davidson says:

    I’ve been reading about how camel milk can help children with autism.

    I haven’t read much about it’s effect on adults, but it promotes good gut health and I think it would be beneficial to adults as well. It helps children on the autism spectrum to be calmer and more sociable.

  5. Ethyl says:

    The Elephant in the Room: Suicide in Patients With Epilepsy

    Suicide is a major cause of premature death among epileptics, also. I couldn’t figure out the numbers here, but it seems epilepsy is also highly (seven times more likely?) over-represented among suicides.(” In adolescence and young adulthood the risk factors include past
    suicide attempt, suicidal ideation, recent romance breakup, family
    history of suicide and of depression, learning problems, and substance

    Twenty eight times more common among autistics? That is an epidemic…maybe we should be delving into this rather than worrying whether they are looking at you or not. Regarding the greater likelihood, “The researchers found that bullying is also a major risk factor — almost 60 percent of the group with autism had experienced teasing and bullying, and those who had were three times more likely to contemplate or attempt suicide than those who had not.” I think it is more important to support our kids, protect them from bullying. Science,really, has been one of the greatest bullies. Look how many “experts” have dehumanized autistics. I was heartened to see the researchers attempt at understanding rather than judgement:

    “It seems that non-suicidal self-injury gives voice to their pain,” White says.

    I never want to lose my son. We have to let go of the awful judgement we put on their shoulders. Parents, we need to grow up and support our kids rather than try and “fix” them. I’ve been trying all my life to “fix” myself, and still trying. Love and support—don’t be as stupid as I was.

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