20064
Suicidality in Children with Autism Spectrum Disorders

Thursday, May 14, 2015: 11:30 AM-1:30 PM
Imperial Ballroom (Grand America Hotel)
A. C. Armour1, Y. Granader1, A. B. Ratto1, C. E. Pugliese1, J. L. Martucci2, L. Mohamed3, L. Kenworthy4 and J. F. Strang5, (1)Center for Autism Spectrum Disorders, Children's National Medical Center, Rockville, MD, (2)Children's National Medical Center, Rockville, MD, (3)Children's National Health System, Rockville, MD, (4)Children’s Research Institute, Children's National Medical Center, Washington, DC, (5)Center for Autism Spectrum Disorders, Silver Spring, MD
Background: Studies indicate that children with Autism Spectrum Disorders (ASD) have increased rates of suicide ideation and attempts (SI/SA).  The available literature indicates demographic characteristics (age 10+, male, African American, Hispanic, low SES) and psychological characteristics (depression, teasing/bullying, aggression, impulsivity and anxiety) as risk factors for SI/SA. 

Objectives:  Based on studies of SI/SA, as well as depression in ASD, we hypothesize that AD/HD diagnosis, impulsivity, executive dysfunction (especially inflexibility), and weak adaptive skills are related to increased SI/SA , while lower IQ and greater autism symptoms (poorer insight/self-awareness) are related to reduced SI/SA.

Methods: Parents of 199 youth with ASD (female=32), age 7-13.83 (M=10.15, SD=1.72), who met CPEA criteria for ‘broad ASD’ on the ADI-R and/or ADOS, completed clinical reports on their children.  SI/SA were measured with item-level data from the Child Behavior Checklist and the Child and Adolescent Symptom Inventory parent-report measures of emotional and behavioral functioning. Independent samples t-tests and chi-square analyses were used to compare youth with and without SI/SA with ADHD diagnosis, Behavior Rating Inventory of Executive Function (BRIEF) scores, Vineland Adaptive Behavior Scales, and ADOS ratings. 

Results: 16.1% of youth with ASD had parent reported SI/SA. SI/SA and non-SI/SA groups did not differ in their sex or age. Problems with inhibition (p<.01), shifting (p<.01), and emotional control (p<.01) were greater in those with SI/SA (see Figure 1). The comparison of those with SI/SA and greater ADHD symptoms approached significance, as did adaptive behavior weaknesses. There were no significant differences between the groups in IQ or ASD symptoms.

Conclusions: Youth with ASD who consider or attempt suicide had poorer inhibition and flexibility skills. Greater ADHD symptoms and poor adaptive behavior approached significance. Findings indicate the importance of considering ADHD, executive function (i.e., flexibility), and adaptive behavior as risk factors when assessing for SI/SA.

See more of: Medical and Psychiatric Comorbidity
See more of: Medical and Psychiatric Comorbidity