A Comparative Study of Suicidality and Its Association with Emotion Regulation Impairment in Large ASD and US Census-Matched Samples


Evidence suggests increased rates of suicidality in autism spectrum disorder (ASD), but the research has rarely used comparison samples and the role of emotion dysregulation has not been considered. We compared the prevalence of parent-reported suicidality ideation and considered the role of emotion dysregulation in 330 psychiatric inpatient youth with ASD, 1169 community youth with ASD surveyed online, and 1000 youth representative of the US census. The prevalence of suicidal ideation was three and five times higher in the community and inpatient ASD samples, respectively, compared to the general US sample. In the ASD groups, greater emotion dysregulation was associated with suicidal ideation. Implications include consideration of emotion regulation as a potential mechanism and treatment target for suicidality in ASD.

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This study was supported with funding from NICHD R01 HD079512 (CM), the Ritvo-Slifka Award for Innovation in Autism Research (CM), Simons Foundation Autism Research Initiative and the Nancy Lurie Marks Family Foundation (SFARI #296318, M.S.). IAN is a Partnership Project of the Kennedy Krieger Institute and the Simons Foundation. IAN is also partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Award for Development of the National Patient-Centered Clinical Research Network, known as PCORnet.

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Subjects were recruited and data obtained in partnership with the Interactive Autism Network (IAN) Research Database at the Kennedy Krieger Institute, Baltimore, MD. IAN collaborating investigators and staff included: PHL, MD, JKL, MD, MPH, ARM, PhD. Data were also collected in partnership with the Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC) through use of Autism Inpatient Collection (AIC) data and YouGov. The ADDIRC is made up of the co-investigators: MS, MD (PI) (Maine Medical Center Research Institute; Tufts University), CE, MD (Cincinnati Children’s Hospital, University of Cincinnati), RLG, PsyD (Children’s Hospital Colorado, University of Colorado), DK, MD and RM, MD (Sheppard Pratt Health System), CM, PhD (UPMC Western Psychiatric Hospital, University of Pittsburgh), EMM, MD, PhD (Bradley Hospital, Brown University), GR, PhD (Bradley Hospital, Brown University), SLS, ScD (Maine Medical Center Research Institute, Tufts University), and LW, MD (Cincinnati Children’s Hospital, University of Cincinnati). Collaborating investigators and staff: JB, BS, CB, MD, CB, MPH, KB, LCSW, CC, BS, BD, BS, TF, BCBA, LCPC, HG, PhD, AG, BS, LH, PhD, BH, PhD, BCBA-D, AK, BS, ML, MD, KM, BS, ZM, MD, JM, PhD, KM, MD, FM, BS, JM, BS, TP, MD, EP, MD, KAP, PhD, CP, BA, JP, MD, CR, MS, CCCSLP, BR, MA, JR, LISW, ES, MD, CS, PhD, NS, MSN, RN, BT, PhD, BT, MA, RDMT, MV, MA, JV, BS, and DW, BA. We thank the study staff for the time and energy they dedicated to this work. Special thanks also to the AIC research participants and their families that made this research possible.

Correspondence to Carla A. Mazefsky.

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Conner, C.M., Golt, J., Righi, G. et al. A Comparative Study of Suicidality and Its Association with Emotion Regulation Impairment in Large ASD and US Census-Matched Samples. J Autism Dev Disord (2020).

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  • Suicidality
  • Emotion regulation
  • ASD
  • Autism
  • Reactivity
  • Dysphoria