Abstract
Background: Autistic adults are more likely to engage in suicidal thoughts and behaviors, but there is little research to explore the underlying reasons. It is unclear whether self-report suicide scales that have been designed for non-autistic people accurately measure suicide risk constructs in autistic people. Therefore, this study explored, for the first time, whether the measurement properties of the self-report scales of the Interpersonal Theory of Suicide are equivalent in autistic and non-autistic adults.Methods: In this study, responses from 342 autistic and 353 non-autistic people on the Interpersonal Needs Questionnaire-10 (INQ-10) and Acquired Capability for Suicide Scale–Fearlessness about Death (ACSS–FAD) were compared by using measurement invariance analysis. Data were gathered through an online cross-sectional survey of the self-report measures.Results: Results suggest that measurement properties of the INQ-10 were different in autistic people. Autistic characteristics, such as different theory of mind and preference for concrete language, may have led the scale items to load differently on the factors in the autistic group than in the non-autistic group. The measurement properties of the ACSS–FAD were invariant between autistic and non-autistic people.Conclusions: Scores on the INQ-10 cannot be meaningfully compared between autistic and non-autistic people due to different measurement properties. Future research could explore how autistic people experience the concepts of burdensomeness and belonging, to consider how measures could accurately capture this. This would allow researchers to explore the role of these constructs in the development of suicidal thoughts and behaviors in autistic people. Clinicians should be aware that suicide risk factors may present differently in autistic people. Scores on the ACSS-FAD can be meaningfully compared, but the negatively worded scale items may pose similar response difficulties to autistic and non-autistic people.
Highlights
Research consistently reports more frequent suicidal thoughts and behaviors[1] and significantly higher rates of death by suicide among autistic* compared with non-autistic people.[2,3] there is a lack of research to explore how proximal risk factors may lead to the development of suicidality in autistic people, and there are no validated tools to identify such constructs and assess risk severity.[4]
Model run by using asymptotic distribution-free estimation in the non-autistic group and maximum likelihood estimation in the autistic group
This study compared the measurement properties of the Interpersonal Needs Questionnaire-10 (INQ-10) and the ACSS–FAD in autistic and non-autistic adults to assess their appropriateness for measuring the Interpersonal Theory of Suicide (ITS) proximal risk factors for suicide in autistic adults
Summary
Research consistently reports more frequent suicidal thoughts and behaviors[1] and significantly higher rates of death by suicide among autistic* compared with non-autistic people.[2,3] there is a lack of research to explore how proximal risk factors may lead to the development of suicidality in autistic people, and there are no validated tools to identify such constructs and assess risk severity.[4] This study explores the appropriateness and measurement properties of. Autistic adults are more likely to engage in suicidal thoughts and behaviors, but there is little research to explore the underlying reasons It is unclear whether self-report suicide scales that have been designed for non-autistic people accurately measure suicide risk constructs in autistic people. Scores on the ACSS-FAD can be meaningfully compared, but the negatively worded scale items may pose similar response difficulties to autistic and non-autistic people
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