Biobehavioral Markers of Suicide Risk in Female Adolescents on the Autism Spectrum
2021 Award: $39,992
Suicide is a leading cause of premature death for individuals on the autism spectrum. Females on the spectrum are at a particularly elevated risk of experiencing suicidal thoughts and behavior. However, very few studies have examined risk factors for suicidal thoughts and behaviors in females on the spectrum. Our project is the first prospective study of potential biological vulnerabilities for suicidal thoughts and behaviors in females on the spectrum. Study findings will set the stage for a program of research focused on identifying females on the spectrum at risk for suicide and developing tailored suicide prevention programs to improve outcomes across the lifespan.
Need/Problem: Suicide is a leading cause of premature death for autistic* individuals (*note that we use identity-first language to respect the preferences of our autistic stakeholders). Autistic females are at a particularly elevated risk of experiencing suicidal thoughts and behavior (STB), compared to autistic males and the general population. However, very few studies have examined risk factors for STB in autistic females.
Grant Summary: In non-autistic adolescent girls, two biological responses to acute psychosocial stress have emerged as compelling predictors of STB: cortisol (CORT), a naturally-occurring steroid hormone that plays a key role in the body’s stress response, and respiratory sinus arrhythmia (RSA), a physiological index of self-regulation. However, these previous studies excluded autistic individuals. In this project, we will examine CORT and RSA responses to psychosocial stress as potential biomarkers of subsequent suicide risk in autistic girls. We will also compare our findings from autistic girls to a large existing dataset of non-autistic girls.
Goals and Projected Outcomes: Identifying biomarkers of suicide risk is particularly important in autistic individuals because this population has social communication difficulties and may face challenges with verbalizing warning signs of a suicidal crisis. The current project will set the stage for a program of research focused on identifying autistic females at risk for suicide and developing tailored suicide prevention programs to improve outcomes across the lifespan. We anticipate that this project will exert a powerful influence on the autism research field by providing the first example of studying biological vulnerability for suicidality in autistic females, an understudied and misunderstood group.
Brenna Maddox, PhD
Clare Harrop, PhD
Grant Details: For both non-autistic and autistic females, adolescence is a pivotal developmental period, with increases in STB. Prior research on suicide and autism has largely relied on cross-sectional and retrospective data, using self-report measures or medical record review, which yields limited information to prevent future STB. In the current study, we will recruit 25 autistic adolescent females (12-16 years) to complete a series of tasks: (a) a structured clinical interview to assess STB; (b) self-report questionnaires; (c) basal assessment of CORT and RSA; and (d) a psychosocial stressor task. Approximately 3 months following the lab visit, we will re-administer the clinical interview over the phone with the autistic adolescent, to assess recent STB. This proposal is our first step in a novel line of research with a high-risk, understudied population. The valuable data from this study will allow us to apply for several future grants.
