Tanatswa Chikaura

Young autistic people experience disproportionately high rates of mental health challenges, yet little is known about factors associated with suicidality in this group. This study leveraged anonymous self‐report data to identify correlates of suicidal thoughts among 365 young users (aged approximately 11–25 years) of a mental health app in the United Kingdom with an autism diagnosis or self‐identifying as autistic. The presence of suicidal thoughts was assessed as a binary item. Binary logistic regression was used to explore correlates of suicidal thoughts across three domains: mental health‐related symptoms, autism‐related factors, and adverse life events/experiences. The final model included all significant correlates from domain‐specific models alongside demographic factors. Suicidal thoughts were reported by 63% of participants, with similar rates across age groups. The final model accounted for nearly 50% of variability in the presence of suicidal thoughts ( R ² _Nagelkerke = 0.48, p < 0.001). Self‐harm and depression showed the strongest positive associations (odds ratio, OR and [95% confidence interval] = 6.41 [3.62, 11.35] and 4.58 [2.51, 8.35], respectively), followed by a history of physical abuse (OR = 3.01 [1.20, 7.56]) and a transgender/gender‐diverse identity (OR = 2.13 [1.11, 4.10]). Personal use of the term “neurodiversity” was associated with a lower likelihood of suicidal thoughts (OR = 0.45 [0.24, 0.83]). These findings contribute to evidence of high rates of suicidal thoughts among young autistic people and associations with self‐harm, depression, a history of abuse, and a gender minority identity. Self‐identification with the term neurodiversity emerged as a potential protective factor, although this novel finding warrants further research. Overall, this study highlights the importance of access to autism‐adapted mental health care, addressing trauma and identity‐related stressors, and fostering belonging and connection as part of comprehensive suicide prevention strategies for autistic youth.

Background: Suicide is a leading cause of death for autistic people, but it is inadequately explained by theories derived in non-autistic populations. Autistic people’s perceptions of the factors underpinning suicidal experiences are vital for guiding conceptual understanding, risk assessment, and policy and clinical practice toward preventing suicide. Methods: We recruited 1369 autistic participants for an online survey designed through consultation with autistic people. Participants were 326 cisgender men, 718 cisgender women, and 325 transgender or gender-divergent individuals, ranging from 16 to 89 years old. We asked them to rate the importance of 19 contributing factors to their suicidal thoughts and feelings and to enter their own explanations of additional factors if desired. Alongside thematically analyzing this qualitative data, we examined whether ratings of contributing factors differed by age and gender and whether ratings statistically predicted levels of lifetime suicidality. Results: Loneliness, feelings of worthlessness/failure, hopelessness, and mental illness were the highest rated contributing factors to suicidal thoughts and feelings, particularly by autistic women and sex/gender minorities; ratings also differed by age. Qualitative responses indicated the complexity of suicidality, wherein autistic status influenced both the nature of the stressors (e.g., societal stigma) and cognitive-emotional states (e.g., feeling disconnected through feeling different to others) that participants identified. Greater perceived importance of bullying, difficulties accessing support, and past trauma characterized participants with experience of suicide plans or attempts. Conclusion: While some of the experiences and mental states identified by participants resembled those identified in non-autistic groups, the psychological profile of autistic participants and their experiences of marginalization appeared to heavily contextualize expressions of hopelessness, burdensomeness, worthlessness, loneliness, and entrapment. Autistic people vary with regard to the factors perceived to underpin suicidality. However, associations between suicidality and the perceived importance of bullying, trauma, and inability to access support highlight the necessity of societal and systemic change to prevent suicide.

Autistic adults have increased risks of trauma, suicide, and poor mental health compared to non‐autistic adults, with 1 in 4 autistic adults attempting suicide. We administered an anonymized, self‐report survey to 424 autistic and 345 non‐autistic adults through a convenience sampling framework. Binomial logistic regression models identified whether trauma and autism diagnosis were related to (i) self‐harm, (ii) suicide attempts, (iii) suicide plans, (iv) a mental health condition that impacts daily life, and (v) substance use to cope. Heatmaps were generated to identify traumas that frequently co‐occur with psychological distress and SRB. After accounting for trauma and demographic differences, autism remained a significant predictor of all outcomes, except whether individuals used substances to cope (OR: 0.78, 95% CI: 0.54–1.12, p = 0.18). Autistic people were more likely to report self‐harm (OR: 2.71, 95% CI: 1.85–4.00, p < 0.01), suicide attempts (OR: 2.45, 95% CI: 1.65–3.68, p < 0.01), suicide plans (OR: 2.00, 95% CI: 1.41–2.83, p < 0.01), and experiencing a mental health condition that impacts daily life (OR: 3.58, 95% CI: 2.42–5.33, p < 0.01) than non‐autistic people. Among autistic people, childhood victimization co‐occurred with a mental health condition that impacts daily life, self‐harm, and suicide plans most frequently. This study provides evidence of complex relationships between autism, trauma, self‐harm, suicide attempts, suicide plans, and a mental health condition that impacts daily life. Focusing on the prevention of trauma, coping strategies, and recovery from traumatic events through safeguarding and support may be critical tools for suicide prevention among autistic people.

Background: Anhedonia is a key symptom of depression, and it has been suggested as a potential target for future individualised treatments. However, much is unknown about how interventions enhancing dopaminergic pathways may affect anhedonia symptoms in the context of depression. Methods: We will perform independent searches in multiple electronic databases to identify clinical and animal experimental studies on pro-dopaminergic interventions in individuals with depression or animal models for depression. The primary outcomes will be overall anhedonia symptoms and their behavioural proxies in animals. Secondary outcomes will include side effects and neurobiological measures. At least two independent reviewers will conduct the study selection, data extraction, and risk of bias assessments using pre-defined tools according to each record’s study design. We will develop ontologies to facilitate study identification and data extraction. We will synthesise data from clinical and animal studies separately. If appropriate, we will use random-effects meta-analyses, or synthesis without meta-analyses. We will investigate study characteristics as potential sources of heterogeneity. We will evaluate the confidence in the evidence for each outcome and source of evidence, considering the summary of the association, potential concerns regarding internal and external validity, and reporting biases. When multiple sources of evidence are available for an outcome, we will draw an overall conclusion in a triangulation meeting involving a multidisciplinary team of experts. We plan updates of the review every 6 months, and any future modifications to the protocol will be documented. We will co-produce this review with multiple stakeholders. PROSPERO registration: CRD42023451821