Temperament and character as risk factor for suicide ideation and attempts in adults with autism spectrum disorders

Persons with autism spectrum disorders (ASDs) are suggested to have an increased risk for suicide ideation and suicide attempts, but this topic is largely understudied. Research indicates that temperament and character traits are associated with suicidal behavior in persons without ASD, with higher scores for novelty seeking (NS), harm avoidance (HA), and self-transcedence (ST), and lower scores for self-directedness (SD) and cooperativeness (CO). Usually persons with ASD have temperament and character profiles with high HA, and low NS, reward dependence (RD), SD, and CO. The aim is to investigate whether there is a relationship between temperament and character traits and suicide ideation and attempts in adults with ASD. Seventy-four adults with ASD participated by completing self-report measures on suicide thoughts and behavior, depression, and temperament. Independent sample t-tests were conducted to compare scores between attempters versus nonattempters and between ideators versus nonideators. Regression analysis was performed to explore the predictive value of temperament and character. T-tests showed lower NS and SD, and higher HA for ideators versus nonideators, but not for attempters versus nonattempters. Regression models showed no significant relation between suicide ideation and NS, SD, HA after the latter were controlled for the significant influence of depression. Temperament and character can probably not be used for predicting suicide ideation and attempts, based on results from the current sample. Clinicians must take note of the high prevalence and risk of depression among persons with ASD, which may be under-reported. Autism Res 2020, 13: 104-111. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The aim of the current study was to uncover risk factors for suicide ideation and attempts in adults with autism, since this urgent topic is largely understudied. We initially investigated whether temperament and character could be risk factors, but found no association. However, we did find that depression might be a high predictor for suicide ideation, which could remain under-reported in adults with autism, due to impaired communication and problems with expressing emotions and thoughts.