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Published on: March 8, 2018
'My Answers Don't Fit Your Options': Measuring Self-Harm With Autistic People Using the Self-Injurious Thoughts and
Isabel Gordon1, Mirabel Pelton2,3, Jane Goodwin2
1University of Nottingham, UK.
Summary
Autistic individuals face challenges with suicide and self-harm assessment tools like the Self-Injurious Thoughts and Behaviours Interview (SITBI). Researchers can improve data collection by validating autistic experiences and adapting question interpretation.
Area of Science:
- Psychiatry
- Neurodevelopmental Disorders
- Clinical Psychology
Background:
- Autistic individuals are at high risk for suicide.
- Self-harm is a significant predictor of suicide death in autistic populations.
- Existing self-harm assessment measures lack validation for autistic people.
Purpose of the Study:
- To identify challenges autistic individuals face when completing the Self-Injurious Thoughts and Behaviours Interview (SITBI).
- To understand researchers' experiences supporting autistic participants during SITBI completion.
- To explore the feasibility of using the SITBI with autistic individuals.
Main Methods:
- Thematic analysis of feasibility interview transcripts from a pilot randomized controlled trial.
- Interviews focused on participants' experiences with the SITBI and researchers' support strategies.
- Data were collected opportunistically during a trial of autism-adapted safety plans.
Main Results:
- A key theme identified was 'Reaching an authentic answer'.
- Subthemes included 'Conceptualising suicidal plans', 'Defining parameters of suicidal thoughts', and 'Capturing self-harm'.
- Researchers overcame challenges by validating experiences, building trust, clarifying language, and collaboratively adapting responses.
Conclusions:
- Researchers and clinicians must validate autistic experiences of self-harm and suicidality.
- Supportive strategies can enable autistic individuals to report self-harm using existing measures.
- Adaptations in question interpretation and response options are crucial for accurate assessment.
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