Suicidality in Children with Elevated Autistic Traits.

By using a nationally representative school-based sample (4,816 children aged 8-14 years), we examined the risk of suicidality in children with elevated autistic traits and assessed the mediation of anxiety/depression and moderation effects of family function and academic performance. The Chinese version of the Social Responsiveness Scale (SRS-C) was used to measure autistic features. Logistic regression models were applied to assess associations between autistic traits and suicidality (suicidal ideation, suicide plans, and suicide attempts) for estimating the mediation effects of anxiety/depression and moderation effects of academic performance and family function after adjustment for control variables. Every 10-point increase in the SRS-C score was associated with a 1.3-1.4-fold increase in suicidality risk. Associations relating to suicide plans and attempts were fully mediated; however, the association with ideation was partially mediated by anxiety/depression. Academic performance and family function did not appear to moderate associations between autistic traits and suicidality. In conclusion, children with elevated autistic traits exhibited increased risk of suicidality, which could be generally attributed to symptoms of anxiety/depression. Because adequate family function and academic performance did not mitigate the link between elevated autistic traits and suicidality, in-depth exploration into specific protective factors in children with elevated autistic traits is warranted. LAY SUMMARY: By using a nationally representative school-based sample (4,816 children aged 8-14 years), we observed that the risk of suicidality increased in children with elevated autistic traits. This association was generally explained by increased levels of anxiety/depression. Furthermore, better family function and academic performance did not appear to mitigate the link between autistic traits and suicidality. Autism Res 2020, 13: 1811-1821. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
(© 2020 International Society for Autism Research, Wiley Periodicals, LLC.)