The role of anxiety and depression in suicidal thoughts for autistic and non‐autistic people: A theory‐driven network analysis

Mirabel Pelton, Hayley Crawford, Kim Bul, Ashley Robertson, Jon Adams, Derek de Beurs, Jacqui Rodgers, Simon Baron-Cohen, Sarah Cassidy

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)
    34 Downloads (Pure)


    Autistic adults experience more frequent suicidal thoughts and mental health difficulties than non-autistic people, but research has yet to explain how these experiences are connected. This study explored how anxiety and depression contribute to suicidal thoughts according to Interpersonal Theory of Suicide for autistic and non-autistic adults.

    Participants (autistic adults n=463, 61% female; non-autistic n=342, 64% female) completed online measures of anxiety, depression, thwarted belonging, and perceived burdensomeness. Network analysis explored whether (i) being autistic is a risk marker for suicide; and (ii) pathways to suicidal thoughts are consistent for autistic and non-autistic adults.

    Being autistic connected closely with feeling like an outsider, anxiety and movement, which connected to suicidal thoughts through somatic experiences, low mood and burdensomeness. Networks were largely consistent for autistic and non-autistic people but connections from mood symptoms to somatic and thwarted belonging experiences were absent for autistic adults.

    Autistic people experience more life stressors than non-autistic people leading to reduced coping, low mood and suicidal thoughts. Promoting belonging, reducing anxiety and understanding the role of movement could inform suicide prevention for autistic people. Research should accurately capture autistic lived experience when modelling suicide to ensure suicide prevention meets autistic needs.
    Original languageEnglish
    Pages (from-to)426-442
    Number of pages17
    JournalSuicide and Life-Threatening Behavior
    Issue number3
    Early online date28 Mar 2023
    Publication statusPublished - 12 Jun 2023

    Bibliographical note

    © 2023 The Authors. Suicide and Life-Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.

    This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.


    We would like to extend gratitude to everyone who took part in this research. We thank Sharon Gardner and other members of the Coventry Design group for their support in conceptualizing the study, selecting and devising the study materials, providing well‐being guidance, discussing and interpreting results, and developing the model. This study acknowledges the kind support of Carrie Allison and Paula Smith at the Autism Research Centre, University of Cambridge for assisting with contacting participants registered in the Cambridge Autism Research Database and of Autistica for advertising our study via their Discover network. We are grateful to Sacha Epskamp, Adela Isvoranu, Jonas Haslbeck, and Julian Berger at the University of Amsterdam Network Analysis Winter school 2020. This study forms part of a component of PhD study with financial support from Coventry University. Mirabel Pelton is grateful for the generous support of grants from Funds for Women Graduates [Ref: GA‐00109], Coventry City of Culture, PsyPAG, Centre for Global Engagement, Coventry University, and Coventry University Students Union. Sarah Cassidy was supported by the Economic and Social Research Council [grant number: ES/N000501/2], Autistica, the International Society for Autism Research, and the Slifka‐Ritvo Foundation. Hayley Crawford is supported by the National Institute for Health Research (NIHR) Applied Research Centre West Midlands. The views expressed are those of the author(s) and not necessarily those of the NHS, NIHR, or Department of Health and Social Care. Simon Baron‐Cohen received funding from the Wellcome Trust 214322\Z\18\Z.


    • autism
    • interpersonal theory of suicide
    • network analysis


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