Examining the Role of Social Connection in Suicide Risk for Older Autistic Adults: A Mixed Methods Study

Univ Of North Carolina Chapel Hill, Chapel Hill NC

Investigators

Abstract

PROJECT SUMMARY Suicide is one of the leading causes of premature death for autistic adults. Autistic adults are more likely to consider, attempt, and die by suicide than non-autistic adults. Understanding suicidal thoughts and behaviors (STB) in autism is a top research priority for autistic individuals, funders, the Interagency Autism Coordinating Committee (IACC), and autism scientific journals. Despite the increased risk, little is known about factors that predict STB in autistic people. In the general population, older adults have the highest rates of suicide relative to all other age groups. Social disconnection is a well-established risk factor for STB in older adults. To date, no study has extended this association to older autistic adults. Older autistic adults are a growing population and their needs have been highlighted as an urgent research priority. The greater social isolation observed in older non-autistic adults is likely mirrored and potentially exacerbated in autism: autistic adults, across the lifespan, report feeling socially isolated and lonely. Given increased rates of STB and death by suicide in autism and the increased rates of suicide observed with older age in the general population, older autistic adults may be doubly vulnerable to the associations between social isolation and STB. In response to RFA-MH-22-136, we will employ a novel mixed-methods approach to characterize the relationship between STB and social disconnection, across multiple dimensions (structural, functional, qualitative), in older autistic adults (aged 55 and older). We will recruit 40 older autistic adults and 25 non-autistic older adults, oversampling for females given reports of heightened STB in autistic females and the differential relationship between STB and social disconnection in older non-autistic males and females. This R21 has three aims: (1) Examine how multiple dimensions (structural, functional, qualitative) of social disconnection predict STB in older autistic and non-autistic adults; (2) Determine how assigned sex at birth impacts the relationship between social disconnection and STB in older autistic and non-autistic adults; and (3) Explore the relative importance of different types of activities and social and community connections and their relation to STB using in-depth qualitative data. This R21 directly aligns with the goals of RFA-MH-22-126 and the focus areas of the NIMH Geriatrics and Aging Processes Research Branch and NIMH Strategic Goals 2 and 3. Further, this R21 combines two priority areas for autism research: understanding STB and aging in autism. Data from this project will characterize how social disconnections across multiple dimensions serve as potential risk factors for STB in older adults and will provide actionable areas for which we can begin to develop effective and scalable interventions for this vulnerable population.