Exploring Patterns of Self-Harm in Autistic Adults Using the Card Sort Task for Self-Harm / Mirabel PELTON in Autism, 30-7 (July 2026)  

Public ISBD [article]  inAutism > 30-7 (July 2026) . - p.1802-1815 Titre : Exploring Patterns of Self-Harm in Autistic Adults Using the Card Sort Task for Self-Harm Type de document : texte imprimé Auteurs : Mirabel PELTON, Auteur ; Victoria NEWELL, Auteur ; Blandine FRENCH, Auteur ; Ruth WADMAN, Auteur ; Ellen TOWNSEND, Auteur ; Sarah CASSIDY, Auteur Article en page(s) : p.1802-1815 Langues : Anglais (eng) Mots-clés : anxiety  autism  Card Sort Task for Self-Harm  emotional distress  self-harm  suicide Index. décimale : PER Périodiques Résumé : Autistic adults self-harm more often than non-autistic adults, but there are no tools to assess patterns of self-harm in autistic people. This study aimed to (1) review the accessibility of a novel visual task – the Card Sort Task for Self-Harm (CaTS) – to explore self-harm with autistic adults and (2) to pilot the CaTS to identify proximal and distal contributing factors leading to self-harm and experiences following self-harm. First, autistic adults (n = 5) with lived experience of self-harm reviewed the CaTS for clarity and accessibility. Second, we undertook a pilot administration of the CaTS and used sequence analysis to explore significant transitions between factors before and after self-harm. Participants (n = 29, autistic or possibly autistic, female = 82%, mean age = 41.62) selected, on average, 42 cards to describe self-harm. Most frequently selected cards described agitation (n = 25), mental pain (n = 22) and depression (n = 22), while most infrequently collected cards included being in a gang and talking to a teacher (n = 0). Agitation and acting on impulse preceded self-harm. Feeling better, worse, exhausted and hopeless followed self-harm. Improving emotion regulation and meeting autistic communication needs could reduce the transition to self-harm. The CaTS offers a systematic approach to explore self-harm in autistic adults.Lay Abstract Why did we do this study?Autistic adults self-harm more often than people who are not autistic. This is particularly worrying because self-harm is something that can contribute to suicide. We know that autistic people feel that their experience of self-harm is not well understood by other people, such as doctors.What did we want to know?We wanted to know if the card sort task for self-harm (called the CaTS for short) is a useful way to explore self-harm with autistic adults.What did we do?First, we worked with five autistic adults to make sure the CaTS is clear and works for autistic people. Second, we invited autistic and non-autistic adults to do the CaTS. To do the CATS, someone chooses the cards that are relevant to their experience and puts them on a timeline to explain what self-harm is like for them.What did we find?We found that (1) the CaTS is helpful and accessible to explore self-harm with autistic adults and (2) the CaTS uncovered patterns of self-harm. Twenty-nine U.K.-based autistic adults did the CaTS: most were female (82%, average age was around 42). Participants picked, on average, 42 cards to describe self-harm. The cards that were chosen most often described agitation, mental pain and depression. The cards that were chosen least described being in a gang and talking to a teacher. The order of the cards suggested that people felt agitated and acted impulsively before self-harm. After self-harm, they felt better, worse and hopeless. We found that it is safe and feasible to do the CaTS with autistic people. Support could consider how best to support people who are impulsive and how to prevent people accessing the means to hurt themselves. En ligne : https://dx.doi.org/10.1177/13623613261447926 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=590 [article] Exploring Patterns of Self-Harm in Autistic Adults Using the Card Sort Task for Self-Harm [texte imprimé] / Mirabel PELTON, Auteur ; Victoria NEWELL, Auteur ; Blandine FRENCH, Auteur ; Ruth WADMAN, Auteur ; Ellen TOWNSEND, Auteur ; Sarah CASSIDY, Auteur . - p.1802-1815. Langues : Anglais (eng) in Autism > 30-7 (July 2026) . - p.1802-1815 Mots-clés : anxiety  autism  Card Sort Task for Self-Harm  emotional distress  self-harm  suicide Index. décimale : PER Périodiques Résumé : Autistic adults self-harm more often than non-autistic adults, but there are no tools to assess patterns of self-harm in autistic people. This study aimed to (1) review the accessibility of a novel visual task – the Card Sort Task for Self-Harm (CaTS) – to explore self-harm with autistic adults and (2) to pilot the CaTS to identify proximal and distal contributing factors leading to self-harm and experiences following self-harm. First, autistic adults (n = 5) with lived experience of self-harm reviewed the CaTS for clarity and accessibility. Second, we undertook a pilot administration of the CaTS and used sequence analysis to explore significant transitions between factors before and after self-harm. Participants (n = 29, autistic or possibly autistic, female = 82%, mean age = 41.62) selected, on average, 42 cards to describe self-harm. Most frequently selected cards described agitation (n = 25), mental pain (n = 22) and depression (n = 22), while most infrequently collected cards included being in a gang and talking to a teacher (n = 0). Agitation and acting on impulse preceded self-harm. Feeling better, worse, exhausted and hopeless followed self-harm. Improving emotion regulation and meeting autistic communication needs could reduce the transition to self-harm. The CaTS offers a systematic approach to explore self-harm in autistic adults.Lay Abstract Why did we do this study?Autistic adults self-harm more often than people who are not autistic. This is particularly worrying because self-harm is something that can contribute to suicide. We know that autistic people feel that their experience of self-harm is not well understood by other people, such as doctors.What did we want to know?We wanted to know if the card sort task for self-harm (called the CaTS for short) is a useful way to explore self-harm with autistic adults.What did we do?First, we worked with five autistic adults to make sure the CaTS is clear and works for autistic people. Second, we invited autistic and non-autistic adults to do the CaTS. To do the CATS, someone chooses the cards that are relevant to their experience and puts them on a timeline to explain what self-harm is like for them.What did we find?We found that (1) the CaTS is helpful and accessible to explore self-harm with autistic adults and (2) the CaTS uncovered patterns of self-harm. Twenty-nine U.K.-based autistic adults did the CaTS: most were female (82%, average age was around 42). Participants picked, on average, 42 cards to describe self-harm. The cards that were chosen most often described agitation, mental pain and depression. The cards that were chosen least described being in a gang and talking to a teacher. The order of the cards suggested that people felt agitated and acted impulsively before self-harm. After self-harm, they felt better, worse and hopeless. We found that it is safe and feasible to do the CaTS with autistic people. Support could consider how best to support people who are impulsive and how to prevent people accessing the means to hurt themselves. En ligne : https://dx.doi.org/10.1177/13623613261447926 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=590

‘My Answers Don’t Fit Your Options’: Measuring Self-Harm With Autistic People Using the Self-Injurious Thoughts and Behaviours Interview (SITBI) / Isabel GORDON in Autism, 30-7 (July 2026)  

Public ISBD [article]  inAutism > 30-7 (July 2026) . - p.1790-1801 Titre : ‘My Answers Don’t Fit Your Options’: Measuring Self-Harm With Autistic People Using the Self-Injurious Thoughts and Behaviours Interview (SITBI) Type de document : texte imprimé Auteurs : Isabel GORDON, Auteur ; Mirabel PELTON, Auteur ; Jane GOODWIN, Auteur ; Ruby HERRINGTON, Auteur ; Jacqui RODGERS, Auteur ; Sarah CASSIDY, Auteur Article en page(s) : p.1790-1801 Langues : Anglais (eng) Mots-clés : measurement  self-harm  SITBI  suicide Index. décimale : PER Périodiques Résumé : Autistic people are a high-risk group for suicide, and self-harm is one of the strongest predictors of death by suicide among autistic people. There are no validated measures to assess self-harm with or without suicidal intent among autistic people. We aimed to describe the challenges reported by autistic people when completing the Self-Injurious Thoughts and Behaviours Interview (SITBI) and researchers’ experiences of supporting them. We undertook thematic analysis of feasibility interview transcripts from a pilot randomised controlled trial of autism-adapted safety plans carried out in the United Kingdom. One theme, ‘Reaching an authentic answer’ overarched three subthemes: ‘Conceptualising suicidal plans’; ‘Defining parameters of suicidal thoughts’; and ‘Capturing self-harm’. Researchers validated autistic experience and developed trusting partnership with participants to overcome ambiguous language and a lack of valid response options. Data were gathered on an opportunistic basis, rather than with this intended purpose, meaning this may not constitute an exhaustive survey of this issue. Researchers can support autistic people to report self-harm using the SITBI and other measures designed with non-autistic people in mind by clarifying the meaning of questions and working collaboratively on a response that matches participants’ experience. Researchers and clinicians should validate autistic experiences of self-harm and suicidality.Lay Abstract The U.K. government has said that autistic people are a very important group for avoiding suicide. Self-harm often leads to death by suicide, but there are no questionnaires that definitely measure self-harm in autistic people. This means that the way that questionnaires ask about self-harm may not include relevant questions and may not ask about things that are important to autistic people. In our study, autistic people did a questionnaire that is often used to measure self-harm called the Self-Injurious Thoughts and Behaviours Inventory (SITBI). We found out about challenges that autistic people had in understanding and responding to the questions. This was part of a larger project, which tested a suicide safety plan that was adapted for autistic people. There was one overall challenge (called an over-arching theme) for autistic people, which was about being able to give honest answers to the SITBI questions with the options given on the questionnaire. Within this, there were three specific challenges (called subthemes), which were about: (1) explaining own meaning of suicide plan within the choice of answers given (called ‘conceptualising suicide plans’); (2) explaining what suicidal thoughts are like showing with the choice of answers given (called ‘defining parameters of suicidal thoughts’); and (3) explaining what self-harm is like with the choice of answers given (called ‘capturing self-harm’). Researchers helped autistic people to answer the questions in four different ways: (1) by showing they understood the person’s experience; (2) by working together with trust; (3) by explaining unclear language; and (4) by helping them to choose answers. We did not set out to get this information when we did the larger project. This work shows researchers that self-harm can be different for autistic people compared to non-autistic people. En ligne : https://dx.doi.org/10.1177/13623613261435249 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=590 [article] â€˜My Answers Don’t Fit Your Options’: Measuring Self-Harm With Autistic People Using the Self-Injurious Thoughts and Behaviours Interview (SITBI) [texte imprimé] / Isabel GORDON, Auteur ; Mirabel PELTON, Auteur ; Jane GOODWIN, Auteur ; Ruby HERRINGTON, Auteur ; Jacqui RODGERS, Auteur ; Sarah CASSIDY, Auteur . - p.1790-1801. Langues : Anglais (eng) in Autism > 30-7 (July 2026) . - p.1790-1801 Mots-clés : measurement  self-harm  SITBI  suicide Index. décimale : PER Périodiques Résumé : Autistic people are a high-risk group for suicide, and self-harm is one of the strongest predictors of death by suicide among autistic people. There are no validated measures to assess self-harm with or without suicidal intent among autistic people. We aimed to describe the challenges reported by autistic people when completing the Self-Injurious Thoughts and Behaviours Interview (SITBI) and researchers’ experiences of supporting them. We undertook thematic analysis of feasibility interview transcripts from a pilot randomised controlled trial of autism-adapted safety plans carried out in the United Kingdom. One theme, ‘Reaching an authentic answer’ overarched three subthemes: ‘Conceptualising suicidal plans’; ‘Defining parameters of suicidal thoughts’; and ‘Capturing self-harm’. Researchers validated autistic experience and developed trusting partnership with participants to overcome ambiguous language and a lack of valid response options. Data were gathered on an opportunistic basis, rather than with this intended purpose, meaning this may not constitute an exhaustive survey of this issue. Researchers can support autistic people to report self-harm using the SITBI and other measures designed with non-autistic people in mind by clarifying the meaning of questions and working collaboratively on a response that matches participants’ experience. Researchers and clinicians should validate autistic experiences of self-harm and suicidality.Lay Abstract The U.K. government has said that autistic people are a very important group for avoiding suicide. Self-harm often leads to death by suicide, but there are no questionnaires that definitely measure self-harm in autistic people. This means that the way that questionnaires ask about self-harm may not include relevant questions and may not ask about things that are important to autistic people. In our study, autistic people did a questionnaire that is often used to measure self-harm called the Self-Injurious Thoughts and Behaviours Inventory (SITBI). We found out about challenges that autistic people had in understanding and responding to the questions. This was part of a larger project, which tested a suicide safety plan that was adapted for autistic people. There was one overall challenge (called an over-arching theme) for autistic people, which was about being able to give honest answers to the SITBI questions with the options given on the questionnaire. Within this, there were three specific challenges (called subthemes), which were about: (1) explaining own meaning of suicide plan within the choice of answers given (called ‘conceptualising suicide plans’); (2) explaining what suicidal thoughts are like showing with the choice of answers given (called ‘defining parameters of suicidal thoughts’); and (3) explaining what self-harm is like with the choice of answers given (called ‘capturing self-harm’). Researchers helped autistic people to answer the questions in four different ways: (1) by showing they understood the person’s experience; (2) by working together with trust; (3) by explaining unclear language; and (4) by helping them to choose answers. We did not set out to get this information when we did the larger project. This work shows researchers that self-harm can be different for autistic people compared to non-autistic people. En ligne : https://dx.doi.org/10.1177/13623613261435249 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=590

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