Earlier studies (Ghaziuddin, Weidmer-Mikhal & Ghaziuddin, 1998; Gillberg & Billstedt, 2000; Tantam, 2000) have explored the comorbid clinical disorders in children and adolescents with Asperger’s Syndrome (AS), but only a recent study has explored suicidal ideation among adolescents with AS (Shtayermman, 2006). Adolescents and young adults diagnosed with AS may be at higher risk for committing suicide than the neurotypical adolescent due to their difficulty with social communication and the social demands of adolescence. Some of the social demands during adolescence include dealing with increasing autonomy, finding peer groups to identify with, and forming intimate relationship with peers for the first time (Green, Gilchrist, Burton & Cox, 2000). Adolescents and young adults diagnosed with AS may find the social demands and transitions of adolescence more challenging because of their lack of social reciprocity in addition to their awareness that their peers thrive from the new social opportunities (Tantam, 2000).
Risk factors for suicide may be organized within a framework that distinguishes between proximal and distal exposures, and researchers believe this combination of factors constitutes sufficient conditions leading to suicide (Lubin, Glasser, Boyko & Barell, 2001). Proximal risk factors are more closely related temporally to the suicidal event and may act as precipitators. These proximal risk factors may include stressful life events, such as sudden illness or bereavement, and the availability of a method for committing suicide (Lubin, Glasser, Boyko & Barell, 2001; Moscicki, 1995). Distal risk factors increase vulnerability to proximal risk factors and include psychopathology, personal characteristics, substance abuse and familial risk factors. Peer victimization is a proximal risk factor for suicidal ideation (Bond, Carlin, Thomas, Rubin & Patton, 2001; Cleary, 2000). Individuals who were victimized by their peers were more vulnerable to developing psychological symptoms of depression and anxiety (Bond, Carlin, Thomas, Rubin & Patton, 2001; Juvonen, Graham & Schuster, 2003). Studies conducted in the U.S. and in other countries have found the prevalence of suicidal ideation among adolescents who were victimized in school to be 23% to 26% (Cleary, 2000; Kim, Koh & Leventhal, 2005).
Individuals with a diagnosis of AS were found to have a prevalence of suicidal ideation—within the range of levels of suicidal ideation reported in previous studies conducted using community samples of adolescents and adults (Alison, Roeger, Martin & Keeves, 2000; Barrios, Everett, Simon & Brener, 2000; Cleary, 2000; Shtayermman, 2006). In addition, a high proportion of adolescents and young adults diagnosed with AS presented with scores above the cutoff point on the overt victimization and relational victimization scales suggesting that these adolescents and young adults experienced high levels of victimization. Mental health professionals who are working with adolescents and young adults diagnosed with AS should incorporate the assessment of suicidal ideation as well as peer victimization into their practice. Thorough assessment of risk factors for suicidal ideation would provide a solid assessment of levels of suicidal ideation and would allow the development of a more comprehensive treatment plan for the adolescent or young adult with AS. It would also alert mental health professionals to which adolescent or young adult with AS is in an immediate danger to themselves.
Oren Shtayermman, PhD, MSW, is an Assistant Professor of Mental Health Counseling, is the Mental Health Counseling Program Coordinator and is a Research Associate at the New York Institute of Technology School of Health Professions, Behavioral and Life Sciences located in Old Westbury, New York.