Autism, ADHD and school absence are risk factors for self-harm

A new report has retrospectively analysed the factors associated with self-harm in over 111,000 adolescents aged 11 to 17 years old across four London boroughs.

The study, led by King’s College London and South Maudsley NHS Foundation Trust, found that the risk for self-harm increased when a number of factors relating to neurodivergence were factored in.

The study found that:

• The risk of self-harm presenting to hospital emergency departments was nearly three times higher for autistic boys compared to non-autistic boys
• ADHD was a strong predictor of self-harm for all sexes 
• There was a four-fold increase for self-harm amongst those with ADHD
• Young people with less than 80 per cent attendance the risk of self-harm was three times greater

This is the first study of its kind to look at the link between neurodivergence and self-harm utilising both school and hospital data. The research provides valuable insight into those groups most at risk, representing an important step in developing preventative strategies for self-harm. The study also revealed findings that may need further research to unpick the possible underlying mechanisms. For example, the finding that autistic girls were at no higher risk to self-harm than non-autistic girls could be explained by underdiagnosis of autism in girls.

Emily Simonoff, Professor of Child & Adolescent Psychiatry at King’s College London, who is a co-author on the paper said:

“We know that autistic adults have higher rates of premature death, including increased rates of suicide.  Self-harming behaviours, like those explored in the present study, may be the precursor to more serious suicide attempts, so early identification and proactive intervention when self-harm first appears is very important. Autistic people often have more difficulty regulating their emotions, which can contribute to high levels of distress and, because of the communication impairments experienced by many autistic people, professionals may not appreciate the level of distress they are experiencing and the seriousness of these behaviours.”