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Research / Funded grants

2020 Young Investigator

Suicidality in youth with autism spectrum disorder: Interaction between biological vulnerabilities and cognitive dysfunction

1 research finding from this AFSP-funded study.

Research finding · May 2026

Suicidal thoughts and behaviors in autistic individuals can emerge early and evolve over time

Autistic individuals are known to face elevated risk for suicidal thoughts and behaviors, and much of the research for this population has focused on specific age. This leaves important gaps in understanding how these experiences unfold over time, including when suicidal thoughts first emerge, how they change across development, and how they relate to patterns like nonsuicidal self-injury. A more complete lifespan perspective can help move beyond one-time assessments of risk and toward a more continuous understanding of support needs, especially in recognizing that experiences of distress may begin earlier and evolve in ways that are not always captured in traditional clinical frameworks.

With her AFSP-funded grant, Dr. Carly McMorris examined suicidal thoughts and behaviors and nonsuicidal self-injury in a multinational sample of 245 autistic youth and adults without intellectual disability recruited with flyers across the United States, Canada, and Australia. Using the lifetime version of the Columbia-Suicide Severity Rating Scale (C-SSRS), Dr. McMorris interviewed participants and found that many individuals reported lifetime experiences of suicidal ideation (87.8%) and nonsuicidal self-injury (56.3%), with nearly one-third reporting at least one suicide attempt. Among those who had attempted, repeated attempts were relatively common. She also found that suicidal thoughts tended to become more severe and longer-lasting with age, with adults reporting more persistent experiences than younger participants. Early emergence was also notable, with some individuals reporting suicidal behavior in childhood and the average first attempt occurring in adolescence. Differences by sex were minimal across most outcomes.

Citation: Schwartzman, J. M., McMorris, C. A., Brown, C. M., Trollor, J. N., Uljarević, M., Stokes, M. A., Williams, Z. J., & Hedley, D. (2025). Elevated Suicidal Thoughts and Behaviors and Nonsuicidal Self-Injury in Autistic Youth and Adults: A Multinational Study. Autism in adulthood, 10.1089/aut.2024.0225. Advance online publication. https://doi.org/10.1089/aut.2024.0225

This finding comes from an AFSP-funded study — see the grant below ↓

The grant behind this work · 2020 Young Investigator

Suicidality in youth with autism spectrum disorder: Interaction between biological vulnerabilities and cognitive dysfunction

Carly McMorris, Ph.D.

Carly McMorris, Ph.D.

University of Calgary (Canada)

Mentor: David Klonsky, Ph.D., University of British Columbia (Canada)

Amount awarded
$89,357 Focus area
Psychosocial, Neurobiological

Inside the Research

Youth with autism spectrum disorder (ASD) experience suicidal thoughts and behaviors, but the contributors are not well known. The biological response to a stressful situation and its interaction with cognitive (thought) processes will be studied to gain insight into potential biological and psychosocial risk factors for suicide among youth with ASD.

Full scientific abstract

Background & Rationale: Suicidality is extremely common in youth with autism spectrum disorder (ASD), affecting approximately 66% of individuals. Importantly, individuals with ASD are 7 times more likely to die by suicide than individuals without ASD, and these rates are rising. Yet little is known about why some autistic individuals experience these thoughts and behaviours, and others do not. In the general population, there is a growing body of research investigating the interaction between biological vulnerabilities (how our bodies respond to stress, or an altered hypothalamic pituitary adrenal [HPA] axis) and cognitive factors (how we think in stressful situations) in the development of suicidality. In times of stress, this altered HPA-axis (aHPA) reactivity prevents individuals from being able to cope successfully, and stop suicidal thoughts and behaviours. To date, no study has examined if aHPA reactivity is related to suicidality in autistic individuals, nor how cognitive flexibility and impulsivity may interact with this altered stress response to heighten the risk of suicidality in autistic individuals. 

Objective & Hypothesis: This project aims to address this knowledge gap by investigating: 1) the relation between aHPA reactivity (biological vulnerability) and lifetime suicidality in autistic youth and 2) if how an individual thinks during stressful situations (cognitive processing) strengthens this relationship. It is expected that aHPA reactivity is associated with lifetime suicidal attempts, and cognitive difficulties will moderate, or strengthen this relationship. 

Sample: One-hundred and thirty youth with ASD (12-18 years of age) and their caregivers will participate in this study.

Measures: Autistic youth's reactivity to stress will be determined by examining cortisol levels (stress hormone found in their saliva) during and after a social stress test (TSST). Cognitive flexibility and impulsivity will be measured using questionnaires (BRIEF), standardized assessment tools (D-KEFS), and two computerized tasks (Go/No-Go Tasks). Lifetime and recent suicidality will be measured using a comprehensive interview (SITBI) with youth and their caregivers, independently, and a brief self-report questionnaire (SBQ). Age, sex, intelligence (WASI-II), medication use, and mental health symptoms (BASC-3) will be controlled for in the analyses.

Procedure: Participation will involve two back-to-back lab visits, each lasting 2 to 3 hours. Session 1 will involve: consent, psychosocial stress test and saliva swabs, and cognitive tasks. At the same time caregivers will complete the suicidality interview and questionnaires. In session 2, youth will complete the suicidality interview, IQ measure, a cognitive task, and questionnaires.

Potential Impact: This is the first study to investigate potential risk factors for suicidality in autistic youth, filling a substantial gap in existing knowledge. Understanding how biological and cognitive vulnerabilities interact to heighten the risk of suicidality in autistic youth is critical for preventing lifelong problems and premature death in this extremely vulnerable population. 

Next Steps: Findings will act as a first step in developing a comprehensive risk model of suicidality for individuals with ASD, and will help to support future projects and grant applications. Clinically, study findings will fill a significant gap in clinical care related to preventative and intervention strategies for autistic individuals.

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