Using the Interpersonal Theory of Suicide to Inform Our Understanding of Suicide Risk in Autism Spectrum Disorder: A Scoping Review

Abstract

Abstract This scoping review is the first to systematically map the literature on suicidality in autistic adults through the lens of Joiner’s Interpersonal Theory of Suicide (ITS). Reviewing 51 studies and distinguishing between those directly assessing ITS constructs and those conceptually interpreted in relation to its components, we find preliminary support for the relevance of thwarted belongingness, perceived burdensomeness, and acquired capability in this population, while identifying meaningful variability in how these constructs manifest compared to non-autistic individuals. A cluster of autism-specific risk processes, including camouflaging, intersecting minority identities, emotional and physiological dysregulation, and intolerance of uncertainty, extends beyond the original framework and warrants further longitudinal empirical investigation. Developed in collaboration with autistic co-researchers, we propose an autism-specific adaptation of the ITS as a theoretically informed scaffold, intended as a pragmatic starting point for future research and for informing suicide risk formulation in clinical practice with autistic adults.