The Relationship of ASD Symptoms with the Occurrence of Self-Injury Behaviors Among Middle School Students
Objectives: The present study examined the effects of ASD symptoms on the occurrence of SIB among students from seventh through ninth grades in Japan.
Methods: The participants were students (N =2,181) attending all junior high schools in a city, along with their parents. The students completed a questionnaire to assess the occurrence of two types of SIB, hitting and cutting. Their parents answered the Autism Spectrum Screening Questionnaire (Ehlers, Gillberg, & Wing, 1999) and the Attention Deficit Hyperactivity Disorder (ADHD) Rating Scale-IV (Du Paul et al., 1998), to assess the ASD and ADHD symptoms that the students exhibited. Multivariate logistic regression analysis was performed to study the effect of ASD symptoms on SIB over and above the effects of age, grades, and ADHD symptoms
Results: Multivariate logistic regression analysis indicated that after controlling for age, grade, and ADHD symptoms, ASD symptoms had an effect on the occurrence of both types of SIB that we assessed. Specifically, students with more severe ASD symptoms were more likely to engage in both hitting and cutting SBI (hitting SIB: OR = 1.404, p < .001; cutting SIB: OR = 1.371, p =.001). Age and ADHD symptoms also had a significant influence on the occurrence of SIB. Female students were more likely to engage in both types of SIB, and students with severe ADHD symptoms had a higher probability of the hitting SBI.
Conclusions: The current study indicated that even after controlling for sex, grade, and the severity of ADHD symptoms, ASD symptoms had a significantly influence on the occurrence of SIB, which suggests that ASD symptoms are a risk factor for SBI. In addition to the result of the current study, previous studies have reported that children and adolescents with ASD show higher levels of depression, which increases the probability of SIB (e.g., Kim et al., 2000). Therefore, we should provide children and adolescents with ASD, even those who have not official diagnosis, with sufficient psychosocial support to prevent them from engaging in SIB.