Preliminary lack of evidence that ecological momentary assessment affects levels of suicidal and self-injury ideation among autistic adults

Introduction: Ecological momentary assessment (EMA) has been used to highlight the moment to moment change in suicidal thinking and its associated risk factors, as well as study mechanisms of change in intervention studies. There has been debate in the field as to if repeatedly asking about suicidal thoughts is iatrogenic. Research in community samples suggests that EMA is not iatrogenic. Considering rates of suicide are even higher in autistic people than the non-autistic population, EMA studies have the potential to provide critical insights into risk and protective factors for this clinical population. Assumptions that EMA carries iatrogenic risk for autistic people may lead to EMA being not seen as a potential methodology in autism studies seeking to better understand the heightened risk for suicide. Methods: The present preliminary analyses leverage clinical trial data to understand whether completion of EMA surveys on suicidal and self-injury ideation impacts levels of ideation among autistic adults. Results: Results provide preliminary evidence that EMA about suicide-related outcomes was not associated with endorsement of suicidal and self-injury ideation in autistic adults. Conclusion: This pilot study underscores that potential for iatrogenic risk should not be used to justify exclusion of EMA from autism suicide research, as such misleading assumptions could impede critical research that will elucidate our understanding of heightened suicide risk in autistic adults.