“My answers don’t fit your options”: measuring self-harm with autistic people using the Self-Injurious Thoughts and Behaviours Interview (SITBI)

AbstractBackgroundAutistic people are a high-risk group for suicide and self-harm is one of the strongest predictors of death by suicide amongst autistic people. There are no validated measures to assess self-harm and suicidality amongst autistic people. AimsWe aimed to describe the challenges reported by autistic people when completing the SITBI and researchers’ experiences of supporting them. MethodWe undertook thematic analysis of feasibility interview transcripts from a pilot randomized controlled trial of autism adapted safety plans. ResultsOne theme ‘Reaching an authentic answer’ overarched 3 sub-themes: ‘Conceptualising suicidal plans’; ‘Defining parameters of suicidal thoughts’; and ‘Capturing self-harm’. Researchers validated autistic experience and developed trusting partnership with participants to overcome ambiguous language and a lack of valid response options LimitationsData were gathered on an opportunistic basis, rather than with this intended purpose meaning this may not constitute an exhaustive survey of this issue. ConclusionResearchers can support autistic people to report self-harm using the SITBI and other measures designed with non-autistic people in mind. This can be done by clarifying meaning of questions and working collaboratively on a response that matches participants’ experience. Researchers should validate autistic experiences of self-harm and suicidality.