• Autism and autistic traits in those who died by suicide in England

      Cassidy, Sarah; Au-Yeung, Sheena K.; Robertson, Ashley E.; Cogger-Ward, Heather; Richards, Gareth; Allison, Carrie; Bradley, Louise; Kenny, Rebecca; O'Connor, Rory; Mosse, David; et al. (Cambridge University Press, 2022-02-15)
      Autism and autistic traits are risk factors for suicidal behaviour. To explore the prevalence of autism (diagnosed and undiagnosed) in those who died by suicide, and identify risk factors for suicide in this group. Stage 1: 372 coroners' inquest records, covering the period 1 January 2014 to 31 December 2017 from two regions of England, were analysed for evidence that the person who died had diagnosed autism or undiagnosed possible autism (elevated autistic traits), and identified risk markers. Stage 2: 29 follow-up interviews with the next of kin of those who died gathered further evidence of autism and autistic traits using validated autism screening and diagnostic tools. Stage 1: evidence of autism (10.8%) was significantly higher in those who died by suicide than the 1.1% prevalence expected in the UK general alive population (odds ratio (OR) = 11.08, 95% CI 3.92-31.31). Stage 2: 5 (17.2%) of the follow-up sample had evidence of autism identified from the coroners' records in stage 1. We identified evidence of undiagnosed possible autism in an additional 7 (24.1%) individuals, giving a total of 12 (41.4%); significantly higher than expected in the general alive population (1.1%) (OR = 19.76, 95% CI 2.36-165.84). Characteristics of those who died were largely similar regardless of evidence of autism, with groups experiencing a comparably high number of multiple risk markers before they died. Elevated autistic traits are significantly over-represented in those who die by suicide.
    • Bodies over borders: the sized body and geographies of transnationalism

      Lloyd, Jenny; Newcastle University (Taylor & Francis, 2013-06-03)
      This article connects the study of transnationalism with the growing area of fat studies. It proposes that a ‘trans-sizing’ approach to the body has the potential to illuminate both accounts of transnational migration and the body. I conclude by outlining two research agendas with the aim of expanding the focus of work on fatness and transnationalism; first, through focusing on (anti)obesity discourse in China, and second, on the relational experiences of migrant encounters in global cities.
    • Development and validation of the suicidal behaviours questionnaire - autism spectrum conditions in a community sample of autistic, possibly autistic and non-autistic adults

      Cassidy, Sarah; Bradley, Louise; Cogger-Ward, Heather; Rodgers, Jacqui; University of Nottingham; University of Bedfordshire; University of Lincoln; Lincolnshire Partnership NHS Foundation Trust; Newcastle University (Biomed Central, 2021-06-21)
      Autistic people and those with high autistic traits are at high risk of experiencing suicidality. Yet, there are no suicidality assessment tools developed or validated for these groups. A widely used and validated suicidality assessment tool developed for the general population (SBQ-R), was adapted using feedback from autistic adults, to create the Suicidal Behaviours Questionnaire-Autism Spectrum Conditions (SBQ-ASC). The adapted tool was refined through nine interviews, and an online survey with 251 autistic adults, to establish clarity and relevance of the items. Subsequently, 308 autistic, 113 possibly autistic, and 268 non-autistic adults completed the adapted tool online, alongside self-report measures of autistic traits (AQ), camouflaging autistic traits (CAT-Q), depression (PHQ-9), anxiety (ASA-A), thwarted belongingness and perceived burdensomeness (INQ-15), lifetime non-suicidal self-injury, and the original version of the suicidality assessment tool (SBQ-R). Analyses explored the appropriateness and measurement properties of the adapted tool between the groups. There was evidence in support of content validity, structural validity, internal consistency, convergent and divergent validity, test-retest validity, sensitivity and specificity (for distinguishing those with or without lifetime experience of suicide attempt), and hypothesis testing of the adapted tool (SBQ-ASC) in each group. The structure of the SBQ-ASC was equivalent between autistic and possibly autistic adults, regardless of gender, or use of visual aids to help quantify abstract rating scales. The samples involved in the development and validation of the adapted tool were largely female, and largely diagnosed as autistic in adulthood, which limits the generalisability of results to the wider autistic population. The SBQ-ASC has been developed for use in research and is not recommended to assess risk of future suicide attempts and/or self-harm. The SBQ-ASC has been designed with and for autistic and possibly autistic adults, and is not appropriate to compare to non-autistic adults given measurement differences between these groups. The SBQ-ASC is a brief self-report suicidality assessment tool, developed and validated with and for autistic adults, without co-occurring intellectual disability. The SBQ-ASC is appropriate for use in research to identify suicidal thoughts and behaviours in autistic and possibly autistic people, and model associations with risk and protective factors.
    • An inter-disciplinary perspective on evaluation of innovation to support care leavers’ transition

      Lynch, Amy; Alderson, Hayley; Kerridge, Gary; Johnson, Rebecca; McGovern, Ruth; Newlands, Fiona; Smart, Deborah; Harrop, Carrie; Currie, Graeme; University of Bedfordshire; et al. (Emerald Group Holdings Ltd., 2021-07-31)
      Purpose: Young people who are looked after by the state face challenges as they make the transition from care to adulthood, with variation in support available. In the past decade, funding has been directed towards organisations to pilot innovations to support transition, with accompanying evaluations often conducted with a single disciplinary focus, in a context of short timescales and small budgets. Recognising the value and weight of the challenge involved in evaluation of innovations that aim to support the transitions of young people leaving care, this paper aims to provide a review of evaluation approaches and suggestions regarding how these might be developed. Design/methodology/approach: As part of a wider research programme to improve understanding of the innovation process for young people leaving care, the authors conducted a scoping review of grey literature (publications which are not peer reviewed) focusing on evaluation of innovations in the UK over the past 10 years. The authors critiqued the evaluation approaches in each of the 22 reports they identified with an inter-disciplinary perspective, representing social care, public health and organisation science. Findings: The authors identified challenges and opportunities for the development of evaluation approaches in three areas. Firstly, informed by social care, the authors suggest increased priority should be granted to participatory approaches to evaluation, within which involvement of young people leaving care should be central. Secondly, drawing on public health, there is potential for developing a common outcomes’ framework, including methods of data collection, analysis and reporting, which aid comparative analysis. Thirdly, application of theoretical frameworks from organisation science regarding the process of innovation can drive transferable lessons from local innovations to aid its spread. Originality/value: By adopting the unique perspective of their multiple positions, the authors’ goal is to contribute to the development of evaluation approaches. Further, the authors hope to help identify innovations that work, enhance their spread, leverage resources and influence policy to support care leavers in their transitions to adulthood.
    • Measurement properties of the suicidal behaviour questionnaire - revised in autistic adults

      Cassidy, Sarah; Bradley, Louise; Cogger-Ward, Heather; Shaw, Rebecca; Bowen, Erica; Glod, Magdalena; Baron-Cohen, Simon; Rodgers, Jacqui; University of Nottingham; University of Bedfordshire; et al. (Springer Verlag (Germany), 2020-03-03)
      We explored the appropriateness and measurement properties of a suicidality assessment tool (SBQ-R) developed for the general population, in autistic adults-a high risk group for suicide. 188 autistic adults and 183 general population adults completed the tool online, and a sub-sample (n = 15) were interviewed while completing the tool. Multi-group factorial invariance analysis of the online survey data found evidence for metric non-invariance of the SBQ-R, particularly for items three (communication of suicidal intent) and four (likelihood of suicide attempt in the future). Cognitive interviews revealed that autistic adults did not interpret these items as intended by the tool designers. Results suggest autistic adults interpret key questions regarding suicide risk differently to the general population. Future research must adapt tools to better capture suicidality in autistic adults.