Bullying is a significant risk factor for suicidal thoughts and behaviors in teenagers with autism spectrum disorders (ASD), according to a new study.

In the study, Rachel Holden and colleagues reviewed the clinical records of 680 teens with ASD who were referred to a mental health clinic, focusing only on teens who initially were not suicidal. To zero in on the effects of bullying, they controlled for the presence of co-occurring psychiatric conditions and a number of other sociodemographic and clinical factors.

In the initial visits, nearly one-third of the teenagers reported being bullied. The researchers report, “We found that if [teenagers] reported being bullied in the first month after they were first seen by mental health services, they were nearly twice as likely to go on to develop suicidal thoughts or behaviors.”

The effects of bullying were much stronger for females than for males. They were also stronger for teens who had a diagnosis of psychosis or affective disorder and for teens with high IQs. However, the effects of bullying remained significant even after the researchers controlled for these factors.

Holden and coauthor Johnny Downs comment in Spectrum News, “We urge clinicians to… make a concerted effort to ask children with autism about bullying. And when a young autistic person reports bullying to mental health professionals, it needs to be taken seriously.”

In addition, they say, “Teachers have a key role to play. In school settings, evidence suggests that intensive anti-bullying interventions in which teachers meet with parents are most effective. Schools can also benefit from autism-specific anti-bullying strategies, including ‘befriending interventions,’ which help autistic children form friendships with typical peers. Schools should use robust evaluations to assess the effectiveness of such interventions and involve young people with autism in the development of their antibullying policies.”

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“Investigating bullying as a predictor of suicidality in a clinical sample of adolescents with autism spectrum disorder,” Rachel Holden, Joanne Mueller, John McGowan, Jyoti Sanyal, Maxim Kikoler, Emily Simonoff, Sumithra Velupillai, and Johnny Downs, Autism Research, June 2020 (online). Address: Johnny Downs, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Box PO84 16 De Crespigny Park, London SE5 8AF, UK, [email protected].

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“Why it is imperative to ask autistic adolescents about bullying,” Johnny Downs and Rachel Holden, Spectrum News, October 6, 2020.


This article originally appeared in Autism Research Review International, Vol. 34, No. 4, 2020