‘My Answers Don’t Fit Your Options’: Measuring Self-Harm With Autistic People Using the Self-Injurious Thoughts and Behaviours Interview (2026). Gordon I., Pelton M.

Open access article: https://journals.sagepub.com/doi/pdf/10.1177/13623613261435249?casa_token=KQXoy-C7lvQAAAAA:yPS_Tn-bVg7i0giaCQKUgDCDrk_H33FTLH57dSoBv7VMNhxfP1Ougcr1YfeDzIe3O1_LyMz7jhL8OQ

Abstract

Autistic people are a high-risk group for suicide, and self-harm is one of the strongest predictors of death by suicide among autistic people. There are no validated measures to assess self-harm with or without suicidal intent among autistic people. We aimed to describe the challenges reported by autistic people when completing the Self-Injurious Thoughts and Behaviours Interview (SITBI) and researchers’ experiences of supporting them. We undertook thematic analysis of feasibility interview transcripts from a pilot randomised controlled trial of autism-adapted safety plans carried out in the United Kingdom. One theme, ‘Reaching an authentic answer’ overarched three subthemes: ‘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. Data were gathered on an opportunistic basis, rather than with this intended purpose, meaning this may not constitute an exhaustive survey of this issue. Researchers can support autistic people to report self-harm using the SITBI and other measures designed with non-autistic people in mind by clarifying the meaning of questions and working collaboratively on a response that matches participants’ experience. Researchers and clinicians should validate autistic experiences of self-harm and suicidality.

Citation: Gordon, Isabel & Pelton, Mirabel & Goodwin, Jane & Herrington, Ruby & Rodgers, Jacqui & Cassidy, Sarah. (2026). ‘My Answers Don’t Fit Your Options’: Measuring Self-Harm With Autistic People Using the Self-Injurious Thoughts and Behaviours Interview (SITBI). Autism. 10.1177/13623613261435249.