The Contribution of Invalidation on Suicidality as Reported by Autistic Adults: A Qualitative Content Analysis

Background: Autistic people experience a higher rate of suicidal thoughts and behaviors (STBs) than the general population and the autism community has identified suicide prevention research, including risk factors, as a priority. One risk factor may be experiencing invalidation (i.e., dismissal or minimization of one’s thoughts, feelings, behaviors, or experiences). However, no studies have asked autistic people about the perceived impact of invalidation on their suicidality. As autistic people report widespread invalidation, including of their diagnosis and characteristics, the relationship between invalidation and STBs in this population deserves exploration. Methods: 106 autistic adults ( M age = 38.8, SD age = 11.1) with a history of suicidality completed an online survey that asked if experiencing invalidation had contributed to STBs and, if yes, to describe the invalidation. Qualitative content analysis was used to summarize open-ended responses. Results: 92% of respondents reported invalidation as a contributor to STBs. A range of sources were reported, most frequently parents or other family members (50%), health care providers (32%), and friends or peers (24%). The most common content was invalidation of mental health challenges (43%) and autistic traits (20%). For example, participants reported experiences of being told they were “mak[ing] things up for attention,” not believed or taken seriously, and having their sensory needs and communication differences dismissed. Some respondents reflected on historical invalidation (i.e., experienced years ago; 12%) and others shared that it was overwhelming to summarize due to the extent or frequency (11%). Conclusion: Most autistic adult respondents endorsed that invalidation contributed to STBs. The invalidation reported was pervasive, spanning many sources and relating to deeply personal experiences across the lifespan. These findings support the need for more research on this relationship in addition to a shift toward neuro-affirming conceptualizations of autism and mental health in community and health care settings to prevent invalidation.