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Reid M, Delgado D, Heinly J, Kiernan B, Shapiro S, Morgan L, Maddox B, Jager-Hyman S. Suicidal Thoughts and Behaviors in People on the Autism Spectrum. Curr Psychiatry Rep 2024:10.1007/s11920-024-01533-0. [PMID: 39348035 DOI: 10.1007/s11920-024-01533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2024] [Indexed: 10/01/2024]
Abstract
PURPOSE OF REVIEW This review synthesizes recent research on suicidal thoughts and behaviors among autistic individuals. We present literature on risk and protective factors, risk assessment, intervention, and crisis services, and recommendations for future research. RECENT FINDINGS Literature on this topic has grown substantially in recent years. Areas of advancement include improved understanding of risk factors (e.g., Interpersonal Theory of Suicide constructs, autistic burnout, mental health conditions, cognitive factors, diagnosis timing, emotion dysregulation), screening, assessment, acute-care services, and suicide-specific psychosocial treatments (e.g., safety planning, dialectical behavior therapy). Gaps include protective factors, impact of intersectional identities, and tailored approaches to screening, assessment, and intervention. Heightened awareness of suicide risk in autistic individuals has led to increased understanding of why autistic individuals think about and attempt suicide and the strategies used to identify and reduce suicide risk. We recommend community-partnered, multi-faceted, and strength-based approaches to inform tailored prevention and intervention efforts.
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Affiliation(s)
- Morganne Reid
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Daylin Delgado
- Department of Psychiatry, TEACCH Autism Program, University of North Carolina - Chapel Hill, Carrboro, NC, USA
| | - Julia Heinly
- Department of Psychiatry, TEACCH Autism Program, University of North Carolina - Chapel Hill, Carrboro, NC, USA
| | - Bridgett Kiernan
- Department of Psychiatry, TEACCH Autism Program, University of North Carolina - Chapel Hill, Carrboro, NC, USA
| | - Samantha Shapiro
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA
| | - Lisa Morgan
- Lisa Morgan Consulting LLC, Kittery, ME, USA
| | - Brenna Maddox
- Department of Psychiatry, TEACCH Autism Program, University of North Carolina - Chapel Hill, Carrboro, NC, USA
| | - Shari Jager-Hyman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA.
- Penn Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
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Hawkins RD, Kuo CH, Robinson C. Young adults' views on the mechanisms underpinning the impact of pets on symptoms of anxiety and depression. Front Psychiatry 2024; 15:1355317. [PMID: 38425998 PMCID: PMC10902138 DOI: 10.3389/fpsyt.2024.1355317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Emerging adulthood is considered a peak age for the onset of mental health difficulties with approximately 75% of mental health disorders being diagnosed during this developmental period. Companion animals confer both risk and benefits to mental health yet the potential underpinning mechanisms which explain such impacts are not fully understood. This study aimed to gather an in-depth understanding of young adults' lived experience of how their companion dogs and cats may impact their mental health symptoms and the perceived mechanisms which explain their effects. Methods Semi-structured interviews were carried out with 16 young adults aged 18-26 years, from the United Kingdom, who either had a companion dog, cat, or both. All participants had difficulties with anxiety and or depression, and 12 had received a formal diagnosis of an affective disorder. Results Five overarching themes and one subtheme were identified through reflexive thematic analysis using an inductive approach: Theme 1: Pet impact on generalized anxiety and panic, Subtheme 1A: Pet impact on social anxiety and loneliness; Theme 2: Pet impact on low mood, depression, and stress; Theme 3: Pet impact on severe mental health and suicide prevention; Theme 4: Staying well; Theme 5: Positive outlook and successful futures. Several perceived mechanisms underpinning the impacts of pets for mental health were also identified. Discussion These findings have relevance for the development and evaluation of mental health interventions and treatment protocols aimed at young adults with mental health difficulties, where companion animals may prove to be effective for symptom management and improvements in positive wellbeing.
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Affiliation(s)
- Roxanne D. Hawkins
- Clinical and Health Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom
| | - Chih-Hsin Kuo
- Psychology Division, The University of Stirling, Stirling, United Kingdom
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Barcelos AM, Kargas N, Assheton P, Maltby J, Hall S, Mills DS. Dog owner mental health is associated with dog behavioural problems, dog care and dog-facilitated social interaction: a prospective cohort study. Sci Rep 2023; 13:21734. [PMID: 38066034 PMCID: PMC10709316 DOI: 10.1038/s41598-023-48731-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Despite numerous qualitative and cross-sectional studies investigating how dog-related factors may impact owners' well-being, empirical studies to test these causal effects are lacking. This prospective cohort study examined the correlation and potential causal effect of 17 dog-related factors with six well-being outcomes (depression, anxiety, loneliness, suicidal ideation, hedonic well-being and eudaimonic well-being) in dog owners. Over a four-week period, 709 adult dog owners reported their weekly well-being and occurrence of each dog-related factor (e.g. how many times they ran with their dogs). A random intercept cross-lagged panel model (RI-CLPM) with significance threshold set at 0.001 was used. Six factors correlated with poorer owner well-being (i.e. aggressive dog behaviour, fearful dog behaviour, poor dog health, failure to provide for the dog, lack of control over the dog, and dog presence). Only 'friendly conversation with others due to the dog' correlated with better well-being. Purposeful reductions in the frequency of dog behavioural and health-related issues are likely to improve owner well-being, as well as greater consistency in dog care (i.e. provide for the dog) and more engagement in friendly dog-facilitated social interactions. No potential causal effects were significant. Further studies investigating causal relationships are essential to improve people's well-being through dog ownership.
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Affiliation(s)
| | - Niko Kargas
- School of Psychology, University of Lincoln, Lincoln, UK
| | | | - John Maltby
- School of Psychology and Vision Sciences, University of Leicester, Leicester, UK
| | - Sophie Hall
- School of Medicine, University of Nottingham, NG7 2RD, Nottingham, UK
| | - Daniel S Mills
- Department of Life Sciences, University of Lincoln, Lincoln, UK
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Kamal AHM, Dell CA, Kang T. Recognizing Zooeyia to Promote Companion Animal Welfare in Urban Bangladesh. Animals (Basel) 2023; 13:ani13091523. [PMID: 37174560 PMCID: PMC10177534 DOI: 10.3390/ani13091523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The One Health concept of zooeyia refers to the benefits of companion animals in human health and is gaining global research attention. This exploratory study aimed to understand contemporary experiences and perceptions of the social benefits and challenges of living with a companion animal in urban Bangladesh. Thirty-five qualitative interviews were conducted with companion animal owners (20), animal sellers (10), and livestock service department officers (5) from two major cities in Bangladesh, Dhaka and Khulna. Thematic analysis found that historically, animals had a utilitarian purpose, such as livestock for food and dogs for security. The role and perceptions of companion animals began to change for some around the turn of the century. Today, companion animal caretakers report social, psychological and physical health benefits from integrating companion animals into their lives. They also report that companion animal ownership can contribute to social problems due to the prevailing stigma against companion animals. This is rooted in the continued utilitarian role attached to companion animals by the majority of the Bangladesh population as well as religious-based non-acceptance. As a result, the Animal Welfare Act (2019) is not well implemented, posing a key concern for companion animal welfare. To tackle this, we propose various ways in which the emerging concept of zooeyia can help promote the welfare of companion animals by challenging the stigma associated with them in Bangladesh.
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Affiliation(s)
- Abu-Hena Mostofa Kamal
- Department of Sociology, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada
- Department of Humanities, Khulna University of Engineering and Technology (KUET), Khulna 9203, Bangladesh
| | - Colleen Anne Dell
- Department of Sociology, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada
| | - Timothy Kang
- Department of Sociology, University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada
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Merkouri A, Graham TM, O’Haire ME, Purewal R, Westgarth C. Dogs and the Good Life: A Cross-Sectional Study of the Association Between the Dog–Owner Relationship and Owner Mental Wellbeing. Front Psychol 2022; 13:903647. [PMID: 35923726 PMCID: PMC9341998 DOI: 10.3389/fpsyg.2022.903647] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
Dog ownership is believed to benefit owner wellbeing but, contrary to popular belief, there is limited evidence to suggest that simply owning a dog is associated with improved mental health. This mixed-methods study investigates whether dog owners with stronger relationships with their dogs experience better mental health. Participants (n = 1,693, adult United Kingdom dog owners) completed an online survey. Owners’ health was measured using the validated PROMIS questions regarding depression, anxiety, emotional support, and companionship. The dog–owner relationship was measured using the validated MDORS scale, which has three subscales: interaction, emotional closeness, and perceived costs. Univariable and multivariable linear regression analyses were conducted, adjusting for confounding factors. Additionally, positive and negative impacts of dog ownership on mental wellbeing were coded from open questions using thematic analysis. A stronger dog–owner relationship was associated with greater feelings of emotional support and companionship but poorer mental health in terms of anxiety or depression. However, the perceived costs (burden) subscale was consistently associated with better mental health outcomes. Direction of causality cannot be inferred as people with poor mental health may acquire dogs to help relieve symptoms, which qualitative analysis supported. Key themes included positive impacts on owner wellbeing and happiness through providing purpose, companionship and self-acceptance, pleasure and distraction, as well as lessening emotional pain and suffering and reducing risk behaviors. However, negative impacts of a strong relationship include anticipatory grief over loss of the dog, and concerns regarding the burden of responsibility and ability to meet dog’s needs. Perceived ability to adequately meet dog’s needs promoted personal growth and positive relationships with others, whereas perceived inability led to feelings of guilt, or anger/frustration, and reduced autonomy and sense of environmental mastery. Dog ownership contributes to both hedonic and eudaimonic wellbeing in multiple ways, including supporting owners through periods of poor mental health and providing purpose. However, the burden of responsibility and owner and dog characteristics can create challenges, and owners may benefit from support in caring for their dogs and reducing problematic behaviors.
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Affiliation(s)
- Aikaterini Merkouri
- School of Veterinary Science, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Taryn M. Graham
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Marguerite Elizabeth O’Haire
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Rebecca Purewal
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
| | - Carri Westgarth
- School of Veterinary Science, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom
- *Correspondence: Carri Westgarth,
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