Why Do Adults with Autistic Traits Have a Higher Risk of Suicide?

A new systematic review study explores the relationship between masking in autistic adults and suicide risk.

Various studies have determined that adults with autism spectrum conditions (ASC) have an increased risk of suicidal thoughts and behaviors. However, the mechanisms explaining this relationship have been understudied so far.

A new systematic review, conducted by researchers from the Complutense University of Madrid and Santo Tomás University in Chile, aims to clarify the mechanisms underlying this association. Specifically, the study focuses on the phenomenon of "masking" or "camouflaging", which refers to a set of strategies that some autistic individuals use to conceal their symptoms and appear "neurotypical".

The review analyzed studies on this topic across six databases. After screening over 6,901 articles, 11 studies were included that specifically examined masking and suicide risk.

Findings highlight that social interactions can pose significant challenges for many autistic individuals, who often feel pressured to conform to neurotypical norms that do not come naturally to them. To cope with the anxiety caused by these demands, some individuals resort to substance use, such as alcohol, tobacco, or caffeine, as an attempt to relieve distress. However, while these coping mechanisms may provide temporary relief, they can become a long-term burden, exacerbating pre-existing health issues, limiting help-seeking behaviors, and ultimately increasing suicide risk.

All the reviewed studies found a positive association between masking and suicidal behavior. What might initially seem like a defensive mechanism turns into a psychological burden that aggravates mental health issues, restricts access to help and support, and heightens suicide risk.

The study underscores the need for longitudinal research to better understand how masking, suicide risk, and other factors interact over time and how they fit within existing theoretical suicide models.

Reference to original work: Pérez-Arqueros, M., Jamett-Cuevas, V., Pulgar-Vera, V., Santander-Gonzalez, R., Pemau, A., & Álvarez-Cabrera, P. (2025). Camouflaging and suicide behavior in adults with autism spectrum condition: A mixed methods systematic review. Research in Autism, 121, 202540. https://doi.org/10.1016/j.reia.2025.202540