Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools

Anxiety in autism is an important treatment target because of its consequences for quality of life and wellbeing. Growing evidence suggests that Cognitive Behaviour Therapies (CBT) and Mindfulness-Based Therapies (MBT) can ameliorate anxiety in autism but cost-effective delivery remains a challenge. This pilot randomized controlled trial examined whether online CBT and MBT self-help programmes could help reduce anxiety in 54 autistic adults who were randomly allocated to either an online CBT (n=16) or MBT (n=19) programme or a waitlist control group (WL; n=19). Primary outcome measures of anxiety, secondary outcome measures of broader wellbeing, and potential process of change variables were collected at baseline, after programme completion, and then 3 and 6 months post-completion. Baseline data confirmed that intolerance of uncertainty and emotional acceptance accounted for up to 61% of self-reported anxiety across all participants. The 23 participants who were retained in the active conditions (14 MBT, 9 CBT) showed significant decreases in anxiety that were maintained over 3, and to some extent also 6 months. Overall, results suggest that online self-help CBT and MBT tools may provide a cost-effective method for delivering mental health support to those autistic adults who can engage effectively with online support tools

Ageing and autism: A longitudinal follow-up study of mental health and quality of life in autistic adults

Research has shown that over half of autistic people experience difficulties related to poor mental health, such as anxiety and depression. Complex physical health conditions and medication can also negatively affect the well-being of autistic people. In the general population, poor mental health is a common contributor to poorer quality of life and social isolation. Little is known about how these conditions affect the quality of life of autistic adults as they grow older, or whether these factors related improve or worsen over time. The research presented in this paper aimed to find out how mental health and physical health conditions affect the quality of life of autistic adults in older age. We worked with a community group of adults across 4 years, which involved assessments at two time points (T1. T2). Over half of all autistic adults experienced mental and physical health difficulties. We report how these conditions affect the quality of life and well-being of autistic adults across the adult lifespan and continue to present difficulties over time. We offer suggestions for future work to support the mental health and well-being of autistic adults in later life that considers individual differences, such as those between men, women or other gender identities

Brief Report: The Role of Task Support in the Spatial and Temporal Source Memory of Adults with Autism Spectrum Disorder

Adults with autism spectrum disorder (ASD) show intact recognition (supported procedure) but impaired recall (unsupported procedure) of incidentally-encoded context. Because this has not been demonstrated for temporal source, we compared the temporal and spatial source memory of adults with ASD and verbally matched typical adults. Because of difficulties with temporal processing in ASD, we predicted ASD adults would benefit from test support for location but not temporal occurrence of studied words. We found similar levels of recognition and source memory for both groups but there was a greater effect of support on memory for location source in the ASD group. The lack of an effect of support for temporal source may simply reflect a difficulty in operationalising temporal cues

Understanding the Mind or Predicting Signal-Dependent Action? Performance of Children With and Without Autism on Analogues of the False-Belief Task

To evaluate the claim that correct performance on unexpected transfer false-belief tasks specifically involves mental-state understanding, two experiments were carried out with children with autism, intellectual disabilities, and typical development. In both experiments, children were given a standard unexpected transfer false-belief task and a mental-state-free, mechanical analogue task in which participants had to predict the destination of a train based on true or false signal information. In both experiments, performance on the mechanical task was found to correlate with that on the false-belief task for all groups of children. Logistic regression showed that performance on the mechanical analogue significantly predicted performance on the false-belief task even after accounting for the effects of verbal mental age. The findings are discussed in relation to possible common mechanisms underlying correct performance on the two tasks

Free Recall Learning of Hierarchically Organised Lists by Adults with Asperger's Syndrome: Additional Evidence for Diminished Relational Processing

The Task Support Hypothesis (TSH, Bowler et al. Neuropsychologia 35:65–70 1997) states that individuals with autism spectrum disorder (ASD) show better memory when test procedures provide support for retrieval. The present study aimed to see whether this principle also applied at encoding. Twenty participants with high-functioning ASD and 20 matched comparison participants studied arrays of 112 words over four trials. Words were arranged either under hierarchically embedded category headings (e.g. Instruments—String—Plucked—Violin) or randomly. Both groups showed similar overall recall and better recall for the hierarchically organised words. However, the ASD participants made less use of information about relations between words and more use of item-specific information in their recall, confirming earlier reports of relational difficulties in this population

Brief report: Suggestibility, compliance and psychological traits in high-functioning adults with autism spectrum disorder

Individuals with autism spectrum disorder (ASD) may be over-represented within the criminal justice system; it is therefore important to understand how they fare under police questioning. The present study examined interrogative suggestibility and compliance in individuals with ASD, and whether this is associated with certain psychological traits. Adults with ASD and their typical counterparts completed the Gudjonsson Suggestibility Scales (GSS), Gudjonsson Compliance Scale (GCS), and measures of state-trait anxiety, self-esteem, fear of negative evaluation by others and paranoia. In contrast to previous research (North, Russell, & Gudjonsson, 2008), there was no difference between the ASD and comparison groups on the measure of compliance, and groups also did not differ on any of the GSS measures, despite the ASD group reporting significantly higher paranoia. Findings indicate that individuals with ASD may be no more likely to succumb to interrogative pressures than their typical counterparts

Binding of multiple features in memory by high-functioning adults with autism spectrum disorder

Diminished episodic memory and diminished use of semantic information to aid recall by individuals with autism spectrum disorder (ASD) are both thought to result from diminished relational binding of elements of complex stimuli. To test this hypothesis, we asked high-functioning adults with ASD and typical comparison participants to study grids in which some cells contained drawings of objects in non-canonical colours. Participants were told at study which features (colour, item, location) would be tested in a later memory test. In a second experiment, participants studied similar grids and were told that they would be tested on object-location or object-colour combinations. Recognition of combinations was significantly diminished in ASD, which survived covarying performance on the Color Trails Test (D'Elia et al. Color trails test. Professional manual. Psychological Assessment Resources, Lutz, 1996), a test of executive difficulties. The findings raise the possibility that medial temporal as well as frontal lobe processes are dysfunctional in ASD

Recognition memory, self-other source memory, and theory-of-mind in children with autism spectrum disorder.

This study investigated semantic and episodic memory in autism spectrum disorder (ASD), using a task which assessed recognition and self-other source memory. Children with ASD showed undiminished recognition memory but significantly diminished source memory, relative to age- and verbal ability-matched comparison children. Both children with and without ASD showed an “enactment effect”, demonstrating significantly better recognition and source memory for self-performed actions than other-person-performed actions. Within the comparison group, theory-of-mind (ToM) task performance was significantly correlated with source memory, specifically for other-person-performed actions (after statistically controlling for verbal ability). Within the ASD group, ToM task performance was not significantly correlated with source memory (after controlling for verbal ability). Possible explanations for these relations between source memory and ToM are considered

Different Verbal Learning Strategies in Autism Spectrum Disorder: Evidence from the Rey Auditory Verbal Learning Test

The Rey Auditory Verbal Learning Test, which requires the free recall of the same list of 15 items over 5 trials, was administered to a group of highfunctioning adolescents and adults with autism spectrum disorder (PDD) and a group of matched typical individuals. Overall levels of free recall were comparable in the two groups, as were the rates of learning over trials. Both groups also subjectively organised their recall to a similar extent. However, the serial position curve of the PDD participants, although similar to that of the comparison group on the first trial, became flatter on subsequent trials and was characterised by a slower growth in the primacy effect. Growth in the middle and recency portions of the curve was comparable in both groups. The findings are discussed in the light of current models of serial position effects and their implications for memory in ASD