{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T21:27:19Z","timestamp":1775251639500,"version":"3.50.1"},"reference-count":46,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec id=\"S2056472423000571_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Brain in Hand (BIH) is a UK-based digital self-support system for managing anxiety and social functioning.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472423000571_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>To identify the impact of BIH on the psychological and social functioning of adults with autism.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472423000571_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Adults with diagnosed or suspected DSM-5 (level 1) autism, identified by seven NHS autism services in England and Wales, were recruited for a 12-week prospective mixed-methods cohort study. The primary quantitative outcome measures were the Health of the Nation Outcome Scales for People with Learning Disabilities (HONOS-LD) and the Hospital Anxiety and Depression Scale (HADS). Fisher's exact test explored sociodemographic associations. Paired<jats:italic>t<\/jats:italic>-test was utilised for pre\u2013post analysis of overall effectiveness of BIH. Multivariable linear regression models, univariable pre\u2013post analysis, Wilcoxon signed-rank test, logistic regression analysis, Bonferroni correction and normative analysis were used to give confidence in changes identified. A thematic analysis of semi-structured exist interviews following Braun and Clarke's six-step process of 10% of participants who completed the study was undertaken.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472423000571_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Sixty-six of 99 participants completed the study. There was significant reduction in mean HONOS-LD scores, with 0.65 s.d. decrease in those who used BIH for 12 weeks. Significant positive changes were identified in HONOS-LD subdomains of \u2018self-injurious behaviours\u2019, \u2018memory and orientation\u2019, \u2018communication problems in understanding\u2019, \u2018occupation and activities\u2019 and \u2018problems with relationship\u2019. A significant reduction in the anxiety, but not depression, component of the HADS scores was identified. Thematic analysis showed high confidence in BIH.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472423000571_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>BIH improved anxiety and other clinical, social and functioning outcomes of adults with autism.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjo.2023.57","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T08:12:03Z","timestamp":1685088723000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["The psychological and social impact of the digital self-support system \u2018Brain in Hand\u2019 on autistic people: prospective cohort study in England and Wales"],"prefix":"10.1192","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0783-285X","authenticated-orcid":false,"given":"Samuel","family":"Tromans","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Henley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Summers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Bilkey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna","family":"Datson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Doherty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Morpeth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Benbow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Jelbert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8432-981X","authenticated-orcid":false,"given":"Ashok","family":"Roy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lance","family":"Watkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9316-9312","authenticated-orcid":false,"given":"Bhathika","family":"Perera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saman","family":"Shazad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Pender","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regi","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9916-343X","authenticated-orcid":false,"given":"Richard","family":"Laugharne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1183-6933","authenticated-orcid":false,"given":"Rohit","family":"Shankar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"S2056472423000571_ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-018-0611-0"},{"key":"S2056472423000571_ref27","article-title":"Sensory processing in people with Asperger syndrome","volume":"16","author":"Shankar","year":"2013","journal-title":"Learn Disabil Pract"},{"key":"S2056472423000571_ref46","doi-asserted-by":"publisher","DOI":"10.4135\/9781446221792"},{"key":"S2056472423000571_ref18","volume-title":"Grounded Theory: A Practical Guide","author":"Birks","year":"2015"},{"key":"S2056472423000571_ref45","doi-asserted-by":"publisher","DOI":"10.1177\/1362361320909174"},{"key":"S2056472423000571_ref31","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0594-7"},{"key":"S2056472423000571_ref44","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.172.1.11"},{"key":"S2056472423000571_ref43","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-1130.2012.00343.x"},{"key":"S2056472423000571_ref36","volume-title":"Columbia-Suicide Severity Rating Scale (C-SSRS)","author":"Posner","year":"2008"},{"key":"S2056472423000571_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(01)00296-3"},{"key":"S2056472423000571_ref22","unstructured":"22 Urbaniak, GC , Plous, S. 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