Tromans Samuel, Henley William, Summers Ian, Bilkey Danielle, Datson Jenna, Doherty Nicola, Morpeth Louise, Benbow Sarah, Jelbert Rebecca, Roy Ashok, Watkins Lance, Perera Bhathika, Shazad Saman, Pender Richard, Alexander Regi, Laugharne Richard, Shankar Rohit
Department of Population Health Sciences, University of Leicester, UK; and Adult Learning Disability Service, Leicestershire Partnership NHS Trust, UK.
Health Statistics Group, University of Exeter Medical School, UK.
BJPsych Open. 2023 May 26;9(3):e96. doi: 10.1192/bjo.2023.57.
Brain in Hand (BIH) is a UK-based digital self-support system for managing anxiety and social functioning.
To identify the impact of BIH on the psychological and social functioning of adults with autism.
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 -test was utilised for pre-post analysis of overall effectiveness of BIH. Multivariable linear regression models, univariable pre-post 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.
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 'self-injurious behaviours', 'memory and orientation', 'communication problems in understanding', 'occupation and activities' and 'problems with relationship'. A significant reduction in the anxiety, but not depression, component of the HADS scores was identified. Thematic analysis showed high confidence in BIH.
BIH improved anxiety and other clinical, social and functioning outcomes of adults with autism.
“手中大脑”（BIH）是一个总部位于英国的用于管理焦虑和社交功能的数字自我支持系统。
确定“手中大脑”对自闭症成年人心理和社交功能的影响。
从英格兰和威尔士的七家国民保健服务（NHS）自闭症服务机构中招募被诊断或疑似患有DSM-5（1级）自闭症的成年人，进行为期12周的前瞻性混合方法队列研究。主要的定量结果指标是学习障碍者国家健康结果量表（HONOS-LD）和医院焦虑抑郁量表（HADS）。费舍尔精确检验用于探索社会人口学关联。配对t检验用于对“手中大脑”的总体有效性进行前后分析。使用多变量线性回归模型、单变量前后分析、威尔科克森符号秩检验、逻辑回归分析、邦费罗尼校正和规范分析来确定所发现变化的可信度。对完成研究的10%参与者按照布劳恩和克拉克的六步流程进行半结构化访谈的主题分析。
99名参与者中有66名完成了研究。HONOS-LD平均得分显著降低，使用“手中大脑”12周的参与者得分下降了0.65个标准差。在HONOS-LD的“自伤行为”“记忆与定向”“理解方面的沟通问题”“职业与活动”以及“人际关系问题”等子领域发现了显著的积极变化。HADS得分中的焦虑成分（而非抑郁成分）显著降低。主题分析显示对“手中大脑”有高度信心。
“手中大脑”改善了自闭症成年人的焦虑以及其他临床、社交和功能结果。
