Feasibility Study of a Novel App‐Based Anxiety Intervention for Autistic People

Authors

Abstract

ABSTRACT At least 50% of autistic people experience clinically relevant anxiety symptoms. However, reasons for elevated rates of anxiety in autism remain poorly understood and there is a high unmet need for novel and adapted therapies for anxiety that are accessible to autistic people. This study aimed to establish the feasibility of a novel app‐based anxiety management tool (“Molehill Mountain”) that has been developed with, and adapted for, autistic people. A single‐centre, single‐arm feasibility study design was employed, whereby autistic people (≥ 16 years) with mild‐to‐severe symptoms of anxiety were recruited to a 13‐week intervention period (King's College London, UK; clinicaltrials.gov identifier NCT05302167). Of 123 prospective participants screened, 100 (81%) participants aged 16–74 years (n = 69 female) were enrolled within approximately 15 months. n = 76 (76%) completed an anxiety measure at ~15 weeks (Generalized Anxiety Disorder—7 Item Scale; GAD‐7). Most adhered to the full intervention duration: 65% (n = 47), with most using the app weekly (1–6 days per week; 58%). 73% of participants agreed that they found the app easy to use overall and that an app is a good format for offering anxiety support to autistic people. There was a significant reduction in self‐reported anxiety symptom severity with mean difference 2.88 (95% CI 1.88, 3.89; p < 0.001; Cohen's d = 0.45). We found that an autism‐adapted app‐based anxiety management tool is acceptable to the community and associated with reduced anxiety symptom severity in autistic adults, on average. Following optimization to further enhance usability, the efficacy of the Molehill Mountain app for reducing anxiety must now be tested under randomized controlled conditions in a full‐scale clinical trial.

1. Katherine Gotham , Somer Bishop , Steven M. Brunwasser , Catherine Lord (2014). Rumination and Perceived Impairment Associated With Depressive Symptoms in a Verbal Adolescent–Adult ASD Sample . Autism Research, 7(3), 381-391. Wiley.

   Type: Article DOI: 10.1002/aur.1377 OpenAlex: https://openalex.org/W1943369087

   Crossref OpenAlex OpenCitations
2. Dawn Adams , Lisa‐Marie Emerson (2021). The Impact of Anxiety in Children on the Autism Spectrum . Journal of Autism and Developmental Disorders, 51(6), 1909. Springer Science and Business Media LLC.

   Type: Article DOI: 10.1007/s10803-020-04673-3 OpenAlex: https://openalex.org/W3081896951

   Crossref
3. Rhys Bevan Jones , Faris Hussain , Sharifah Shameem Agha , Bryony Weavers , Mathijs Lucassen , Sally Merry et al. (2023). Digital technologies to support adolescents with depression and anxiety: review . BJPsych Advances, 29(4), 239-253. Royal College of Psychiatrists.

   Type: Article DOI: 10.1192/bja.2022.3 OpenAlex: https://openalex.org/W4213447123

   Crossref OpenAlex OpenCitations
4. Annelies A. Spek , Nadia C. van Ham , Ivan Nyklíček (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: A randomized controlled trial . Research in Developmental Disabilities, 34(1), 246-253. Elsevier BV.

   Type: Article DOI: 10.1016/j.ridd.2012.08.009 OpenAlex: https://openalex.org/W1964450263

   Crossref OpenAlex OpenCitations
5. Kathryn Ambrose , Dawn Adams , Kate Simpson , Deb Keen (2020). Exploring profiles of anxiety symptoms in male and female children on the autism spectrum . Research in Autism Spectrum Disorders, 76, 101601. Elsevier BV.

   Type: Article DOI: 10.1016/j.rasd.2020.101601 OpenAlex: https://openalex.org/W3036207910

   Crossref OpenAlex OpenCitations
6. González Moreno, Andrés Santiago (2013). Diagnostic and Statistical Manual of Mental Disorders . American Psychiatric Association.

   Type: Book DOI: 10.1176/appi.books.9780890425596 OpenAlex: https://openalex.org/W4247665917

   Crossref OpenAlex OpenCitations
7. Lorenzo Lorenzo-Luaces , Ramaris E. German , Robert J. DeRubeis (2015). It's complicated: The relation between cognitive change procedures, cognitive change, and symptom change in cognitive therapy for depression . Clinical Psychology Review, 41, 3-15. Elsevier BV.

   Type: Article DOI: 10.1016/j.cpr.2014.12.003 OpenAlex: https://openalex.org/W1984747549

   Crossref OpenAlex OpenCitations
8. Sylvia Deidre Kauer , Cheryl Mangan , Lena Sanci (2014). Do Online Mental Health Services Improve Help-Seeking for Young People? A Systematic Review . Journal of Medical Internet Research, 16(3), e66. JMIR Publications Inc..

   Type: Article DOI: 10.2196/jmir.3103 OpenAlex: https://openalex.org/W2121693378

   Crossref OpenAlex OpenCitations
9. Debbie Spain , Jacqueline Sin , Trudie Chalder , Declan Murphy , Francesca Happé (2015). Cognitive behaviour therapy for adults with autism spectrum disorders and psychiatric co-morbidity: A review . Research in Autism Spectrum Disorders, 9, 151-162. Elsevier BV.

   Type: Article DOI: 10.1016/j.rasd.2014.10.019 OpenAlex: https://openalex.org/W1987537720

   Crossref OpenAlex OpenCitations
10. Mikle South , Jacqui Rodgers (2017). Sensory, Emotional and Cognitive Contributions to Anxiety in Autism Spectrum Disorders . Frontiers in Human Neuroscience, 11(20), 20. Frontiers Media SA.

    Type: Article DOI: 10.3389/fnhum.2017.00020 OpenAlex: https://openalex.org/W2582531027

    Crossref OpenAlex OpenCitations
11. James J. Gross (2015). Emotion Regulation: Current Status and Future Prospects . Psychological Inquiry, 26(1), 1-26. Informa UK Limited.

    Type: Article DOI: 10.1080/1047840x.2014.940781 OpenAlex: https://openalex.org/W2003220763

    Crossref OpenAlex OpenCitations
12. Anna Backman , Lise Roll-Pettersson , Are Mellblom , Elisabet Norman-Claesson , Emma Sundqvist , Eric Zander et al. (2024). Internet-Delivered Psychoeducation (SCOPE) for Transition-Aged Autistic Youth: Pragmatic Randomized Controlled Trial . Journal of Medical Internet Research, 26, e49305. JMIR Publications Inc..

    Type: Article DOI: 10.2196/49305 OpenAlex: https://openalex.org/W4403404458

    Crossref OpenAlex OpenCitations
13. Max E. Maisel , Kevin G. Stephenson , Mikle South , Jacqui Rodgers , Mark Freeston , Sebastian B. Gaigg (2016). Modeling the cognitive mechanisms linking autism symptoms and anxiety in adults. Journal of Abnormal Psychology, 125(5), 692-703. American Psychological Association (APA).

    Type: Article DOI: 10.1037/abn0000168 OpenAlex: https://openalex.org/W2398408223

    Crossref OpenAlex OpenCitations
14. Tim Cadman , Hanna Eklund , Deirdre Howley , Hannah Hayward , Hanna Clarke , James Findon et al. (2012). Caregiver Burden as People With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder Transition into Adolescence and Adulthood in the United Kingdom . Journal of the American Academy of Child & Adolescent Psychiatry, 51(9), 879-888. Elsevier BV.

    Type: Article DOI: 10.1016/j.jaac.2012.06.017 OpenAlex: https://openalex.org/W2010533293

    Crossref OpenAlex OpenCitations
15. Amit Baumel , Keren Faber , Nandita Mathur , John M Kane , Fred Muench (2017). Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions . Journal of Medical Internet Research, 19(3), e82. JMIR Publications Inc..

    Type: Article DOI: 10.2196/jmir.7270 OpenAlex: https://openalex.org/W2597656898

    Crossref OpenAlex OpenCitations
16. Rebecca Sutherland , David Trembath , Jacqueline Roberts (2018). Telehealth and autism: A systematic search and review of the literature . International Journal of Speech-Language Pathology, 20(3), 324-336. Informa UK Limited.

    Type: Article DOI: 10.1080/17549507.2018.1465123 OpenAlex: https://openalex.org/W2802741593

    Crossref OpenAlex OpenCitations
17. Robert L. Spitzer , Kurt Kroenke , Janet B. W. Williams , Bernd Löwe (2006). A Brief Measure for Assessing Generalized Anxiety Disorder . Archives of Internal Medicine, 166(10), 1092. American Medical Association (AMA).

    Type: Article DOI: 10.1001/archinte.166.10.1092 OpenAlex: https://openalex.org/W2043705607

    Crossref OpenAlex OpenCitations
18. Teal W. Benevides , Stephen Mark Shore *Autistic author. Learn more… , May-Lynn Andresen , Reid Caplan *Autistic author. Learn more… , Barb Cook *Autistic author. Learn more… , Dena L. Gassner *Autistic author. Learn more… et al. (2020). Interventions to address health outcomes among autistic adults: A systematic review . Autism, 24(6), 1345-1359. SAGE Publications.

    Type: Article DOI: 10.1177/1362361320913664 OpenAlex: https://openalex.org/W3023076213

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
19. David W. Evans , Mirko Uljarevic , Laina G. Lusk , Eva Loth , Thomas W Frazier (2017). Development of Two Dimensional Measures of Restricted and Repetitive Behavior in Parents and Children . Journal of the American Academy of Child & Adolescent Psychiatry, 56(1), 51-58. Elsevier BV.

    Type: Article DOI: 10.1016/j.jaac.2016.10.014 OpenAlex: https://openalex.org/W2548617447

    Crossref OpenAlex OpenCitations
20. Susan Dickerson Mayes , Susan L. Calhoun , Richa Aggarwal , Courtney Baker , Santosh Mathapati , Sarah Molitoris et al. (2013). Unusual fears in children with autism . Research in Autism Spectrum Disorders, 7(1), 151-158. Elsevier BV.

    Type: Article DOI: 10.1016/j.rasd.2012.08.002 OpenAlex: https://openalex.org/W2052046114

    Crossref OpenAlex OpenCitations
21. Bethany Oakley , Charlotte Boatman , Sophie Doswell , Antonia Dittner , Andrew Clarke , Ann Ozsivadjian et al. (2023). Molehill Mountain feasibility study: Protocol for a non-randomised pilot trial of a novel app-based anxiety intervention for autistic people . PLOS ONE, 18(7), e0286792. Public Library of Science (PLoS).

    Type: Article DOI: 10.1371/journal.pone.0286792 OpenAlex: https://openalex.org/W4383199291

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
22. Meng-Chuan Lai , Michael Lombardo , Bonnie Auyeung , Bhismadev Chakrabarti , Simon Baron-Cohen (2015). Sex/Gender Differences and Autism: Setting the Scene for Future Research . Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 11-24. Elsevier BV.

    Type: Article DOI: 10.1016/j.jaac.2014.10.003 OpenAlex: https://openalex.org/W2069328123

    Crossref OpenAlex OpenCitations
23. G Bird , R Cook (2013). Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism . Translational Psychiatry, 3(7), e285-e285. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1038/tp.2013.61 OpenAlex: https://openalex.org/W2098593065

    Crossref OpenAlex OpenCitations
24. Christina Nicolaidis , Dora M. Raymaker *Autistic author. Learn more… , Elesia Ashkenazy *Autistic author. Learn more… , Katherine McDonald , Sebastian Dern *Autistic author. Learn more… , Mel Baggs *Autistic author. Learn more… et al. (2015). “Respect the way I need to communicate with you”: Healthcare experiences of adults on the autism spectrum . Autism, 19(7), 824-831. SAGE Publications.

    Type: Article DOI: 10.1177/1362361315576221 OpenAlex: https://openalex.org/W2095111403

    AutiHub · Autistic Autism Scholarship Project AutiHub · Documentation center Crossref OpenAlex OpenCitations
25. Janina Brede , Eilidh Cage , Joseph Trott , Lisa Palmer , Anika Smith , Lucy Serpell et al. (2022). “We Have to Try to Find a Way, a Clinical Bridge” - autistic adults' experience of accessing and receiving support for mental health difficulties: A systematic review and thematic meta-synthesis . Clinical Psychology Review, 93, 102131. Elsevier BV.

    Type: Article DOI: 10.1016/j.cpr.2022.102131 OpenAlex: https://openalex.org/W4210911395

    Crossref OpenAlex OpenCitations
26. Julianna Catania , Steph Beaver , Rakshitha S Kamath , Emma Worthington , Minyi Lu , Hema Gandhi et al. (2024). Evaluation of Digital Mental Health Technologies in the United States: Systematic Literature Review and Framework Synthesis . JMIR Mental Health, 11, e57401. JMIR Publications Inc..

    Type: Article DOI: 10.2196/57401 OpenAlex: https://openalex.org/W4399908404

    Crossref OpenAlex OpenCitations
27. Laura Crane , Lorna Goddard , Linda Pring (2009). Sensory processing in adults with autism spectrum disorders . Autism, 13(3), 215-228. SAGE Publications.

    Type: Article DOI: 10.1177/1362361309103794 OpenAlex: https://openalex.org/W2133335974

    Crossref OpenAlex OpenCitations
28. Kate Cooper , M.E. Loades , Ailsa Russell (2018). Adapting psychological therapies for autism . Research in Autism Spectrum Disorders, 45, 43-50. Elsevier BV.

    Type: Article DOI: 10.1016/j.rasd.2017.11.002 OpenAlex: https://openalex.org/W2770749461

    Crossref OpenAlex OpenCitations
29. Eya-Mist Rødgaard *Autistic author. Learn more… , Kristian Jensen , Kamilla Woznica Miskowiak , Laurent Mottron (2022). Representativeness of autistic samples in studies recruiting through social media . Autism Research, 15(8), 1447-1456. Wiley.

    Type: Article DOI: 10.1002/aur.2777 OpenAlex: https://openalex.org/W4284991023

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
30. Francisca J. A. van Steensel , Susan M. Bögels , Carmen D. Dirksen (2012). Anxiety and Quality of Life: Clinically Anxious Children With and Without Autism Spectrum Disorders Compared . Journal of Clinical Child & Adolescent Psychology, 41(6), 731-738. Informa UK Limited.

    Type: Article DOI: 10.1080/15374416.2012.698725 OpenAlex: https://openalex.org/W2160162048

    Crossref OpenAlex OpenCitations
31. Laura Crane , Fern Adams *Autistic author. Learn more… , Georgia Harper *Autistic author. Learn more… , Jack Welch , Elizabeth Pellicano (2019). ‘Something needs to change’: Mental health experiences of young autistic adults in England . Autism, 23(2), 477-493. SAGE Publications.

    Type: Article DOI: 10.1177/1362361318757048 OpenAlex: https://openalex.org/W2787370458

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
32. Bram B. Sizoo , Erik Kuiper (2017). Cognitive behavioural therapy and mindfulness based stress reduction may be equally effective in reducing anxiety and depression in adults with autism spectrum disorders . Research in Developmental Disabilities, 64, 47-55. Elsevier BV.

    Type: Article DOI: 10.1016/j.ridd.2017.03.004 OpenAlex: https://openalex.org/W2601014375

    Crossref OpenAlex OpenCitations
33. Sebastian C.K. Shaw *Autistic author. Learn more… , Laura Carravallah *Autistic author. Learn more… , Mona Johnson *Autistic author. Learn more… , Jane O’Sullivan , Nicholas Chown *Autistic author. Learn more… , Stuart Neilson et al. (2024). Barriers to healthcare and a 'triple empathy problem' may lead to adverse outcomes for autistic adults: a qualitative study . Autism, 28(7), 1746. SAGE Publications.

    Type: Article DOI: 10.1177/13623613231205629 OpenAlex: https://openalex.org/W4387692103

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
34. Beth Patterson , Michael H. Boyle , Michelle Kivlenieks , Michael Van Ameringen (2016). The use of waitlists as control conditions in anxiety disorders research . Journal of Psychiatric Research, 83, 112-120. Elsevier BV.

    Type: Article DOI: 10.1016/j.jpsychires.2016.08.015 OpenAlex: https://openalex.org/W2512180041

    Crossref OpenAlex OpenCitations
35. Jacquiline den Houting *Autistic author. Learn more… , Dawn Adams , Jacqueline Roberts , Deb Keen (2019). An exploration of autism‐specific and non‐autism‐specific measures of anxiety symptomatology in school‐aged autistic children . Clinical Psychologist, 23(3), 237-248. Informa UK Limited.

    Type: Article DOI: 10.1111/cp.12174 OpenAlex: https://openalex.org/W2898416155

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
36. Mackenzie Robeson , Kyle M Brasil , Haley C Adams , Kimberly R Zlomke (2024). Measuring depression and anxiety in autistic college students: A psychometric evaluation of the PHQ-9 and GAD-7 . Autism, 28(11), 2793-2805. SAGE Publications.

    Type: Article DOI: 10.1177/13623613241240183 OpenAlex: https://openalex.org/W4393077040

    Crossref OpenAlex OpenCitations
37. Mary Doherty *Autistic author. Learn more… , Stuart Neilson , Jane O’Sullivan , Laura Carravallah *Autistic author. Learn more… , Mona Johnson *Autistic author. Learn more… , Walter Cullen et al. (2022). Barriers to healthcare and self-reported adverse outcomes for autistic adults: a cross-sectional study . BMJ Open, 12(2), e056904. BMJ.

    Type: Article DOI: 10.1136/bmjopen-2021-056904 OpenAlex: https://openalex.org/W4213379370

    AutiHub · Autistic Autism Scholarship Project Crossref
38. Matthew Hollocks , Jian Wei Lerh , Iliana Magiati , Richard Meiser-Stedman , Traolach Brugha (2019). Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis . Psychological Medicine, 49(4), 559-572. Cambridge University Press (CUP).

    Type: Article DOI: 10.1017/s0033291718002283 OpenAlex: https://openalex.org/W2889987209

    Crossref OpenAlex OpenCitations
39. Chris Hollis , Caroline J. Falconer , Jennifer L. Martin , Craig Whittington , Sarah Stockton , Cris Glazebrook et al. (2017). Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta‐review . Journal of Child Psychology and Psychiatry, 58(4), 474-503. Wiley.

    Type: Article DOI: 10.1111/jcpp.12663 OpenAlex: https://openalex.org/W2560151242

    Crossref OpenAlex OpenCitations
40. Michael C. W. English , Gilles E. Gignac , Troy A. W. Visser , Andrew Whitehouse , James T. Enns , Murray Maybery (2021). Correction to: The Comprehensive Autistic Trait Inventory (CATI): development and validation of a new measure of autistic traits in the general population . Molecular Autism, 12(1). Springer Science and Business Media LLC.

    Type: Article DOI: 10.1186/s13229-021-00475-1

    Crossref
41. Sebastian B. Gaigg , Paul E Flaxman , Gracie McLaven , Ritika Shah , Dermot Bowler , Brenda Meyer et al. (2020). Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools . Autism, 24(4), 867-883. SAGE Publications.

    Type: Article DOI: 10.1177/1362361320909184 OpenAlex: https://openalex.org/W3014587805

    Crossref OpenAlex OpenCitations
42. Ashley Robertson , Andrew C. Stanfield , Jane Watt , Fiona Barry , Matthew Day , Magnus Cormack et al. (2018). The experience and impact of anxiety in autistic adults: A thematic analysis . Research in Autism Spectrum Disorders, 46, 8-18. Elsevier BV.

    Type: Article DOI: 10.1016/j.rasd.2017.11.006 OpenAlex: https://openalex.org/W2769940437

    Crossref OpenAlex OpenCitations
43. Saskia Riedelbauch , Sebastian B. Gaigg , Tobias Thiel , Veit Roessner , Melanie Ring (2024). Examining a model of anxiety in autistic adults . Autism, 28(3), 565-579. SAGE Publications.

    Type: Article DOI: 10.1177/13623613231177777 OpenAlex: https://openalex.org/W4381046726

    Crossref OpenAlex OpenCitations
44. Rebecca Grist , Abigail Croker , Megan Denne , Paul Stallard (2019). Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis . Clinical Child and Family Psychology Review, 22(2), 147-171. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10567-018-0271-8

    Crossref
45. Jeffrey Wood , Philip C. Kendall , Karen S. Wood , Connor Kerns , Michael Seltzer , Brent J. Small et al. (2020). Cognitive Behavioral Treatments for Anxiety in Children With Autism Spectrum Disorder . JAMA Psychiatry, 77(5), 474. American Medical Association (AMA).

    Type: Article DOI: 10.1001/jamapsychiatry.2019.4160 OpenAlex: https://openalex.org/W2989651886

    Crossref OpenAlex OpenCitations
46. Emily Josyfon , Debbie Spain , Charlotte Blackmore , Declan Murphy , Bethany Oakley (2023). Alexithymia in Adult Autism Clinic Service-Users: Relationships with Sensory Processing Differences and Mental Health . Healthcare, 11(24), 3114. MDPI AG.

    Type: Article DOI: 10.3390/healthcare11243114 OpenAlex: https://openalex.org/W4389440380

    Crossref OpenAlex OpenCitations
47. Emma Kinnaird , Catherine Stewart , Kate Tchanturia (2019). Investigating alexithymia in autism: A systematic review and meta-analysis . European Psychiatry, 55, 80-89. Cambridge University Press (CUP).

    Type: Article DOI: 10.1016/j.eurpsy.2018.09.004 OpenAlex: https://openalex.org/W2899269258

    Crossref OpenAlex OpenCitations
48. Connor Kerns , Philip C. Kendall , Leandra Berry , Margaret C. Souders , Martin E. Franklin , Robert T. Schultz et al. (2014). Traditional and Atypical Presentations of Anxiety in Youth with Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 44(11), 2851. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-014-2141-7 OpenAlex: https://openalex.org/W2073231072

    Crossref
49. Kirsten L Spaargaren , Yvette Roke , Sander Begeer , Annemieke van Straten , Heleen Riper , Kirstin Greaves-Lord et al. (2025). A randomized controlled trial into the effectiveness of a mobile health application (SAM) to reduce stress and improve well-being in autistic adults . Autism, 29(10), 2588-2603. SAGE Publications.

    Type: Article DOI: 10.1177/13623613251346885 OpenAlex: https://openalex.org/W4411683310

    Crossref OpenAlex OpenCitations
50. Samuel Tromans , William Henley , Ian Summers , Danielle Bilkey , Jenna Datson , Nicola Doherty et al. (2023). The psychological and social impact of the digital self-support system ‘Brain in Hand’ on autistic people: prospective cohort study in England and Wales . BJPsych Open, 9(3), e96-e96. Royal College of Psychiatrists.

    Type: Article DOI: 10.1192/bjo.2023.57 OpenAlex: https://openalex.org/W4378348728

    Crossref OpenAlex OpenCitations
51. Jacqui Rodgers , Kirstin Farquhar , David Mason *Autistic author. Learn more… , Samuel Brice , Sarah Wigham , Barry Ingham et al. (2020). Development and Initial Evaluation of the Anxiety Scale for Autism-Adults . Autism in Adulthood, 2(1), 24-33. SAGE Publications.

    Type: Article DOI: 10.1089/aut.2019.0044 OpenAlex: https://openalex.org/W3008810730

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex OpenCitations
52. Ance Kreslins , Ashley Robertson , Craig Melville (2015). The effectiveness of psychosocial interventions for anxiety in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis . Child and Adolescent Psychiatry and Mental Health, 9(1), 22. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1186/s13034-015-0054-7 OpenAlex: https://openalex.org/W1861083419

    Crossref
53. Meng-Chuan Lai , Caroline Kassee , Richard Besney , Sarah Bonato , Laura Hull , Will Mandy et al. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis . Lancet Psychiatry, 6(10), 819. Elsevier BV.

    Type: Article DOI: 10.1016/s2215-0366(19)30289-5 OpenAlex: https://openalex.org/W2936336589

    Crossref
54. Bethany Oakley , Emily Jones , Daisy Crawley , Tony Charman , Jan K. Buitelaar , Julian Tillmann et al. (2022). Alexithymia in autism: cross-sectional and longitudinal associations with social-communication difficulties, anxiety and depression symptoms . Psychological Medicine, 52(8), 1458-1470. Cambridge University Press (CUP).

    Type: Article DOI: 10.1017/s0033291720003244 OpenAlex: https://openalex.org/W3091896502

    Crossref OpenAlex OpenCitations
55. Susanna Lehtimaki , Jana Martic , Brian Wahl , Katherine T Foster , Nina Schwalbe (2021). Evidence on Digital Mental Health Interventions for Adolescents and Young People: Systematic Overview . JMIR Mental Health, 8(4), e25847. JMIR Publications Inc..

    Type: Article DOI: 10.2196/25847 OpenAlex: https://openalex.org/W3134071992

    Crossref OpenAlex OpenCitations
56. Cindy E. Li , Kimberly L. Wang , Isaac N. Treves , Lindsay Bungert , John D. E. Gabrieli , Liron Rozenkrantz (2025). Smartphone Mindfulness Intervention Reduces Anxiety Symptoms and Perceived Stress in Autistic Adults: A Randomized Controlled Trial . Mindfulness, 16(6), 1504-1521. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s12671-025-02558-z OpenAlex: https://openalex.org/W4409255718

    Crossref
57. David Mason *Autistic author. Learn more… , Barry Ingham , Anna Urbanowicz , Cos Michael *Autistic author. Learn more… , Heather Birtles , Marc Woodbury-Smith et al. (2019). A Systematic Review of What Barriers and Facilitators Prevent and Enable Physical Healthcare Services Access for Autistic Adults . Journal of Autism and Developmental Disorders, 49(8), 3387-3400. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-019-04049-2 OpenAlex: https://openalex.org/W2945521062

    AutiHub · Autistic Autism Scholarship Project AutiHub · Documentation center Crossref
58. Farhad Montazeri , Annelies de Bildt , Vera Dekker , George M. Anderson (2019). Network Analysis of Anxiety in the Autism Realm . Journal of Autism and Developmental Disorders, 49(6), 2219-2230. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-018-3474-4

    Crossref
59. (n.d.). National Autistic Society. 2019.“The Autism Act 10 Years On: A Report from the All Party Parliamentary Group on Autism on Understanding Services and Support for Autistic People and Their Families in England.”

    Type: Other

    Crossref
60. Kimberly Noel , Brooke Ellison (2020). Inclusive innovation in telehealth . npj Digital Medicine, 3(1), 89. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1038/s41746-020-0296-5 OpenAlex: https://openalex.org/W3037092559

    Crossref
61. Janette Ribaut , Annette DeVito Dabbs , Fabienne Dobbels , Alexandra Teynor , Elisabeth Veronica Mess , Theresa Hoffmann et al. (2024). Developing a Comprehensive List of Criteria to Evaluate the Characteristics and Quality of eHealth Smartphone Apps: Systematic Review . JMIR mHealth and uHealth, 12, e48625. JMIR Publications Inc..

    Type: Article DOI: 10.2196/48625 OpenAlex: https://openalex.org/W4388541973

    Crossref OpenAlex OpenCitations
62. Bethany Oakley , Julian Tillmann , Amber Ruigrok , Aurélie Baranger , Christian Takow , Tony Charman et al. (2021). COVID-19 health and social care access for autistic people: A European policy review . BMJ Open, 11(6), e045341. BMJ.

    Type: Article DOI: 10.1136/bmjopen-2020-045341 OpenAlex: https://openalex.org/W3163765937

    AutiHub · Autistic Autism Scholarship Project Crossref
63. Dheeraj Rai , Doug Webb , Amanda Lewis , Leonora Cotton , Jade Eloise Norris , Regi Alexander et al. (2024). Sertraline for anxiety in adults with a diagnosis of autism (STRATA): study protocol for a pragmatic, multicentre, double-blind, placebo-controlled randomised controlled trial . Trials, 25(1), 37-37. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1186/s13063-023-07847-3 OpenAlex: https://openalex.org/W4390751693

    AutiHub · Autistic Autism Scholarship Project Crossref
64. Ailsa Russell , Kate Cooper , Stephen Barton , Ian Ensum , Daisy Gaunt , Jeremy Horwood et al. (2017). Protocol for a feasibility study and randomised pilot trial of a low-intensity psychological intervention for depression in adults with autism: the Autism Depression Trial (ADEPT) . BMJ Open, 7(12), e019545. BMJ.

    Type: Article DOI: 10.1136/bmjopen-2017-019545 OpenAlex: https://openalex.org/W2766918698

    Crossref
65. Debbie Spain , Francesca Happé (2020). How to Optimise Cognitive Behaviour Therapy (CBT) for People with Autism Spectrum Disorders (ASD): A Delphi Study . Journal of Rational-Emotive & Cognitive-Behavior Therapy, 38(2), 184-208. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10942-019-00335-1 OpenAlex: https://openalex.org/W2996582381

    Crossref
66. Denis G. Sukhodolsky , Michael H. Bloch , Kaitlyn E. Panza , Brian Reichow (2013). Cognitive-Behavioral Therapy for Anxiety in Children With High-Functioning Autism: A Meta-analysis . Pediatrics, 132(5), e1341-e1350. American Academy of Pediatrics (AAP).

    Type: Article DOI: 10.1542/peds.2013-1193 OpenAlex: https://openalex.org/W2110855627

    Crossref
67. Danielle Ung , Robert Selles , Brent J. Small , Eric A. Storch (2015). A Systematic Review and Meta-Analysis of Cognitive-Behavioral Therapy for Anxiety in Youth with High-Functioning Autism Spectrum Disorders . Child Psychiatry & Human Development, 46(4), 533-547. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10578-014-0494-y OpenAlex: https://openalex.org/W2081456881

    Crossref
68. Sasha Walters , Maria Loades , Ailsa Russell (2016). A Systematic Review of Effective Modifications to Cognitive Behavioural Therapy for Young People with Autism Spectrum Disorders . Review Journal of Autism and Developmental Disorders, 3(2), 137-153. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s40489-016-0072-2 OpenAlex: https://openalex.org/W2307776763

    Crossref
69. Anna Woodall , Craig Morgan , Claire Sloan , Louise Howard (2010). Barriers to participation in mental health research: are there specific gender, ethnicity and age related barriers? BMC Psychiatry, 10(1). Springer Science and Business Media LLC.

    Type: Article DOI: 10.1186/1471-244x-10-103

    Crossref
70. (n.d.). World Health Organisation. 2023.“Anxiety Disorders.”September 27. https://www.who.int/news‐room/fact‐sheets/detail/anxiety‐disorders .

    Type: Other

    Crossref
71. Yoon Jung Yang , Kyong-Mee Chung (2023). Pilot Randomized Control Trial of an App-Based CBT Program for Reducing Anxiety in Individuals with ASD without Intellectual Disability . Journal of Autism and Developmental Disorders, 53(4), 1331-1346. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-022-05617-9 OpenAlex: https://openalex.org/W4281949981

    Crossref
72. A. S. Zigmond , R. P. Snaith (1983). The Hospital Anxiety and Depression Scale . Acta Psychiatrica Scandinavica, 67(6), 361-370. Wiley.

    Type: Article DOI: 10.1111/j.1600-0447.1983.tb09716.x OpenAlex: https://openalex.org/W2166281097

    Crossref