Luminance Contrast Drives Interactions between Perception and Working Memory.

Visual working memory (WM) enables the use of past sensory experience in guiding behavior. Yet, laboratory tasks commonly evaluate WM in a way that separates it from its sensory bottleneck. To understand how perception interacts with visual memory, we used a delayed shape recognition task to probe how WM may differ for stimuli that bias processing toward different visual pathways. Luminance compared with chromatic signals are more efficient in driving the processing of shapes and may thus also lead to better WM encoding, maintenance, and memory recognition. To evaluate this prediction, we conducted two experiments. In the first psychophysical experiment, we measured contrast thresholds for different WM loads. Luminance contrast was encoded into WM more efficiently than chromatic contrast, even when both sets of stimuli were equated for discriminability. In the second experiment, which also equated stimuli for discriminability, early sensory responses in the EEG that are specific to luminance pathways were modulated by WM load and thus likely reflect the neural substrate of the increased efficiency. Our results cannot be accounted for by simple saliency differences between luminance and color. Rather, they provide evidence for a direct connection between low-level perceptual mechanisms and WM by showing a crucial role of luminance for forming WM representations of shape.

Post-stroke object affordances: An EEG investigation.

Rehabilitating upper limb function after stroke is a key therapeutic goal. In healthy brains, objects, especially tools, are said to cause automatic motoric 'affordances'; affecting our preparation to handle objects. For example, the N2 event-related potential has been shown to correlate with the functional properties of objects in healthy adults during passive viewing. We posited that such an affordance effect might also be observed in chronic-stage stroke survivors. With either dominant or non-dominant hand forward, we presented three kinds of stimuli in stereoscopic depth; grasp objects affording a power-grip, pinch objects affording a thumb and forefinger precision-grip and an empty desk, affording no action. EEG data from 10 stroke survivors and 15 neurologically healthy subjects were analysed for the N1 and N2 ERP components. Both components revealed differences between the two object stimuli categories and the empty desk for both groups, suggesting the presence of affordance-related motor priming from around 100 to 370 ms after stimulus onset. Hence, we speculate that stroke survivors with loss of upper limb function may benefit from object presentation regimes designed to maximise motor priming when attempting movements with manipulable objects. However, further investigation would be necessary with acute stage patients, especially those diagnosed with apraxia.

Objects rapidly prime the motor system when located near the dominant hand.

Objects are said to automatically "afford" various actions depending upon the motor repertoire of the actor. Such affordances play a part in how we prepare to handle or manipulate tools and other objects. Evidence obtained through fMRI, EEG and TMS has proven that this is the case but, as yet, the temporal evolution of affordances has not been fully investigated. The aim here was to further explore the timing of evoked motor activity using visual stimuli tailored to drive the motor system. Therefore, we presented three kinds of stimuli in stereoscopic depth; whole hand grasp objects which afforded a power-grip, pinch-grip objects which afforded a thumb and forefinger precision-grip and an empty desk, affording no action. In order to vary functional motor priming while keeping visual stimulation identical, participants adopted one of two postures, with either the dominant or non-dominant hand forward. EEG data from 29 neurologically healthy subjects were analysed for the N1 evoked potential, observed in visual discrimination tasks, and for the N2 ERP component, previously shown to correlate with affordances (Proverbio, Adorni, & D'Aniello, 2011). We observed a link between ERPs, previously considered to reflect motor priming, and the positioning of the dominant hand. A significant interaction was detected in the left-hemisphere N2 between the participants' posture and the object category they viewed. These results indicate strong affordance-related activity around 300ms after stimulus presentation, particularly when the dominant hand can easily reach an object.

The When and Where of Working Memory Dysfunction in Early-Onset Schizophrenia-A Functional Magnetic Resonance Imaging Study.

Behavioral evidence indicates that working memory (WM) in schizophrenia is already impaired at the encoding stage. However, the neurophysiological basis of this primary deficit remains poorly understood. Using event-related fMRI, we assessed differences in brain activation and functional connectivity during the encoding, maintenance and retrieval stages of a visual WM task with 3 levels of memory load in 17 adolescents with early-onset schizophrenia (EOS) and 17 matched controls. The amount of information patients could store in WM was reduced at all memory load levels. During encoding, activation in left ventrolateral prefrontal cortex (VLPFC) and extrastriate visual cortex, which in controls positively correlated with the amount of stored information, was reduced in patients. Additionally, patients showed disturbed functional connectivity between prefrontal and visual areas. During retrieval, right inferior VLPFC hyperactivation was correlated with hypoactivation of left VLPFC in patients during encoding. Visual WM encoding is disturbed by a failure to adequately engage a visual-prefrontal network critical for the transfer of perceptual information into WM. Prefrontal hyperactivation appears to be a secondary consequence of this primary deficit. Isolating the component processes of WM can lead to more specific neurophysiological markers for translational efforts seeking to improve the treatment of cognitive dysfunction in schizophrenia.

Glutamatergic correlates of gamma-band oscillatory activity during cognition: a concurrent ER-MRS and EEG study.

Frequency specific synchronisation of neuronal firing within the gamma-band (30-70 Hz) appears to be a fundamental correlate of both basic sensory and higher cognitive processing. In-vitro studies suggest that the neurochemical basis of gamma-band oscillatory activity is based on interactions between excitatory (i.e. glutamate) and inhibitory (i.e. GABA) neurotransmitter concentrations. However, the nature of the relationship between excitatory neurotransmitter concentration and changes in gamma band activity in humans remains undetermined. Here, we examine the links between dynamic glutamate concentration and the formation of functional gamma-band oscillatory networks. Using concurrently acquired event-related magnetic resonance spectroscopy and electroencephalography, during a repetition-priming paradigm, we demonstrate an interaction between stimulus type (object vs. abstract pictures) and repetition in evoked gamma-band oscillatory activity, and find that glutamate levels within the lateral occipital cortex, differ in response to these distinct stimulus categories. Importantly, we show that dynamic glutamate levels are related to the amplitude of stimulus evoked gamma-band (but not to beta, alpha or theta or ERP) activity. These results highlight the specific connection between excitatory neurotransmitter concentration and amplitude of oscillatory response, providing a novel insight into the relationship between the neurochemical and neurophysiological processes underlying cognition.

Association between psychotic symptoms and cortical thickness reduction across the schizophrenia spectrum.

The current study provides a complete magnetic resonance imaging (MRI) analysis of thickness throughout the cerebral cortical mantle in patients with schizophrenia (SZ) and rigorously screened and matched unaffected relatives and controls and an assessment of its relation to psychopathology and subjective cognitive function. We analyzed 3D-anatomical MRI data sets, obtained at 3 T, from 3 different subject groups: 25 SZ patients, 29 first-degree relatives, and 37 healthy control subjects. We computed whole-brain cortical thickness using the Freesurfer software and assessed group differences. We also acquired clinical and psychometric data. The results showed markedly reduced cortical thickness in SZ patients compared with controls, most notably in the frontal and temporal lobes, in the superior parietal lobe and several limbic areas, with intermediate levels of cortical thickness in relatives. In both patients and relatives, we found an association between subjective cognitive dysfunction and reduced thickness of frontal cortex, and predisposition toward hallucinations and reduced thickness of the superior temporal gyrus. Our findings suggest that changes in specific cortical areas may predispose to specific symptoms, as exemplified by the association between temporal cortex thinning and hallucinations.

Comparing two measures of schizotypy and their relationship with psychological distress in British university students.

AIMS: Schizotypy reflects the vulnerability to schizophrenia in the general population. Different questionnaires have been developed to measure aspects of schizotypy. Higher schizotypy scores have also been linked with depression, anxiety, and stress sensitivity. Here we examine the associations of schizotypy with symptoms of depression and anxiety in a sample of university students, using two different measures (N = 271). METHODS: A series of confirmatory factor analyses was used to examine two distinct and frequently employed measures of schizotypy: the Community Assessment of Psychic Experiences (CAPE), and the Schizotypy Personality Questionnaire (SPQ). We assessed their relationship with each other and their predictive validity for anxiety, depression, and stress sensitivity. RESULTS: Our results indicated the brief 7-factor SPQ (SPQ-BR) factor solution for the SPQ and the 15-item and 3 factor solution for the CAPE (i.e., CAPE-P15) as best fitting models. Particularly the CAPE dimension of persecutory ideation was a strong predictor of anxiety, depression, and stress sensitivity, whereas the SPQ dimensions of no close friends and social anxiety predicted psychological distress and stress in our student sample. CONCLUSIONS: Our findings extend earlier work in general and patient samples and point to the importance of understanding the contribution of particularly positive schizotypy symptoms and different interpersonal aspects to psychological distress.

Trait and State Anxiety Effects on Mismatch Negativity and Sensory Gating Event-Related Potentials.

We used the auditory roving oddball to investigate whether individual differences in self-reported anxiety influence event-related potential (ERP) activity related to sensory gating and mismatch negativity (MMN). The state-trait anxiety inventory (STAI) was used to assess the effects of anxiety on the ERPs for auditory change detection and information filtering in a sample of thirty-six healthy participants. The roving oddball paradigm involves presentation of stimulus trains of auditory tones with certain frequencies followed by trains of tones with different frequencies. Enhanced negative mid-latency response (130-230 ms post-stimulus) was marked at the deviant (first tone) and the standard (six or more repetitions) tone at Fz, indicating successful mismatch negativity (MMN). In turn, the first and second tone in a stimulus train were subject to sensory gating at the Cz electrode site as a response to the second stimulus was suppressed at an earlier latency (40-80 ms). We used partial correlations and analyses of covariance to investigate the influence of state and trait anxiety on these two processes. Higher trait anxiety exhibited enhanced MMN amplitude (more negative) (F(1,33) = 14.259, p = 6.323 × 10-6, ηp2 = 0.302), whereas state anxiety reduced sensory gating (F(1,30) = 13.117, p = 0.001, ηp2 = 0.304). Our findings suggest that high trait-anxious participants demonstrate hypervigilant change detection to deviant tones that appear more salient, whereas increased state anxiety associates with failure to filter out irrelevant stimuli.

Interhemispheric hypoconnectivity in schizophrenia: fiber integrity and volume differences of the corpus callosum in patients and unaffected relatives.

Changes in hemispheric asymmetry and inter-hemispheric connectivity have been reported in schizophrenia. However, the genetic contribution to these alterations is still unclear. In the current study, we applied an automatic segmentation method to structural MRI and diffusion tensor imaging (DTI) data and examined volume and fiber integrity of the corpus callosum (CC), the main interhemispheric fiber tract, in 16 chronic schizophrenia (SZ) patients, matched first degree relatives and controls. SZ patients and relatives had smaller CC volumes than controls, particularly in the posterior genu, isthmus and splenium. Fractional anisotropy (FA), an indicator of fiber integrity, was reduced in patients and relatives in the whole CC, the inferior genu, the superior genu and the isthmus. Correspondingly, the mean diffusivity (MD) values of the whole CC and the isthmus were higher in patients and their unaffected relatives, indicating decreased compactness and increased intercellular space. Relatives had intermediate values in the volumetric and fiber integrity measurements between patients and controls. Lower CC volume and fiber integrity in SZ patients were associated with more severe auditory hallucinations. These results support the connectivity hypothesis of SZ (Friston, 1998) and particularly highlight the altered interhemispheric connectivity, which appears to be a genetic feature of SZ risk.

Neural correlates of autobiographical memory in amnestic Mild Cognitive Impairment.

Episodic memory dysfunction, commonly assessed with word list recall, is the main characteristic of amnestic Mild Cognitive Impairment (aMCI). While brain pathology underlying this kind of memory impairment is well established in aMCI, little is known about the effect of neurodegeneration on autobiographical memory. The present study investigated neuronal correlates of autobiographical memory in aMCI patients (n=12) and healthy elderly controls (n=13) using functional magnetic resonance imaging (fMRI). Additionally, voxel-based morphometry (VBM) was employed to reveal brain pathology in aMCI patients. Neuropsychological assessment showed significant impairment in episodic memory tasks (immediate and delayed word list recall) in aMCI patients. Moreover, VBM revealed significantly reduced gray matter concentration, which was most pronounced in the temporal lobes of aMCI patients. Despite episodic memory impairment and atrophy in areas that are associated with encoding and recall of episodic memories, aMCI patients showed no alterations in brain activation associated with autobiographical memory retrieval. These findings could suggest that autobiographical memory is subserved by a different neuronal network than episodic memory and that the two memory systems are differently affected by aMCI.

Patterns of autobiographical memory in bipolar disorder examined by psychometric and functional neuroimaging methods.

This is the first study to combine psychometric and functional neuroimaging methods to study altered patterns of autobiographical memory in bipolar disorder (BD). All participants were interviewed with an expanded version of the Bielefelder Autobiographical Memory Inventory (Bielefelder Autobiographisches Gedächtnis Inventar 2004;Lisse: Swets and Zeitlinger). We then acquired functional magnetic resonance imaging data during a task of individually designed autobiographical recall. Compared with healthy controls, BD patients reported a stronger emotionality of autobiographical memories and more frequent recollections of autobiographical events during their everyday life. Furthermore, they failed to deactivate areas in the cuneus and lingual gyrus and showed decreased activation in the inferior frontal and precentral areas compared with the control group. More frequent intrusions from a person's past, which had a neural correlate in the lack of deactivation in some default mode network areas in BD patients, may contribute to manic or depressive symptoms.

The development of neural synchrony reflects late maturation and restructuring of functional networks in humans.

Brain development is characterized by maturational processes that span the period from childhood through adolescence to adulthood, but little is known whether and how developmental processes differ during these phases. We analyzed the development of functional networks by measuring neural synchrony in EEG recordings during a Gestalt perception task in 68 participants ranging in age from 6 to 21 years. Until early adolescence, developmental improvements in cognitive performance were accompanied by increases in neural synchrony. This developmental phase was followed by an unexpected decrease in neural synchrony that occurred during late adolescence and was associated with reduced performance. After this period of destabilization, we observed a reorganization of synchronization patterns that was accompanied by pronounced increases in gamma-band power and in theta and beta phase synchrony. These findings provide evidence for the relationship between neural synchrony and late brain development that has important implications for the understanding of adolescence as a critical period of brain maturation.

Loneliness, positive, negative and disorganised Schizotypy before and during the COVID-19 pandemic.

Loneliness is common in psychosis and occurs along a continuum. Here we investigate inter-relationships between loneliness, three-dimensional schizotypy, and depressive symptoms before and during the COVID-19 pandemic. The sample included 507 university students (48.3% participated before and 51.7% during the COVID-19 pandemic) who completed the Multidimensional Schizotypy Scale-Brief, the Counseling Center Assessment of Psychological Symptoms depression scale and the University of California, Los Angeles Loneliness Scale. Schizotypy and depression scores were regressed onto loneliness individually and in multiple regressions. The cohorts did not differ in any of the schizotypy domains (all p > .29). Depressive symptoms (p = .05) and loneliness (p = .006) were higher during the pandemic than before. Across cohorts, loneliness was significantly associated with positive (ß = 0.23, p < .001), negative (ß = 0.44, p < .001), and disorganised schizotypy (ß = 0.44, p < .001), and with depression (ß = 0.72, p < .001). Schizotypy together explained a significant amount of variance in loneliness (R2 = 0.26), with significant associations with positive (ß = -0.09, p = .047), negative (ß = 0.31, p < .001) and disorganised schizotypy (ß = 0.34, p < .001). When depression was included (ß = 0.69, p < .001), only positive (ß = -0.09, p = .008) and negative schizotypy (ß = 0.22, p < .001) significantly predicted loneliness. When all schizotypy dimensions and depression were considered together, only negative schizotypy and depression significantly predicted loneliness. Loneliness and depressive symptoms were higher during the pandemic, but this did not relate to cohort differences in schizotypy.

Functional neurodevelopment of working memory in early-onset schizophrenia: A longitudinal FMRI study.

Schizophrenia, a debilitating disorder with typical manifestation of clinical symptoms in early adulthood, is characterized by cognitive impairments in executive processes such as in working memory (WM). However, there is a rare case of individuals with early-onset schizophrenia (EOS) starting before their 18th birthday, while WM and its neural substrates are still undergoing maturation. Using the WM n-back task with functional magnetic resonance imaging, we assessed the functional neurodevelopment of WM in adolescents with EOS and age- and gender-matched typically developing controls. Participants underwent neuroimaging in the same scanner twice, once at age 17 and at 21 (mean interscan interval = 4.3 years). General linear model analysis was performed to explore WM neurodevelopmental changes within and between groups. Psychopathological scores were entered in multiple regressions to detect brain regions whose longitudinal functional change was predicted by baseline symptoms in EOS. WM neurodevelopment was characterized by widespread functional reductions in frontotemporal and cingulate brain areas in patients and controls. No between-group differences were found in the trajectory of WM change. Baseline symptom scores predicted functional neurodevelopmental changes in frontal, cingulate, parietal, occipital, and cerebellar areas. The adolescent brain undergoes developmental processes such as synaptic pruning, which may underlie the refinement WM of network. Prefrontal and parietooccipital activity reduction is affected by clinical presentation of symptoms. Using longitudinal neuroimaging methods in a rare diagnostic sample of patients with EOS may help the advancement of neurodevelopmental biomarkers intended as pharmacological targets to tackle WM impairment.

Reduced laterality as a trait marker of schizophrenia--evidence from structural and functional neuroimaging.

Laterality is a characteristic principle of the organization of the brain systems for language, and reduced hemispheric asymmetry has been considered a risk factor for schizophrenia. Here we sought support for the risk factor hypothesis by investigating whether reduced asymmetry of temporal lobe structure and function is also present in unaffected relatives. Sixteen schizophrenia patients, 16 age-matched first-degree relatives, and 15 healthy controls underwent high-resolution three-dimensional anatomical imaging and functional magnetic resonance imaging during auditory stimulation. Both the overall auditory cortex and planum temporale volumes and the lateralization to the left hemisphere were markedly reduced in patients. The decrease of lateralization correlated with increased severity of symptoms. In addition, both the overall functional activation in response to auditory stimulation and its asymmetry were reduced in the patients. Relatives had intermediate values between patients and controls on both structural and functional measures. This study provides added support for the idea that reduced hemispheric asymmetry is a biological risk factor for schizophrenia.

Common capacity-limited neural mechanisms of selective attention and spatial working memory encoding.

One characteristic feature of visual working memory (WM) is its limited capacity, and selective attention has been implicated as limiting factor. A possible reason why attention constrains the number of items that can be encoded into WM is that the two processes share limited neural resources. Functional magnetic resonance imaging (fMRI) studies have indeed demonstrated commonalities between the neural substrates of WM and attention. Here we investigated whether such overlapping activations reflect interacting neural mechanisms that could result in capacity limitations. To independently manipulate the demands on attention and WM encoding within one single task, we combined visual search and delayed discrimination of spatial locations. Participants were presented with a search array and performed easy or difficult visual search in order to encode one, three or five positions of target items into WM. Our fMRI data revealed colocalised activation for attention-demanding visual search and WM encoding in distributed posterior and frontal regions. However, further analysis yielded two patterns of results. Activity in prefrontal regions increased additively with increased demands on WM and attention, indicating regional overlap without functional interaction. Conversely, the WM load-dependent activation in visual, parietal and premotor regions was severely reduced during high attentional demand. We interpret this interaction as indicating the sites of shared capacity-limited neural resources. Our findings point to differential contributions of prefrontal and posterior regions to the common neural mechanisms that support spatial WM encoding and attention, providing new imaging evidence for attention-based models of WM encoding.

What Can Performance in the IEDS Task Tell Us About Attention Shifting in Clinical Groups?

The Intra-Extra-dimensional set shift task (IEDS) is a widely used test of learning and attention, believed to be sensitive to aspects of executive function. The task proceeds through a number of stages, and it is generally claimed that patterns of errors across stages can be used to discriminate between reduced attention switching and more general reductions in rates of learning. A number of papers have used the IEDS task to argue for specific attention shifting difficulties in Autism Spectrum Disorder (ASD) and Schizophrenia, however, it remains unclear how well the IEDS really differentiates between reduced attention shifting and other causes of impaired performance. To address this issue, we introduce a simple computational model of performance in the IEDS task, designed to separate the competing effects of attention shifting and general learning rate. We fit the model to data from ASD and comparison individuals matched on age and IQ, as well as to data from four previous studies which used the IEDS task. Model fits do not show consistent evidence for reductions in attention shifting rates in ASD and Schizophrenia. Instead, we find performance is better explained by differences in learning rate, particularly from punishment, which we show correlates with IQ. We, therefore, argue that the IEDS task is not a good measure of attention shifting in clinical groups. LAY SUMMARY: The Intra-Extra-Dimensional Set shift task (IEDS) is often given to autistic individuals, who tend to make more errors relative to comparison groups. This higher error rate is taken to mean that autistic individuals struggle with attention control. Our computational model of the IEDS shows that the performance of ASD and some other clinical groups can be explained instead by differences in learning rate, rather than differences in attention control.

State anxiety influences P300 and P600 event-related potentials over parietal regions in the hollow-mask illusion experiment.

The hollow-mask illusion is an optical illusion where a concave face is perceived as convex. It has been demonstrated that individuals with schizophrenia and anxiety are less susceptible to the illusion than controls. Previous research has shown that the P300 and P600 event-related potentials (ERPs) are affected in individuals with schizophrenia. Here, we examined whether individual differences in neuroticism and anxiety scores, traits that have been suggested to be risk factors for schizophrenia and anxiety disorders, affect ERPs of healthy participants while they view concave faces. Our results confirm that the participants were susceptible to the illusion, misperceiving concave faces as convex. We additionally demonstrate significant interactions of the concave condition with state anxiety in central and parietal electrodes for P300 and parietal areas for P600, but not with neuroticism and trait anxiety. The state anxiety interactions were driven by low-state anxiety participants showing lower amplitudes for concave faces compared to convex. The P300 and P600 amplitudes were smaller when a concave face activated a convex face memory representation, since the stimulus did not match the active representation. The opposite pattern was evident in high-state anxiety participants in regard to state anxiety interaction and the hollow-mask illusion, demonstrating larger P300 and P600 amplitudes to concave faces suggesting impaired late information processing in this group. This could be explained by impaired allocation of attentional resources in high-state anxiety leading to hyperarousal to concave faces that are unexpected mismatches to standard memory representations, as opposed to expected convex faces.

Cortical oscillatory activity is critical for working memory as revealed by deficits in early-onset schizophrenia.

Impairments in working memory (WM) are a core cognitive deficit in schizophrenia. Neurophysiological models suggest that deficits during WM maintenance in schizophrenia may be explained by abnormalities in the GABAergic system, which will lead to deficits in high-frequency oscillations. However, it is not yet clear which of the three WM phases (encoding, maintenance, retrieval) are affected by dysfunctional oscillatory activity. We investigated the relationship between impairments in oscillatory activity in a broad frequency range (3-100 Hz) and WM load in the different phases of WM in 14 patients with early-onset schizophrenia and 14 matched control participants using a delayed matching to sample paradigm. During encoding, successful memorization was predicted by evoked theta, alpha, and beta oscillatory activity in controls. Patients showed severe reductions in the evoked activity in these frequency bands. During early WM maintenance, patients showed a comparable WM load-dependent increase in induced alpha and gamma activity to controls. In contrast, during the later maintenance phase, patients showed a shift in the peak of induced gamma activity to the lower WM load conditions. Finally, induced theta and gamma activity were reduced in patients during retrieval. Our findings suggest that the WM deficit in schizophrenia is associated with impaired oscillatory activity during all phases of the task and that the cortical storage system reaches its capacity limit at lower loads. Inability to maintain oscillatory activity in specific frequency bands could thus result in the information overload that may underlie both cognitive deficits and psychopathological symptoms of schizophrenia.

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

LAY ABSTRACT: Anxiety in autism is an important target for psychological therapies because it is very common and because it significantly impacts upon quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can help autistic individuals learn to manage feelings of anxiety but access to such therapies remains problematic. In the current pilot study, we examined whether existing online cognitive behaviour therapy and mindfulness-based therapy self-help tools can help reduce anxiety in autistic adults. Specifically, 35 autistic adults were asked to try either an existing online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme while a further 19 autistic adults served as a waitlist comparison group. A first important finding was that 23 of the 35 (66%) participants who tried the online tools completed them, suggesting that such tools are, in principle, acceptable to many autistic adults. In addition, adults in the cognitive behaviour therapy and mindfulness-based therapy conditions reported significant decreases in anxiety over 3 and to some extent also 6 months that were less apparent in the waitlist group of participants. On broader measures of mental health and well-being, the benefits of the online tools were less apparent. Overall, the results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools should be explored further as a means of providing cost-effective mental health support to at least those autistic individuals who can engage effectively with such online tools.