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Autistic people often camouflage, i.e. they adopt certain behaviors in order to fit in in neurotypical environments. Autobiographical accounts suggest that autistic trans people experience camouflaging in a unique, more complex and often heightened way than cis autistic people, and this has not been studied. They have autistic traits to mask, as well as gendered traits, in a hostile neuronormative and cisnormative world. This intersection of experience is worthy of exploration, not least because this group of people are typically misunderstood and silenced, as well as being particularly at risk of the mental distress that can come from camouflaging. In this paper I discuss autistic trans people's accounts of camouflaging and begin a preliminary phenomenological analysis. I draw primarily from Simone de Beauvoir's concept of "doubling", whereby (cis) women experience being both oneself and the image of oneself, under patriarchal objectification. One can argue that autistic people are similarly "doubled" when camouflaging, experiencing their neurodivergent selves as well as their more neurotypical presentation. Going beyond de Beauvoir, it can be further argued that many trans people experience "tripling" and therefore that trans autistic people experience being at least "quadrupled" if not "quintupled". [ABSTRACT FROM AUTHOR]

Background: Camouflaging or camouflaging autistic traits—strategies that hide social impairments to match societal norms—has been linked to empathy and depressive symptoms in autism research. Much epidemiological evidence has further revealed that characteristics of autism and autistic traits are distributed continuously throughout the general population. Nonetheless, the relationship between these variables in the Chinese general population is unclear. Method: The present study aimed to elucidate the relationships between autistic traits, empathy, camouflaging, and depressive symptoms in a subclinical sample of 1215 Chinese university students of ages 18–27, using self-report assessments. Results: Correlational analysis revealed that autistic traits, camouflaging, and depressive symptoms were significantly intercorrelated. Empathy was significantly correlated with autistic traits and camouflaging. Mediation analysis revealed that camouflaging mediated the positive link between autistic traits and depressive symptoms. Moderated mediation analysis further indicated that the first stage mediated path (autistic traits → camouflaging) was weaker for students with lower levels of empathy. Conclusions: The results suggest that camouflaging is a key contributor in the positive association between autistic traits and depressive symptoms, and that empathy help stimulate the development and maintenance of camouflaging. [ABSTRACT FROM AUTHOR]

Background: Adolescent girls with diagnoses of autism, ADHD and/or developmental coordination disorder (DCD) are at higher risk for mental health problems than boys with the same diagnoses and neurotypical girls. These girls are called neurodivergent here, though neurodivergence includes a broader range of diagnoses. One possible reason for this mental health disparity could be camouflaging, a coping strategy used more by girls. Camouflaging is when the individual pretends to be neurotypical, often involving substantial effort. This study aims to understand: (a) if the use of camouflaging has started by early adolescence, (b) how components of camouflaging (assimilation, masking, and compensation) present at this age, (c) if age predicts camouflaging and (d) what is the relationship with mental health. Methods: Participatory methods: A co‐production team of 15 adult neurodivergent women co‐produced the project and ranked camouflaging as their most important research theme. Main Study: Participants were 119 girls (70 neurodivergent, 49 neurotypical) aged 11–14 years. A transdiagnostic approach was adopted and the neurodivergent group had a diagnosis of autism, ADHD and/or DCD. Girls completed self‐report measures of camouflaging, anxiety, and depression in an online meeting with a researcher. Results: Neurodivergent and neurotypical girls presented similarly on two components of camouflaging namely masking and compensation, components related to presenting in a socially acceptable way and mimicry. Groups differed on the assimilation component, which is related to trying to fit in and involves the feelings of pretending/acting. Age had a medium effect on camouflaging with higher levels of camouflaging observed in older girls. Camouflaging scores strongly predicted anxiety and depression scores in both groups. Conclusions: The use of camouflaging, specifically assimilation, is evident in a transdiagnostic sample of 11–14 year old neurodivergent girls. Importantly, the strong relationship between camouflaging and poor mental health is present at this early age, substantiating the co‐production team's insights. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore the role that Autistic identity, sensory processing and camouflaging behaviours have on eating disorder symptomology in Autistic adults. Previous research has focused on cognitive and sensory factors to explain the association between autism and eating disorders, but the roles of social identity and camouflaging are yet to be explored. Autistic participants (N = 180) were recruited from NHS settings and community groups. The participants completed online questionnaires measuring autistic identity, camouflaging behaviours, sensory processing, autistic traits and eating disorder symptoms. Multiple regression revealed that camouflaging significantly predicted eating disorder symptoms. Although sensory processing was related, it did not significantly predict eating disorder symptom severity. In addition, there was no significant relationship between autistic identity and eating disorder symptom severity. This study highlights the impact that camouflaging behaviours and sensory processing can have on eating disorder symptomatology in autism and may indicate important considerations for the treatment of eating disorders in Autistic people. This study aimed to explore the impact of Autistic identity (i.e. feeling like you belong to the Autistic community), sensory profiles (e.g. being over or under responsive to sensations) and camouflaging behaviours (i.e. masking) on eating disorder symptoms in Autistic adults. 180 Autistic people were recruited from the community and NHS. The Autistic people completed online questionnaires measuring Autistic identity, sensory profiles, camouflaging behaviours, autistic traits and eating disorder symptoms. The analysis showed that higher levels of camouflaging behaviour predicted higher levels of eating disorder symptoms. Sensory profiles were related to but did not predict eating disorder symptoms and there was no relationship between level of Autistic identity and eating disorder symptoms. This shows that camouflaging is the most important predictor of eating disorder symptoms in Autistic people, and warrants further exploration. [ABSTRACT FROM AUTHOR]

Background: Camouflaging, the strategies that some autistic people use to hide their differences, has been hypothesized to trigger mental health ramifications. Camouflaging might reflect ubiquitous impression management experiences that are not unique to autistic people and similarly impact the mental health of non-autistic people. Aims: We first examined whether individuals in the general population camouflage and manage impressions while experiencing mental health repercussions, and how gender and neurodivergent traits modified these associations. We then assessed how camouflaging and impression management arose from internalized stigma, and their inter-relationships in shaping mental health outcomes. Methods: Data were collected from 972 adults from a representative U.S. general population sample, with measures pertaining to camouflaging, impression management, mental health, internalized stigma, and neurodivergent traits. Multivariate hierarchical regression and moderated mediation analyses were used to address the two research aims. Results: Both camouflaging and self-presentation (a key component of impression management) were associated with mental health presentations in the general population, which overlapped with those previously reported in autistic people. These associations were more pronounced in women compared with men and were of different directions for individuals with higher autistic traits versus higher ADHD traits. Internalized stigma might be a key stressor that could elicit camouflaging and impression management through social anxiety, which in turn might lead to adverse mental health outcomes. Conclusions: These findings advance the conceptual clarity and clinical relevance of camouflaging and impression management across social and neurodiverse groups in the general population. The ramifications of camouflaging and impression management underscore the need to alleviate internalized stigma for better mental health across human groups. [ABSTRACT FROM AUTHOR]

Background/Objectives: Autistic people employ various social strategies to form and maintain interpersonal relationships in their daily environments. These strategies can help autistic people with social interactions (leading to self-perceived efficacy of using social strategies), but can also lead to cognitive fatigue (self-perceived effort of using social strategies). However, previous studies have focused primarily on self-perceived effort, overlooking the self-perceived efficacy of using social strategies, and the balance between self-perceived effort and efficacy. To address this gap, this study examined the impact of autistic people's use of social strategies on their well-being, focusing on self-perceived effort, self-perceived efficacy, and their interaction effect. Methods: An online survey was conducted among self-reported autistic people in Japan aged 18–65 years, using a modified Compensation Checklist. Data from 104 self-reported autistic participants were analyzed using linear regression. Results: High self-perceived effort in using social strategies was negatively associated with well-being, whereas high self-perceived efficacy was positively associated with well-being. The interaction effect between effort and efficacy was not significant. These results were supported even when loneliness was used as an index of social well-being. Additionally, the number of strategies used by an autistic person was positively associated with well-being. Conclusions: This study highlights the double-edged effect of autistic people using social strategies, and that using a broader repertoire of social strategies may improve the well-being of autistic people. These findings call for a nuanced approach by researchers and clinicians considering both the positive and negative aspects of using social strategies. [ABSTRACT FROM AUTHOR]

Background: Camouflaging of autistic traits involves hiding or compensating for autistic characteristics, often due to stigma or a desire to fit in with others. This behaviour has been associated with mental health issues in autistic individuals. The 2 5-item Camouflaging Autistic Traits Questionnaire (CAT-Q) is the most commonly used self-report measure of camouflaging. In this study, a 9-item short form version was developed for use in clinical and research settings. Aims: To construct and psychometrically validate a brief self-report measure of camouflaging. Method: The Camouflaging Autistic Traits Questionnaire – Short Form (CATQ-SF) was developed and its factor structure and psychometric properties were evaluated in two studies. Study 1 used a large, online sample of autistic and non-autistic adults (N = 832) to evaluate the factor structure, psychometric properties, and measurement invariance of the CATQ-SF. Study 2 used an independent sample of autistic and non-autistic adults (N = 80) to test Study 1's findings. Results: In Study 1, evidence for a three-factor structure was observed, with good internal consistency (combined autistic & non-autistic α = 0.84). In addition, the instrument demonstrated measurement invariance, and reliably predicted higher levels of autistic traits. In Study 2, the 3-factor structure was replicated, and good internal consistency was again observed (combined autistic and non-autistic α = 0.89). In both studies, psychometric properties were of similar or higher validity compared to the full-form CAT-Q. Conclusions: The CATQ-SF can be used by clinicians and researchers to measure camouflaging in autistic and non-autistic adults quickly and reliably.

Abstract Autism is a neurodevelopmental condition, behaviourally identified, which is generally characterised by social communication differences, and restrictive and repetitive patterns of behaviour and interests. It has long been claimed that it is more common in males. This observed preponderance of males in autistic populations has served as a focussing framework in all spheres of autism-related issues, from recognition and diagnosis through to theoretical models and research agendas. One related issue is the near total absence of females in key research areas. For example, this paper reports a review of over 120 brain-imaging studies of social brain processes in autism that reveals that nearly 70% only included male participants or minimal numbers (just one or two) of females. Authors of such studies very rarely report that their cohorts are virtually female-free and discuss their findings as though applicable to all autistic individuals. The absence of females can be linked to exclusionary consequences of autism diagnostic procedures, which have mainly been developed on male-only cohorts. There is clear evidence that disproportionately large numbers of females do not meet diagnostic criteria and are then excluded from ongoing autism research. Another issue is a long-standing assumption that the female autism phenotype is broadly equivalent to that of the male autism phenotype. Thus, models derived from male-based studies could be applicable to females. However, it is now emerging that certain patterns of social behaviour may be very different in females. This includes a specific type of social behaviour called camouflaging or masking, linked to attempts to disguise autistic characteristics. With respect to research in the field of sex/gender cognitive neuroscience, there is emerging evidence of female differences in patterns of connectivity and/or activation in the social brain that are at odds with those reported in previous, male-only studies. Decades of research have excluded or overlooked females on the autistic spectrum, resulting in the construction of inaccurate and misleading cognitive neuroscience models, and missed opportunities to explore the brain bases of this highly complex condition. A note of warning needs to be sounded about inferences drawn from past research, but if future research addresses this problem of male bias, then a deeper understanding of autism as a whole, as well as in previously overlooked females, will start to emerge.

Autism is a neurodevelopmental condition, behaviourally identified, which is generally characterised by social communication differences, and restrictive and repetitive patterns of behaviour and interests. It has long been claimed that it is more common in males. This observed preponderance of males in autistic populations has served as a focussing framework in all spheres of autism-related issues, from recognition and diagnosis through to theoretical models and research agendas. One related issue is the near total absence of females in key research areas. For example, this paper reports a review of over 120 brain-imaging studies of social brain processes in autism that reveals that nearly 70% only included male participants or minimal numbers (just one or two) of females. Authors of such studies very rarely report that their cohorts are virtually female-free and discuss their findings as though applicable to all autistic individuals. The absence of females can be linked to exclusionary consequences of autism diagnostic procedures, which have mainly been developed on male-only cohorts. There is clear evidence that disproportionately large numbers of females do not meet diagnostic criteria and are then excluded from ongoing autism research. Another issue is a long-standing assumption that the female autism phenotype is broadly equivalent to that of the male autism phenotype. Thus, models derived from male-based studies could be applicable to females. However, it is now emerging that certain patterns of social behaviour may be very different in females. This includes a specific type of social behaviour called camouflaging or masking, linked to attempts to disguise autistic characteristics. With respect to research in the field of sex/gender cognitive neuroscience, there is emerging evidence of female differences in patterns of connectivity and/or activation in the social brain that are at odds with those reported in previous, male-only studies. Decades of research have excluded or overlooked females on the autistic spectrum, resulting in the construction of inaccurate and misleading cognitive neuroscience models, and missed opportunities to explore the brain bases of this highly complex condition. A note of warning needs to be sounded about inferences drawn from past research, but if future research addresses this problem of male bias, then a deeper understanding of autism as a whole, as well as in previously overlooked females, will start to emerge. Plain Language Summary: Autism is a neurodevelopmental condition, behaviourally identified, which is generally characterised by social communication differences, and restrictive and repetitive patterns of behaviour and interests. It has long been claimed that it is more common in males, with oft-quoted ratios of 4M: 1F. This has been reflected in the development of diagnostic criteria for autism and, consequently, of measures of eligibility for autism research programmes, with females being (as is now emerging) disproportionately excluded. As outlined in this review, this issue has been particularly problematic in brain-based studies of autism. Many studies have only tested male autistic participants, or minimal numbers of autistic females. By default, sex differences were not examined. But the impression given by such research reports has commonly been that the findings would be applicable to all autistic individuals. Recent psychological and clinical research has shown that there are a significant number of autistic females who have been missed by traditional diagnostic practices. Their inclusion has increased their eligibility for autism research studies. With respect to brain research, it has become possible to devise studies with matched numbers of autistic females and males, and to replicate studies that have previously only tested males. Newly emerging findings from such studies are demonstrating that the 'robust' autism-related differences previously observed in autistic male-only cohorts do not fully generalise to autistic females. It will be necessary to exercise caution in drawing inferences from previous male-biased studies of the autistic brain. However, the identification and inclusion of previously excluded female autistic participants hopefully offers more accurate insights into this highly complex and heterogeneous condition. Highlights: Several decades of neuroimaging research into autism has been based almost entirely on males; even big data sets show strong evidence of male bias. There is clear evidence that autistic females are being excluded from the research process by failures in diagnostic practices that have been developed on male-biased cohorts. Models of autism which inform research protocols are based on male autism phenotypes; it appears to have been assumed that the substantially fewer females that are diagnosed will present with equivalent, if milder, patterns of autistic differences. Newly emerging findings from social cognitive neuroscience research studies investigating sex/gender differences in autistic behaviour and associated biological correlates are demonstrating that the 'robust' autism-related differences previously observed in autistic male-only cohorts do not fully generalise to autistic females. Autism research programmes should prioritise the exploration of sex/gender effects. [ABSTRACT FROM AUTHOR]

Recent research strongly indicates emerging evidence for an autistic female phenotype that differs from presentations of autism in males. The hallmarks of autism in women and girls are difficulties in social relationships, often accompanied by the phenomenon of camouflaging or masking. An estimated 80 percent of autistic females remain undiagnosed by the age of 18, resulting in the potential for enormous mental health challenges for a significant number of women. Key concepts in identifying autism in women and girls is an ability to articulate the characteristics of the autistic female phenotype, to define the phenomenon of masking and the instruments designed to measure it, and to identify the challenges with the current "gold-standards" of autism assessment. Sharing new knowledge in this newly-emerging field of female autism is critical to ensure clinicians are kept up-to-date in their assessment practices and professional counseling approaches. [ABSTRACT FROM AUTHOR]

Given that camouflaging has been suggested to contribute to delayed diagnosis and mental health problems among autistic people, validated measures of the construct are needed. This study describes the psychometric evaluation of the Swedish adaptation of the self-reported Camouflaging Autistic Traits Questionnaire (CAT-Q) in autistic (n = 100) and general population (n = 539) samples aged 10 to 83 years. Analyses indicated good-to-excellent internal consistency and test-retest reliability. Construct validity was supported by autistic participants scoring higher than non-autistic, and autistic females scoring higher than autistic males on the measure. Also as expected, camouflaging was associated with theoretically linked traits, including autistic behaviors and depressive symptoms. On the other hand, the factor structure of the original CAT-Q did not provide a good fit in the Swedish data set, and validity issues were found, particularly in children younger than 15 years, warranting further investigation of the construct validity of the scale. Different age trajectories were observed, where camouflaging behaviors decreased during adulthood in non-autistic people but remained at an elevated level among autistic people. [ABSTRACT FROM AUTHOR]

Camouflaging is hypothesized to play an important role in developing mental health difficulties. But this might not be true for everyone. It remains unclear for whom camouflaging is associated with mental health. In this preregistered study (AsPredicted #45095), we investigated whether (1) camouflaging and mental health were associated and (2) we could detect subgroups with a different association between camouflaging and mental health. For this study, 352 autistic adults aged 30–84 years filled in, among others, the Dutch Camouflaging Autistic Traits Questionnaire to measure camouflaging and the Symptom Checklist-90 Revised to measure mental health difficulties. We found a moderate correlation between camouflaging and mental health difficulties (r = 0.45). However, there was only a strong association between camouflaging and mental health in a small subgroup, while the association was small in most autistic adults. For varying levels of negative affect and (to a lesser extent) autism traits, the association between camouflaging and mental health differed, but not for biological sex, age, or educational level. Thus, while one should be careful with group-based conclusions regarding the (negative) impact of camouflaging, camouflaging can be important to consider in clinical practice, especially for people with a substantial level of negative affect. When autistic people use strategies to hide their autistic characteristics, we call this camouflaging. Autistic adults suggested that camouflaging can result in mental health difficulties. That is, people who report to camouflage also report mental health difficulties. However, since there are many differences between autistic people, this relationship may also differ between subgroups. Therefore, in this study we investigated whether camouflaging and mental health difficulties are related and whether this relationship is equal for all autistic adults. For this study, 352 autistic adults aged 30–84 years filled in the Dutch Camouflaging Autistic Traits Questionnaire to measure camouflaging and the Symptom Checklist-90 Revised to measure mental health difficulties. We found that camouflaging was moderately related to mental health difficulties. This means that people who report more camouflaging also report more mental health difficulties. When we looked closer, we found that this relationship was strong for only a small subgroup of autistic adults. In most other autistic adults, there was a small or no relationship between camouflaging and mental health difficulties. Therefore, it is important that clinicians are aware of camouflaging and its possible relationship with mental health difficulties, but that they do not generalize the negative consequences to everyone. [ABSTRACT FROM AUTHOR]

In some social situations, autistic people feel pressure to modify their innate social behaviour (i.e. camouflage), while in other social situations they feel free to engage in ways that feel authentic or true to themselves. To date, the latter aspect of autistic people's experience has rarely been explored. Using an online qualitative survey, this study examined 133 autistic people's experiences and perspectives of socialising in ways that felt authentic to them, with a particular focus on mixed-neurotype interactions and the role of nonautistic people. Using reflexive thematic analysis, four themes were generated: (1) embracing diverse communication styles, interests and perspectives; (2) creating a more inclusive mixed-neurotype social environment together; (3) minimising and managing mixed-neurotype miscommunication in mutually beneficial ways; and (4) enjoyable interactions involving reduced anxiety and exhaustion as well as genuine connection and rapport. These findings are discussed with reference to theory and research involving the construct of authenticity both inside and outside the field of autism research. The knowledge generated in this study illuminates a previously underexplored aspect of autistic people's experience and elucidates potential avenues through which to enhance the social experiences and well-being of this group. In some situations, autistic people feel pressure to change their social behaviour by camouflaging. In other situations, autistic people feel they don't need to change their social behaviour. Instead, they feel they can socialise in ways that feel authentic or true to themselves. Past research has tended to focus on autistic people's experiences of camouflaging rather than their experiences of authenticity. In this study, we asked autistic people what it is like for them when they can socialise in ways that feel authentic or true to themselves. Autistic people described authentic-feeling socialising as more free, spontaneous and open than camouflaging. In supportive environments, this kind of socialising had more positive and less negative consequences than camouflaging. Autistic people felt that having self-awareness and acceptance of their own social needs and being around autistic and nonautistic people who were accepting and understanding helped them to socialise in authentic-feeling ways. Autistic people also spoke about communication behaviours they felt nonautistic people should use to help overcome misunderstandings and create autism-friendly social environments. These findings suggest it is helpful for autistic people to have access to supportive and accepting social environments in which they feel able to socialise in ways that feel authentic to them. In creating such social environments, it is important to focus on nonautistic people's knowledge and attitude towards autistic people and also their ability to use helpful communication behaviours. [ABSTRACT FROM AUTHOR]

Camouflaging (using (un)conscious strategies to appear as non‐autistic) is thought to be an important reason for late autism diagnoses and mental health difficulties. However, it is unclear whether only autistic people camouflage or whether people with other neurodevelopmental or mental health conditions also use similar camouflaging strategies. Therefore, in this preregistered study (AsPredicted: #41811) study, we investigated if adults with attention‐deficit/hyperactivity‐disorder (ADHD) also camouflage. Adults aged 30–90 years filled in the Dutch Camouflaging Autistic Traits Questionnaire (CAT‐Q‐NL), the ADHD Self‐Report (ADHD‐SR) and the Autism Spectrum Quotient (AQ). We investigated differences in camouflaging between adults with ADHD, autism, and a comparison group in an age and sex‐matched subsample (N = 105 per group). We explored if autism and ADHD traits explained camouflaging levels in adults with an autism and/or ADHD diagnosis (N = 477). Adults with ADHD scored higher on total camouflaging and assimilation subscale compared to the comparison group. However, adults with ADHD scored lower on total camouflaging, and subscales compensation and assimilation than autistic adults. Autism traits, but not ADHD traits, were a significant predictor of camouflaging, independent of diagnosis. Thus, camouflaging does not seem to be unique to autistic adults, since adults with ADHD also show camouflaging behavior, even though not as much as autistic adults. However, as the CAT‐Q‐NL specifically measures camouflaging of autistic traits it is important to develop more general measures of camouflaging, to compare camouflaging more reliably in people with different mental health conditions. Furthermore, focusing on camouflaging in adults with ADHD, including potential consequences for late diagnoses and mental health seems a promising future research avenue. Lay Summary: In the present study, we investigated whether only autistic people use strategies to hide one's autistic traits (also referred to as camouflaging) or whether people with ADHD use similar strategies. We found that people with ADHD reported more camouflaging behavior compared to a neurotypical comparison group, but less than autistic people. Thus, these results indicate that camouflaging is not unique for autism and it is important to be aware of camouflaging strategies in people with ADHD. [ABSTRACT FROM AUTHOR]

Camouflaging is a strategy adopted by neurodivergent individuals to cope in neurotypical social contexts, likely related to perceived stress. Despite increasing research in autistic adults, studies of camouflaging in adolescents remain sparse. The self-reported Camouflaging Autistic Traits Questionnaire has been validated in adults in some Western societies, but not in non-Western populations. We examined the psychometric properties of the self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire in Taiwanese adolescents. We enrolled 100 autistic and 105 non-autistic adolescents (aged 12–18 years) and their caregivers. As an initial development, we found a two-factor structure ("compensation-masking" and "assimilation") via exploratory factor analysis, alongside good internal consistency and test–retest reliability, for both the self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire. Self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire scores were moderately to highly correlated. Autistic adolescents showed higher total Chinese version Camouflaging Autistic Traits Questionnaire and assimilation scores than non-autistic adolescents in both males and females. Female autistic adolescents showed higher assimilation than male autistic adolescents, but there was no significant difference between sex assigned at birth on compensation-masking in either autistic or non-autistic adolescents. Assimilation correlated with higher self-perceived stress for both autistic and non-autistic adolescents. Both self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire were reliable and offered meaningful information to understand social coping of Taiwanese autistic and non-autistic adolescents. Camouflaging is a coping strategy used by some autistic and other neurodivergent people to fit in neurotypical social contexts. The self-reported Camouflaging Autistic Traits Questionnaire has been validated for use in research with adults in some Western societies, but not in non-Western cultural-ethnic groups. We translated Camouflaging Autistic Traits Questionnaire into traditional Chinese and examined the use of this measure in Taiwanese adolescents via both self-report and caregiver-report in 100 autistic and 105 non-autistic adolescents. Both self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire were composed of two factors (i.e. a "compensation-masking" subscale and an "assimilation" subscale). Both adolescent self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire total score and subscales were reliable in measurement, and they highly correlated with each other. Taiwanese autistic adolescents were more likely to camouflage than non-autistic adolescents, especially on assimilation. Female autistic adolescents showed higher assimilation than male autistic adolescents. Higher camouflaging, especially assimilation, was associated with higher stress in autistic and non-autistic adolescents alike. Both self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire were reliable and offered meaningful information to help us understand the social coping experiences of autistic and non-autistic adolescents. [ABSTRACT FROM AUTHOR]

Camouflaging (or otherwise referred to as masking or passing) involves hiding one's autistic-related characteristics and differences to get by in social situations in predominantly non-autistic societies. Very little is known to date about the course of camouflaging motivations and strategies over time or the psychosocial factors that may influence autistic people's camouflaging choices and trajectories. In an exploratory qualitative study within an Asian sociocultural context, we interviewed 11 Singaporean autistic adults (9 males, 2 females, aged 22–45 years) about their camouflaging experiences to better understand (1) their camouflaging motivations and strategies over time, and (2) related psychosocial influences. Organised across four phases (pre-camouflaging, beginnings, continuity and change over time), 17 themes relating to camouflaging motivations and 8 themes relating to strategies were identified. The earliest camouflaging motivations were predominantly relational, linked to a negative self-identity that had been shaped by adverse social experiences. Camouflaging strategies became increasingly complex and integrated into one's sense of self over time. Our findings highlight the role of psychosocial pressures precipitating camouflaging and emphasise the need for individual and societal changes, including moving towards enhanced acceptance and inclusion to reduce psychosocial pressures on autistic people to camouflage. Over their lifetimes, many autistic people learn to camouflage (hide or mask) their autism-related differences to forge relationships, find work and live independently in largely non-autistic societies. Autistic adults have described camouflaging as a 'lifetime of conditioning... to act normal' involving 'years of effort', suggesting that camouflaging develops over an autistic person's lifetime and may start early on, in childhood or adolescence. Yet, we know very little about why and how autistic people start to camouflage, or why and how their camouflaging behaviours continue or change over time. We interviewed 11 Singaporean autistic adults (9 male, 2 female, 22–45 years old) who shared their camouflaging experiences. We found that autistic adults' earliest motivations to camouflage were largely related to the desire to fit in and connect with others. They also camouflaged to avoid difficult social experiences (such as being teased or bullied). Autistic adults shared that their camouflaging behaviours became more complex and that, for some, camouflaging became a part of their self-identity over time. Our findings suggest that society should not pathologise autistic differences, but instead accept and include autistic people, to reduce the pressure on autistic people to hide who they truly are. [ABSTRACT FROM AUTHOR]

Objectives: Some autistic people “camouflage” their differences by modeling neurotypical behaviors to survive in a neurotypical-dominant social world. It remains elusive whether camouflaging is unique to autism or if it entails similar experiences across human groups as part of ubiquitous impression management (IM). Here we examined camouflaging engagement and theoretical drivers in the general population, drawing on the transactional IM framework and contextualizing findings within both contemporary autism research and the past IM literature. Methods: A large representative U.S. general population sample (N = 972) completed this survey study. We combined exploratory item factor analysis and graph analysis to triangulate the dimensional structure of the Camouflaging Autistic Traits Questionnaire (CAT-Q) and examined its correspondence with prior autism-enriched psychometric findings. We then employed hierarchical regression and elastic-net regression to identify the predictors of camouflaging, including demographic (e.g., age, gender), neurodivergence (i.e., autistic and ADHD traits), socio-motivational, and cognitive factors. Results: We found a three-factor/dimensional structure of the CAT-Q in the general population, nearly identical to that found in previous autism-enriched samples. Significant socio-motivational predictors of camouflaging included greater social comparison, greater public self-consciousness, greater internalized social stigma, and greater social anxiety. These camouflaging drivers overlap with findings in recent autistic camouflaging studies and prior IM research. Conclusions: The novel psychometric and socio-motivational evidence demonstrates camouflaging as a shared social coping experience across the general population, including autistic people. This continuity guides a clearer understanding of camouflaging and has key implications for autism scholars, clinicians, and the broader clinical intersecting with social psychology research. Future research areas are mapped to elucidate how camouflaging/IM manifests and functions within person-environment transactions across social-identity and clinical groups.

Studies are emerging documenting the experience of fatigue, exhaustion and loss of functioning that has long been described by autistic adults as autistic burnout. New assessment tools are needed to enable identification and diagnosis. Here, we sought to identify factors associated with severity, develop an autistic burnout assessment and test the prepublication AASPIRE Autistic Burnout Measure tool. A co-produced survey of 141 autistic adults with experience of autistic burnout (98% above cut-off for depression) was subjected to exploratory factor analysis and scale reduction to identify a grouping of Autistic Burnout Severity Items. Autistic Burnout Severity Items showed strong overall internal consistency and acceptable internal consistency across four factors. Masking and depression were associated with the Autistic Burnout Severity Items, once variation in alexithymia, interoception, repetitive behaviours, sensory sensitivities and autism severity had been adjusted for. There is some suggestion that the Autistic Burnout Measure may not be as robust as the Autistic Burnout Severity Items, particularly as it showed a significant relationship with depression but not masking. Our findings alongside recent literature highlight a core phenomenon, comprising exhaustion, withdrawal and cognitive overload, associated with stressors potentially unique to autistic people. Further disambiguation from autistic shutdown and other conditions is needed in work towards the measurement of autistic burnout. Autistic burnout has been talked about by autistic adults for some time on blogs and in social media. Now, research describes fatigue, exhaustion and other related symptoms experienced by autistic people. We need new ways to help identify autistic burnout. In this study, we tested a new questionnaire called the AASPIRE Autistic Burnout Measure, and we investigated things that are linked to worse autistic burnout. We also trialled a group of Autistic Burnout Severity Items that we made. Working with an autistic researcher, we made the Autistic Burnout Severity Items based on published definitions of autistic burnout. Autistic adults (n = 141) who had experienced autistic burnout completed an online survey. We found that autistic burnout was connected to masking and depression. The Autistic Burnout Measure tool was associated with depression but not with masking. It was not very accurate in telling apart participants who were currently experiencing burnout versus those who were reporting on their past experience. The Autistic Burnout Severity Items might have problems with subscales adding together to measure autistic burnout. More work is needed on how to measure autistic burnout. Our research and other recent studies show autistic people experience a combination of exhaustion, withdrawal and problems with their concentration and thinking. Burnout seems to be linked to the stress experienced by autistic people in their daily lives. We need more research to understand the difference between autistic burnout and other conditions and experiences. We need to develop assessment tools that can help identify this burnout. [ABSTRACT FROM AUTHOR]

Autistic burnout is an experience commonly described by autistic people (#AutBurnout and #AutisticBurnout on social media). Recently, two definitions of this syndrome have been published. Both describe debilitating exhaustion with onset related to various stressors including masking, though several differences exist, such as the characteristic of interpersonal withdrawal. We sought to explore the content validity of these definitions including duration and frequency criteria, using descriptive statistics, content analysis and reflexive thematic analysis. A co-produced survey of 141 autistic adults with experience of autistic burnout showed strong endorsement of the definition by Higgins et al., where exhaustion and interpersonal withdrawal occur alongside reduced functioning, executive functioning difficulties, and increased manifestation of autistic traits. Duration and frequency criteria were unresolved, with qualitative data highlighting varying (both acute and chronic) experiences. Autistic burnout is frequently misdiagnosed as depression, anxiety, bipolar disorder, borderline personality disorder or other conditions. Work is needed to increase community and clinician awareness, as well as initiatives to improve unaccommodating neurotypical environments. More research and validation are needed in larger samples not restricted to autistic adults who have experienced autistic burnout to determine prevalence and risk factors as well as duration and frequency. Autistic burnout is something autistic people have been talking about for a while (see #AutBurnout and #AutisticBurnout on social media). Recently, researchers published two different definitions of autistic burnout. We wanted to test these definitions. We wanted to confirm the duration and frequency of autistic burnout. That is, how long and how often do people get autistic burnout? We surveyed 141 autistic adults who had autistic burnout. We used descriptive statistics, content analysis and reflexive thematic analysis to analyse the survey responses. Autistic adults strongly agreed with the definition published by Higgins et al. How long and how often people get autistic burnout was not clear. Participants told us they have both short and long episodes. Participants told us that autistic burnout leads to exhaustion. They needed to withdraw from being with other people. They needed to stay away from autism unfriendly places. Many had been misdiagnosed as having depression, anxiety, bipolar disorder, borderline personality disorder or other conditions. We need increased awareness of autistic burnout. Autistic people need more help. More research is needed, we need to have bigger studies to understand autistic burnout. [ABSTRACT FROM AUTHOR]

Autistic people face many challenges entering the workforce, for example, during job interviews where performance is reliant on particular social skills. To be competitive during job interviews, autistic people may experience pressure to conceal or 'camouflage' their autistic traits and behaviour. This qualitative study used semi-structured interviews to explore the job interview experiences of 10 autistic people. Based on the literature, we were curious as to whether participants would report behaviour consistent with the camouflaging hypothesis. Thematic analysis identified six themes reflecting individual and environmental factors. Participants reported engaging in camouflaging behaviour during job interviews, with external factors (e.g. avoid being treated differently) cited as the primary reason. Participants reported that camouflaging required effort, leading to stress, anxiety, exhaustion and feeling 'burnt out'. They expressed a desire for an inclusive, understanding and accommodating environment where they would feel more comfortable disclosing their diagnosis without feeling they needed to conceal their autistic traits and behaviour. These preliminary findings add to the current literature regarding autism, camouflaging and employment. When applying for a job, autistic job candidates are likely to face a number of challenges. Job interviews are one of these challenges – they require communicating and relationship-building with unfamiliar people and involve expectations about behaviour (that may vary between companies and are not made clear to job candidates). Given autistic people communicate differently to non-autistic people, autistic job candidates may be disadvantaged in the interview process. Autistic candidates may not feel comfortable or safe sharing with organisations their autistic identity and may feel pressure to hide any characteristics or behaviour they feel might indicate they are autistic. To explore this issue, we interviewed 10 autistic adults about their job interview experiences in Australia. We analysed the content of the interviews and found three themes that related to the individual person and three themes that related to environmental factors. Participants told us that they engaged in camouflaging behaviour during job interviews, feeling pressure to conceal aspects of themselves. Those who camouflaged during job interviews reported that it took a lot of effort, which resulted in increased stress, anxiety and exhaustion. The autistic adults we spoke to reported a need for inclusive, understanding and accommodating employers to help them feel more comfortable disclosing their autism diagnosis in the job application process. These findings add to current research that has explored camouflaging behaviour and barriers to employment for autistic people. [ABSTRACT FROM AUTHOR]

Although the bystander effect is one of the most important findings in the psychological literature, researchers have not explored whether autistic individuals are prone to the bystander effect. The present research examines whether autistic employees are more likely to report issues or concerns in an organization's systems and practices that are inefficient or dysfunctional. By bringing attention to these issues, autistic employees may foster opportunities to improve organizational performance, leading to the development of a more adaptive, high performing, and ethical culture. Thirty‐three autistic employees and 34 nonautistic employees completed an online survey to determine whether employees on the autism spectrum (1) are more likely to report they would voice concerns about organizational dysfunctions, (2) are less likely to report they were influenced by the number of other witnesses to the dysfunction, (3) if they do not voice concerns, are more likely to acknowledge the influence of other people on the decision, (4) are less likely to formulate "elaborate rationales" for their decisions to intervene or not, and (5) whether any differences between autistic and nonautistic employees with regards to the first two hypotheses, intervention likelihood and degree of influence, are moderated by individual differences in camouflaging. Results indicate that autistic employees may be less susceptible to the bystander effect than nonautistic employees. As a result, autistic employees may contribute to improvements in organizational performance because they are more likely to identify and report inefficient processes and dysfunctional practices when they witness them. These preliminary findings suggesting potential benefits of neurodiversity in the workplace are promising. However, further research is required. Lay Summary: According to the bystander effect, when witnessing situations that are inappropriate or harmful, the likelihood of intervening and its promptness decreases with increasing group size. Although the bystander effect is one of the most important findings in the psychological literature, researchers have not explored whether autistic individuals are prone to the bystander effect. This preliminary study suggests that autistic employees may be less prone to the bystander effect than nonautistic employees and, as a result, contribute to improved organizational effectiveness and performance because of an increased willingness to identify and report inefficient processes or dysfunctional practices when they witness them. [ABSTRACT FROM AUTHOR]

The Questionnaire for Autism Spectrum Conditions (Q-ASC; Attwood, Garnett & Rynkiewicz, 2011) is one of the few screening instruments that includes items designed to assess female-specific ASD-Level 1 traits. This study examined the ability of a modified version of the Q-ASC (Q-ASC-M; Ormond et al., 2018) to differentiate children with and without ASD-Level 1. Participants included 111 parents of autistic children and 212 parents of neurotypical children (5–12 years). Results suggested that the gendered behaviour, sensory sensitivity, compliant behaviours, imagination, and imitation subscales differentiated autistic females from neurotypical females. Compared to autistic males, autistic females had higher scores on gendered behaviour, sensory sensitivity, social masking, and imitation. Results are discussed in relation to early detection of autistic female children. [ABSTRACT FROM AUTHOR]

The present study was conducted to investigate the mediating role of perceived stigma and camouflaging in relationship between autistic identity and psychological wellbeing among autistic adults. This study investigates how the complex social identity of autistic adults, affects their wellbeing and how frequent stigma in various contexts results in camouflaging, potentially worsening mental health and preventing the development of a strong autistic identity. The study was conducted on autistic adults (N=400). Autism Spectrum Identity Scale, Stigma Consciousness Scale, Camouflaging of Autistic Traits Questionnaire and Warwick Edinburgh Mental Wellbeing Scale were used for data collection. The results showed that there was a mediating effect. Higher autistic identity was related to positive psychological wellbeing and less stigma. Higher stigma related to more camouflaging which is correlated to poorer wellbeing. Promoting societal awareness and acceptance of autism will contribute to improve the quality of life for autistic adults, promoting their overall wellbeing. [ABSTRACT FROM AUTHOR]

Autistic individuals are frequently exposed to stigmatizing attitudes and discrimination. Through the lived experience of stigmatizing attitudes, autistic people can internalize the negative stereotypes associated with autism. This phenomenon is known as self-stigma. In non-autistic populations, self-stigma is associated with shame and negative mental health outcomes. In this study, we aim to better understand the mental health outcomes associated with self-stigma in autism and to investigate whether and how self-compassion compared to camouflaging may protect from self-stigma in autistic individuals. For this purpose, 689 adults who reported a diagnosis of autism were recruited online and completed self-reported questionnaires for self-stigma (Internalized Stigma of Mental Illness Scale–9 items), self-compassion (Self-Compassion Scale–short form), depression (Depression, Anxiety and Stress Scale-21) and camouflaging (Camouflaging Autistic Traits Questionnaire). We conducted mediation analysis and moderated mediation analysis. Our results indicate that self-stigma is highly prevalent in autistic adults (45.5%), correlated to depression (ρ (687) = 0.437, p < 0.001) and that internalized shame mediates the relationship between self-stigma and depressive symptoms (b = 1.48, 95% confidence interval = (1.11, 1.94)). Self-compassion moderates this mediation (Indirect Effect, IE = −0.305, 95% confidence interval = (0.601, 0.014), β = 0.183, z = 2.012, p = 0.044), whereas camouflaging does not (IE = 0.003, 95% confidence interval = (0.009, 0.015), β = 0.0531, z = 0.514, p = 0.607). These results highlight the protective effect of self-compassion on the negative impacts of self-stigma in autistic individuals. Future research should explore how to adapt existing compassion-focused interventions and evaluate their feasibility and efficacy to reduce self-stigma and shame in autistic populations. What is already known about the topic? Autistic individuals are frequently exposed to stigmatizing attitudes and discrimination. Negative stereotypes about autism, such as dangerousness or inability to work, are very frequent in our societies. Through exposure to these stigmatizing ideas, autistic people can internalize these ideas and begin to believe them to be true about themselves. This is self-stigma. Past research conducted with non-autistic individuals indicate that self-stigma can lead people to feel ashamed of who they are and deteriorate their mental health. What this paper adds? In this paper, we found that self-stigma in autistic people increases depressive symptoms through feelings of shame. We then showed that relating to self with compassion – that is, to be friendly towards oneself (kindness), be aware of one’s feelings and thoughts (mindful awareness) and realize that everyone feels pain and makes mistakes (common humanity) – helps reducing the negatives consequences of self-stigma on mental health. We also demonstrated that camouflaging does not modify the impact of self-stigma on mental health. Implications for practice, research or policy? Because self-compassion can protect from the negative effects of self-stigma, future research should explore how to adapt existing compassion-focused interventions and evaluate their feasibility and efficacy to reduce self-stigma and shame in autistic people. [ABSTRACT FROM AUTHOR]

In the recent years, growing attention has been paid to the use of camouflaging strategies by adult populations suffering from autism spectrum disorder (ASD) with milder manifestations and without intellectual impairment, which may lead to a delay in diagnosis or even a misdiagnosis. In fact, high-functioning ASD individuals were reported to be more aware of their communication difficulties and were more likely make considerable efforts to adjust their behavior to conventional rules of non-autistic individuals, learning to imitate other non-ASD individuals. Moreover, females reported a higher frequency of camouflaging strategies, suggesting a role of camouflaging in the gender gap of the ASD diagnosis. Although camouflaging strategies can sometimes grant a better level of adjustment, even resulting in a hyper-adaptive behavior, they are also often correlated with negative mental health consequences due to the long-term stress associated with continuous attempts to adapt in day-to-day life. In this framework, the aim of the present work was to review the available studies that assessed the presence and correlates of camouflaging strategies in individuals with ASD. Although the literature available on the topic is still scarce, some interesting correlations between camouflaging and anxious and depressive symptoms, as well as suicidality, were highlighted. In particular, the controversial and sometime opposite thoughts and results about camouflaging may be clarified and integrated in light of a dimensional approach to psychopathology. [ABSTRACT FROM AUTHOR]

Many autistic individuals camouflage socially atypical behaviours. Evidence suggests autistic females camouflage more than autistic males. Although camouflaging may confer some benefits, it is also associated with negative outcomes including poorer mental health and well-being. Those with high autistic traits but no clinical diagnosis are not seldom included in camouflaging research, therefore we cannot ascertain whether camouflaging plays a role in the underdiagnosis of autistic females. Data from young adults with a diagnosis of autism (n = 78), high autistic traits but no diagnosis (n = 177) or low autistic traits (n = 180) revealed autistic females reported camouflaging significantly more than other groups. Males and females with low autistic traits reported significantly lower camouflaging than high trait and diagnosed groups. Loneliness was a key predictor of camouflaging for the diagnosed group only. Camouflaging was found to predict lower psychological quality of life for the diagnosed group, and lower social quality of life for the high trait and low trait groups. Overall, findings indicated that, although all groups reported camouflaging, the motivations for doing so may be different for diagnosed autistic individuals. It is important for stakeholders and society to improve understanding of autism and acceptance of atypical behaviour to alleviate possible negative outcomes associated with camouflaging. Many autistic people use strategies that help them adapt in social situations and hide behaviours that may seem different to non-autistic individuals – this is called camouflaging. Camouflaging may help autistic people fit in socially; however, it might also lead to poorer well-being. It has been suggested that autistic females camouflage more than autistic males. This article explored differences between males and females who have an autism diagnosis, have characteristics of autism but no diagnosis and those with few autistic characteristics. It is important to include these groups as camouflaging may make it more difficult to get an autism diagnosis and therefore make it less likely a person will receive support. We found that autistic women camouflaged more than all other groups. The group with few autistic characteristics (males and females) camouflaged the least. Loneliness was found to be a possible reason for camouflaging for the diagnosed autistic group only. In terms of outcomes related to camouflaging, it was found that those who camouflaged most had a lower quality of life; this was true of all groups. This tells us that there may be different reasons to camouflage, and different outcomes related to camouflaging for those with many characteristics of autism (including those with a diagnosis), and those with few. It is important that clinicians, teachers, parents and other stakeholders are aware of the negative outcomes associated with camouflaging so that more support can be provided for those who need it. [ABSTRACT FROM AUTHOR]

In order to fit into the environment, satisfy social norms, and increase the opportunities of creating successful interpersonal interactions, individuals with autism spectrum disorder (hereinafter referred to as ASD) often try to develop coping strategies, and one such strategy is camouflaging. Camouflaging can be seen as a way in which individuals try to hide the less desirable aspects of their personality. The aim of this review was to determine the sex/gender differences in the representation of camouflaging in individuals with ASD by reviewing the relevant literature, to determine the impact of camouflaging on mental health, as well as the reasons and consequences of the camouflaging. By searching the SCOPUS database and after applying inclusion and exclusion criteria for publications in the field of autism spectrum disorder and camouflaging, a total of 10 publications were included and analyzed in the current review. Results show that individuals of the female sex/gender with ASD report higher levels of camouflaging compared to individuals of the male sex/gender with ASD. In addition to the above, it has been found that camouflaging is associated with mental health challenges. The results showed that individuals of the female sex/gender with ASD were more supportive of conventional reasons than individuals of the male sex/gender with ASD. The results of research on the consequences of camouflaging show that people with ASD who camouflage themselves most often feel unhappy because they perceive camouflaging their true identity and personality as lying and deceiving about who they really are. Also, research indicates that thanks to camouflaging, individuals with ASD did not encounter the stereotype of "autistic person", however, this caused negative consequences such as delaying or questioning their diagnosis of ASD, especially in individuals of female sex/gender with ASD. [ABSTRACT FROM AUTHOR]

Interest in social camouflaging has led to a multiplicity of measurement methods of uncertain validity. This two‐part investigation first used a systematic review ("Study 1") to identify and appraise methods used to quantify camouflaging of autistic traits, using the Consensus‐based Standards for the Selection of Health Status Measurement Instruments checklist. A total of 16 distinct measurement tools were identified; all are in the preliminary phases of psychometric evaluation. The systematic review highlighted: (1) the need for parent‐report tools which specifically measure camouflaging; and (2) a lack of studies looking at associations between different methods of camouflaging, which limits understanding of their validity. "Study 2" aimed to begin to address these gaps in knowledge. We created a parent‐report version of the Camouflaging Autistic Traits Questionnaire (CAT‐Q) and evaluated its concurrent validity in autistic young people by examining associations with the self‐report CAT‐Q and a discrepancy measure. Discriminant validity was investigated by comparing all three methods of measuring camouflaging to a measure of social skills, to test whether they assess a construct distinct from social ability. The self‐ and parent‐report CAT‐Q were significantly related (r = 0.47, 95% CI = 0.24–0.65), and were related weakly (r = 0.20, 95% CI = −0.06 to 0.43) and strongly (r = 0.46, 95% CI = 0.23–0.64), respectively, to the discrepancy approach. No measure was associated with social skills. Improving the psychometric properties of these methods, and introducing a novel parent‐report measure, may help selection of appropriate methods in future research and integration into clinical practice. Lay Summary: The first study looked at published research to evaluate tools used to measure camouflaging in autism; showing that there is still much to learn about whether existing measures are accurate, and that there are no parent‐report tools designed to measure camouflaging. The second study started to fill these gaps in knowledge, by developing and testing a parent‐report camouflaging measure, and comparing it to other common ways of measuring camouflaging. This showed that, for teenagers, a new parent‐report questionnaire can be useful for measuring camouflaging. [ABSTRACT FROM AUTHOR]

Camouflaging of autistic traits involves hiding or compensating for autistic characteristics, often due to stigma or a desire to fit in with others. This behaviour has been associated with mental health issues in autistic individuals. The 2 5-item Camouflaging Autistic Traits Questionnaire (CAT-Q) is the most commonly used self-report measure of camouflaging. In this study, a 9-item short form version was developed for use in clinical and research settings. Aims: To construct and psychometrically validate a brief self-report measure of camouflaging. The Camouflaging Autistic Traits Questionnaire – Short Form (CATQ-SF) was developed and its factor structure and psychometric properties were evaluated in two studies. Study 1 used a large, online sample of autistic and non-autistic adults (N = 832) to evaluate the factor structure, psychometric properties, and measurement invariance of the CATQ-SF. Study 2 used an independent sample of autistic and non-autistic adults (N = 80) to test Study 1's findings. In Study 1, evidence for a three-factor structure was observed, with good internal consistency (combined autistic & non-autistic α = 0.84). In addition, the instrument demonstrated measurement invariance, and reliably predicted higher levels of autistic traits. In Study 2, the 3-factor structure was replicated, and good internal consistency was again observed (combined autistic and non-autistic α = 0.89). In both studies, psychometric properties were of similar or higher validity compared to the full-form CAT-Q. The CATQ-SF can be used by clinicians and researchers to measure camouflaging in autistic and non-autistic adults quickly and reliably. • The CATQ – Short Form (CATQ-SF) was developed as a brief measure of camouflaging of autistic characteristics. • In two samples of adults, the CATQ-SF demonstrated good psychometric properties for both autistic and non-autistic participants. • The CATQ-SF can be used in clinical and research settings to quantitatively measure camouflaging quickly and easily. [ABSTRACT FROM AUTHOR]

Camouflaging of autistic traits may make autism harder to diagnose. The current study evaluated the relations between camouflaging intent, first impressions, and age of autism diagnosis. Participants comprised autistic and non-autistic adults (n = 80, 50% female) who completed the Camouflaging of Autistic Traits Questionnaire. They were later video-recorded having a conversation with a person unaware of their diagnostic status. Ten-second clips from half these videos were later shown to 127 non-autistic peers, who rated their first impressions of each participant. Results showed that autistic participants were rated more poorly on first impressions, males were rated less favourably than females, and male raters were particularly harsh in their evaluations of autistic males. Camouflaging intent did not predict first impressions but better first impressions were linked with a later age of diagnosis. [ABSTRACT FROM AUTHOR]

Social performances pervade human interactions. Some autistic people describe their social performances as 'camouflaging' and engage in these performances to mitigate social challenges and survive in the neurotypical world. Here, we reconsider autistic camouflaging under the unifying framework of impression management (IM) by examining overlapping and unique motivations, neurocognitive mechanisms, and consequences. Predictive coding and Bayesian principles are synthesized into a computational model of IM that applies to autistic and neurotypical people. Throughout, we emphasize the inherently transactional, context-dependent nature of IM, the distinct computational challenges faced by autistic people, and the psychological toll that compelled IM can take. Viewing camouflaging through this lens highlights the pressing needs to change societal attitudes, destigmatize autism, refine social skills-building programs for autistic individuals, and integrate these programs with environment-focused support. Autistic 'camouflaging' (or masking, compensation, accommodation, or passing as non-autistic) is associated with social adaptation and wellbeing in some autistic individuals, but the unclear conceptual structure impedes research interpretation and directions. 'Camouflaging' conceptually overlaps with ubiquitous impression management (IM) in humans, yet unique aspects exist considering autistic cognition in neurotypical contexts across motivations, neurocognition, and consequences for wellbeing. Autistic–autistic dyads experience more efficient and rewarding interactions compared with cross-neurotype dyads, suggesting that autistic social challenges should always be understood within their interactive contexts. The transactional, context-dependent, dynamic, and iterative nature of IM warrants a generalized computational account that is extensible to autistic cognition. [ABSTRACT FROM AUTHOR]

Diagnostic criteria for autism are relatively vague, and may lead to over and underdiagnosis when applied without clinical expertise. Indeed, autism is best reliably identified by experienced clinicians who take into account qualitative aspects of the condition. When assessing for autism in women, little guidance exists to support clinicians deciding whether to attribute adaptive difficulties to autism, a psychiatric condition, or both. The purpose of this study was therefore to propose guidelines for clinicians assessing for autism in women. To do this, we aimed to describe the clinical expertise involved in making positive and differential diagnoses of autism in adult women of typical intelligence. We interviewed 20 experienced clinicians from seven countries. We then elaborated Delphi statements summarizing participant views on the topic, which our participants rated. We obtained a final list of 37 suggested clinical guidelines to improve specificity and sensitivity of autism diagnosis in women. Participants had developed individual assessment strategies, although much overlap existed across participants. Participants provided insight to differentiate autism from post-traumatic stress disorder and Borderline Personality Disorder, and underlined the importance of being able to make differential diagnoses particularly in cases where non-autistic people had strongly self-identified with the spectrum. [ABSTRACT FROM AUTHOR]

In order to fit into the environment, satisfy social norms, and increase the opportunities of creating successful interpersonal interactions, individuals with autism spectrum disorder (hereinafter referred to as ASD) often try to develop coping strategies, and one such strategy is camouflaging. Camouflaging can be seen as a way in which individuals try to hide the less desirable aspects of their personality. The aim of this review was to determine the sex/gender differences in the representation of camouflaging in individuals with ASD by reviewing the relevant literature, to determine the impact of camouflaging on mental health, as well as the reasons and consequences of the camouflaging. By searching the SCOPUS database and after applying inclusion and exclusion criteria for publications in the field of autism spectrum disorder and camouflaging, a total of 10 publications were included and analyzed in the current review. Results show that individuals of the female sex/gender with ASD report higher levels of camouflaging compared to individuals of the male sex/gender with ASD. In addition to the above, it has been found that camouflaging is associated with mental health challenges. The results showed that individuals of the female sex/gender with ASD were more supportive of conventional reasons than individuals of the male sex/ gender with ASD. The results of research on the consequences of camouflaging show that people with ASD who camouflage themselves most often feel unhappy because they perceive camouflaging their true identity and personality as lying and deceiving about who they really are. Also, research indicates that thanks to camouflaging, individuals with ASD did not encounter the stereotype of “autistic person”, however, this caused negative consequences such as delaying or questioning their diagnosis of ASD, especially in individuals of female sex/gender with ASD. [ABSTRACT FROM AUTHOR]

Autistic masking and camouflaging – concealing Autistic traits and "passing" as non-Autistic – are linked to negative developmental consequences including stress, mental illness, identity loss, and suicidality. Recent psychological literature on masking and camouflaging seeks to urgently address these issues – yet overlooks relevant sociological research. This study uses Sara Ahmed and Frantz Fanon's work on masking, alongside Judith Butler's concept of performativity, to formulate distinct sociological definitions for Autistic masking and camouflaging. I offer a qualitative critical discourse analysis of 2018's #TakeTheMaskOff neurodiversity activism campaign, alongside psychology masking/camouflaging literature, to question the social drivers of masking and camouflaging. Autism is widely understood as an "invisible" disability. However, I found that the necessity of masking and camouflaging to avoid discrimination renders Autistic people a "visible Neurominority group." Proposing a new Minority Group Model of Neurodiversity, I argue that Neurotypical hegemony, invisibility, and majority group privilege are key social drivers of masking and camouflaging. [ABSTRACT FROM AUTHOR]

Camouflaging refers to strategies used by autistic people to mask or hide social difficulties. The current study draws on Social Identity Theory to examine the relationship between camouflaging and autism-related stigma, testing the hypothesis that camouflaging represents an individualistic strategy in response to stigma. Two hundred and twenty-three autistic adults completed an online survey measuring perceived autism-related stigma, individualistic and collective strategies, camouflaging and mental wellbeing. Results indicated that higher camouflaging was positively associated with autism-related stigma and both individualistic and collective strategy use. Autism-related stigma was associated with lower wellbeing however this relationship was not mediated by camouflaging. These findings demonstrate how stigma contributes to camouflaging and highlight the complexities of navigating autistic identity while still camouflaging. [ABSTRACT FROM AUTHOR]

Camouflaging is described as a set of strategies used to prevent others from noticing one's social difficulties. Research indicates heightened levels of camouflaging behaviours in the adult autistic population. To extend understanding of camouflaging in adolescents, this mixed-methods study explored camouflaging behaviours in offline and online contexts with 40 autistic and 158 non-autistic adolescents. At the quantitative phase, participants completed measures of camouflaging behaviours (online vs offline) and measures of social media use. Following this, six autistic adolescents participated in semi-structured interviews. Findings indicate that in the offline context, autistic adolescents camouflage more than non-autistic adolescents. Online, autistic participants camouflage less than they do offline, and females camouflage more than males. Implications for research and theory are discussed. [ABSTRACT FROM AUTHOR]

Camouflaging in autism spectrum disorder could be a factor in later diagnosis of individuals without co-occurring intellectual disability, particularly among those designated female sex at birth. Little research to date has examined how gender identity impacts camouflaging, however. Further, no study has compared groups that differ in diagnostic timing to directly investigate if later-diagnosed individuals demonstrate elevated camouflaging relative to those receiving an earlier diagnosis. Using the Camouflaging Autistic Traits Questionnaire subscales (Assimilation, Compensation, and Masking), we investigated the roles of sex, gender identity (gender diverse vs cisgender), and diagnostic timing (childhood/adolescent-diagnosed vs adult-diagnosed), and the interactions of these factors, in autistic adults (N = 502; age 18–49 years). Main effects of sex, gender identity, and diagnostic timing were revealed. Autistic females reported more camouflaging across Camouflaging Autistic Traits Questionnaire subscales compared to males. Gender diverse adults reported elevated camouflaging on the Compensation subscale compared to cisgender adults. Adulthood-diagnosed individuals reported elevated Assimilation and Compensation compared to childhood/adolescence-diagnosed individuals. We discuss how aspects of camouflaging may have particular implications for later diagnostic timing and for the intersection of neurodiversity and gender diversity. Camouflaging in autism spectrum disorder refers to behaviors and/or strategies that mask the presentation of autism spectrum disorder features in social contexts in order to appear "non-autistic" (Attwood, 2007). Camouflaging modifies the behavioral presentation of core autism spectrum disorder features (e.g. social and communication differences), but the underlying autistic profile is unaffected, yielding a mismatch between external observable features and the internal lived experience of autism. Camouflaging could be an important factor in later diagnosis of individuals without co-occurring intellectual disability, especially among those designated female sex at birth. Little research to date has examined how gender identity impacts camouflaging, however. Furthermore, no study has compared groups that differ in diagnostic timing to directly investigate if later-diagnosed individuals show elevated camouflaging relative to those receiving an earlier diagnosis. We used the Camouflaging Autistic Traits Questionnaire subscales (Assimilation, Compensation, and Masking) and investigated the roles of sex, gender identity (gender diverse vs cisgender), and diagnostic timing (childhood/adolescent-diagnosed vs adult-diagnosed), and the interactions of these factors, in autistic adults (N = 502; ages 18–49 years). Main effects of sex, gender identity, and diagnostic timing were revealed. Autistic females reported more camouflaging across all three Camouflaging Autistic Traits Questionnaire subscales compared to males. Gender diverse adults reported elevated camouflaging on the Compensation subscale compared to cisgender adults. Adulthood-diagnosed individuals reported elevated Assimilation and Compensation compared to childhood/adolescence-diagnosed individuals. We discuss how the aspects of camouflaging may have unique implications for later diagnostic timing and for the intersection of neurodiversity and gender diversity. [ABSTRACT FROM AUTHOR]

Autistic people may camouflage their innate autistic social behaviours to adapt to, cope within and/or influence the predominately neurotypical social landscape. This study describes behaviours exhibited, altered or avoided by autistic adults whilst camouflaging (i.e. camouflaging behaviours). Using Interpersonal Process Recall methodology, 17 autistic adults (8 women, 6 men and 3 agender/gender neutral individuals) participated in a brief social task designed to replicate a common day-to-day social situation. Participants then watched a video of their interaction with a researcher, actively identifying and describing camouflaging behaviours. Using qualitative content analysis, descriptions of 38 camouflaging behaviours described by participants were clustered into four main categories and seven subcategories: (1) masking, (2) innocuous engagement (subcategories: passive encouragement, centring social partner, deferential engagement and reducing social risk), (3) modelling neurotypical communication and (4) active self-presentation (subcategories: reciprocal social behaviours, risky social behaviours, and comfortable and familiar social behaviours). The novel use of Interpersonal Process Recall methodology addressed limitations in existing camouflaging research and facilitated the identification of previously unreported camouflaging behaviours. These camouflaging behaviours are discussed with reference to literature concerning interpersonal research and theory within and outside the field of autism. Camouflaging can be thought of as the process through which autistic people modify their natural social behaviours to adapt to, cope within or influence the largely neurotypical (non-autistic) social world. Many autistic people experience negative reactions to their natural or intuitive social behaviours when interacting with non-autistic people. Over time, in response to these negative reactions, autistic people's social behaviour often changes. We refer to autistic people's changed behaviours as 'camouflaging behaviours'. Research exploring camouflaging behaviours is still at an early stage. This study investigated camouflaging behaviours used by autistic adults in everyday social interactions using a research method that was new to the field of autism. Specifically, 17 autistic adults were filmed taking part in a common everyday social situation – a conversation with a stranger. With the help of the video of this conversation, they then showed and described their camouflaging behaviours to a researcher. These autistic people identified and described a total of 38 different camouflaging behaviours. The detailed and specific information provided by autistic adults about camouflaging behaviours generated important new insights into the ways in which autistic people adapt to, cope within and influence the neurotypical (non-autistic) social world. [ABSTRACT FROM AUTHOR]

Camouflaging includes strategies used by individuals to mask or hide autistic traits. Research has shown that both autistic and neurotypical individuals engage in camouflaging and that there may be sex differences in the reasons for camouflaging in autistic adults. The purpose of this qualitative study was to extend previous research on the lived experience of camouflaging through exploring camouflaging motivations and consequences in autistic and neurotypical adolescents through both questionnaires (n = 132) and semi-structured interviews (n = 19). Results revealed trends in camouflaging motivations and consequences by diagnosis and sex, as well as by sex within the autistic group. These findings further inform our understanding of camouflaging and why it may be reported as particularly detrimental for autistic females. [ABSTRACT FROM AUTHOR]