The Associations Between Camouflaging, Autistic Traits, and Mental Health in Nonautistic Adults

Background: Camouflaging is frequently reported in autistic people and entails the disguising of autistic traits in social situations. Camouflaging is associated with poor mental health in autistic people. This study examined the manifestation of camouflaging in a nonautistic sample, examining the relationship between autistic traits, self-reported camouflaging, gender, and mental health.Method: In total 110 nonautistic adults completed standardized self-report questionnaires that measured autistic traits, mental health symptoms, and camouflaging behaviors. Hierarchical multiple linear regression models were used to analyze data and examine the unique contributions of autistic traits and camouflaging to mental health.Results: Self-reported autistic traits were associated with increased symptoms of poor mental health. However, autistic traits were not associated with mental health symptoms when controlling for self-reported camouflaging, and self-reported camouflaging predicted increased mental health symptoms over and above the effects of autistic traits. Women had poorer mental health than men in our sample, and in women there was a stronger relationship between camouflaging and mental health than in men.Conclusions: Camouflaging may contribute to poor mental health outcomes in the general population, just as it does for autistic people, to the extent that camouflaging more clearly relates to mental health profile than self-reported autism traits. This suggests camouflaging is an important construct for understanding mental health in general, and for exploring the complex relationship between autism and autistic traits. Community brief Why was this study done?Some autistic individuals report trying to hide their autistic traits to blend in with others, referring to this as "camouflaging" or "masking." Many autistic people who camouflage describe it as being a very difficult and distressing process, which can be harmful to their mental health. In nonautistic people, a higher level of autistic traits is related to poor mental health. Nonautistic people have also reported camouflaging autistic traits, but we know less about whether this might also impact their mental health. What was the purpose of this study?We did this study to find out more about the relationship between mental health and camouflaging of autistic traits in nonautistic people. What did the researchers do?We asked 110 nonautistic adults to complete a series of questionnaires. These questionnaires asked them about their autistic traits, their camouflaging behaviors, and their mental health. We then used statistical tests to look at the relationships between autistic traits, camouflaging, gender, and mental health. What were the results of the study?We found that people who camouflaged more had poorer mental health, including symptoms of anxiety, depression, and stress. People with more autistic traits also had poorer mental health. When we looked at both of these relationships at the same time, only camouflaging was related to poor mental health, and not autistic traits. When we also looked at gender, we found that women in our study had poorer mental health than men, and the relationship between camouflaging and mental health was stronger for women. What do these findings add to what was already known?These findings help us understand the relationship between autistic traits and mental health by demonstrating that it may be the camouflaging of autistic traits that is related to poorer mental health. These findings also help us better understand camouflaging by showing that the negative consequences of camouflaging for mental health may apply to both autistic and nonautistic people. What are the potential weaknesses in the study?Our study only looked at the relationship between autistic traits, camouflaging, gender, and mental health. It is possible that there are other factors our study did not investigate, such as ethnicity or sexual identity, which also play an important role. Our study also cannot tell us whether or not camouflaging is the cause of poor mental health, only that there is a relationship between camouflaging and mental health. How will these findings help autistic adults now or in the future?By studying camouflaging in different groups and seeing what is shared and what is unique between autistic and nonautistic people, we can develop a better understanding of camouflaging. Knowledge of the mental health consequences of camouflaging can help mental health services to reduce the negative impact of camouflaging for autistic and nonautistic people. Our findings also show an important similarity between autistic and nonautistic people, showing that both groups of people may camouflage, and this negatively impacts mental health. Acknowledgment of this shared experience may help to reduce the discrimination and stigma that autistic people face.