Camouflaging in autism: A cause or a consequence of mental health difficulties?

IF 5.2 2区 心理学 Q1 PSYCHOLOGY, DEVELOPMENTAL
Autism Pub Date : 2025-06-28 DOI:10.1177/13623613251347104
Wikke J van der Putten, Audrey Jj Mol, Tulsi A Radhoe, Carolien Torenvliet, Joost A Agelink van Rentergem, Annabeth P Groenman, Hilde M Geurts
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引用次数: 0

Abstract

Camouflaging ([un]consciously hiding one's autism traits) is hypothesized to be an underlying mechanism explaining elevated levels of mental health difficulties in autistic adults. As previous studies investigating this relationship were all cross-sectional, the direction of this association remains unclear. Therefore, we investigated whether (1) camouflaging predicts a change in mental health difficulties and (2) mental health difficulties predict a change in camouflaging. For this, 332 autistic adults aged 30 to 84 years (157 women) filled in the Dutch Camouflaging Autistic Traits Questionnaire, Symptom Checklist-90 Revised, and Autism Spectrum Quotient at two timepoints with an average time interval of 2 years. Preregistered multilevel analyses showed a negative interaction between initial camouflaging and time, indicating that people with higher initial levels of camouflaging showed a decrease in mental health difficulties, while for lower initial levels of camouflaging there was an increase. However, this effect was small. Initial mental health difficulties did not predict changes in camouflaging behavior, but findings were inconsistent across total camouflaging and assimilation. Thus, we did not find strong evidence for camouflaging to be associated with development of mental health difficulties. However, future research is needed before we can draw strong conclusions about directionality and causality.Plain Language SummaryWhen autistic people use strategies to hide their autism traits, we refer to this as camouflaging. It has been thought that camouflaging could be a reason why autistic people develop mental health difficulties more often than non-autistic people. Research has shown that, in general, people who report more camouflaging behavior also report more mental health difficulties. However, we do not know whether camouflaging can be a reason for people to develop mental health difficulties or whether mental health difficulties may explain why autistic people use camouflaging strategies. Therefore, in this study we investigated whether (1) camouflaging is a predictor for a change in mental health difficulties and (2) mental health difficulties are a predictor for a change in camouflaging. For this study, 332 autistic adults aged 30 to 84 years (157 women) filled in questionnaires about camouflaging, mental health difficulties, and autism traits at two moments with an average of 2 years between measurements. We found that people with a higher level of initial camouflaging showed a decrease in mental health difficulties, while for people with lower levels of initial camouflaging behavior there was an increase in mental health difficulties. However, this effect was small. Initial mental health difficulties did not seem to predict a change in camouflaging behavior. Thus, we did not find evidence that camouflaging was followed by an increase in mental health difficulties. Therefore, future research is needed before we can draw strong conclusions about what comes first and what causes what, camouflaging or mental health.

自闭症的伪装:心理健康问题的原因还是结果?
伪装(有意识地隐藏一个人的自闭症特征)被假设为解释自闭症成年人心理健康问题水平升高的潜在机制。由于之前调查这种关系的研究都是横断面的,因此这种关联的方向仍不清楚。因此,我们研究了(1)伪装能否预测心理健康困难的变化,(2)心理健康困难能否预测伪装的变化。为此,332名年龄在30岁至84岁之间的自闭症成年人(157名女性)在平均间隔2年的两个时间点填写了荷兰伪装自闭症特征问卷、症状检查表-90修订版和自闭症谱系商数。预先登记的多层次分析显示,初始伪装与时间之间存在负相互作用,表明初始伪装水平较高的人的心理健康问题有所减少,而初始伪装水平较低的人的心理健康问题有所增加。然而,这种影响很小。最初的心理健康困难不能预测伪装行为的变化,但在完全伪装和同化方面的发现是不一致的。因此,我们没有发现强有力的证据表明伪装与心理健康问题的发展有关。然而,在我们对方向性和因果关系得出强有力的结论之前,还需要进一步的研究。当自闭症患者使用策略来隐藏他们的自闭症特征时,我们称之为伪装。人们一直认为,伪装可能是自闭症患者比非自闭症患者更容易出现心理健康问题的原因之一。研究表明,一般来说,有更多伪装行为的人也有更多的心理健康问题。然而,我们不知道伪装是否可以成为人们产生心理健康问题的原因,或者心理健康问题是否可以解释为什么自闭症患者使用伪装策略。因此,在本研究中,我们调查了(1)伪装是心理健康困难变化的预测因子,(2)心理健康困难是伪装变化的预测因子。在这项研究中,332名年龄在30到84岁之间的自闭症成年人(157名女性)填写了关于伪装、心理健康问题和自闭症特征的问卷,问卷间隔平均为2年。我们发现,初始伪装水平较高的人心理健康困难减少,而初始伪装行为水平较低的人心理健康困难增加。然而,这种影响很小。最初的心理健康问题似乎并不能预测伪装行为的改变。因此,我们没有发现证据表明伪装会增加心理健康问题。因此,在我们能够就伪装或心理健康孰先孰后得出强有力的结论之前,还需要进行进一步的研究。
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来源期刊
Autism
Autism PSYCHOLOGY, DEVELOPMENTAL-
CiteScore
9.80
自引率
11.50%
发文量
160
期刊介绍: Autism is a major, peer-reviewed, international journal, published 8 times a year, publishing research of direct and practical relevance to help improve the quality of life for individuals with autism or autism-related disorders. It is interdisciplinary in nature, focusing on research in many areas, including: intervention; diagnosis; training; education; translational issues related to neuroscience, medical and genetic issues of practical import; psychological processes; evaluation of particular therapies; quality of life; family needs; and epidemiological research. Autism provides a major international forum for peer-reviewed research of direct and practical relevance to improving the quality of life for individuals with autism or autism-related disorders. The journal''s success and popularity reflect the recent worldwide growth in the research and understanding of autistic spectrum disorders, and the consequent impact on the provision of treatment and care. Autism is interdisciplinary in nature, focusing on evaluative research in all areas, including: intervention, diagnosis, training, education, neuroscience, psychological processes, evaluation of particular therapies, quality of life issues, family issues and family services, medical and genetic issues, epidemiological research.
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