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For autistic adults, hiding or suppressing traits to fit in with social expectations is often linked to higher rates of depression and distress. A recent study published in Autism Research reveals that these negative mental health outcomes may actually be driven by underlying social anxiety and social challenges, rather than the act of camouflaging itself. The findings suggest that current psychological questionnaires might be measuring overlapping concepts, pointing to a need for more precise tools to understand autistic well-being.
Autism is a neurodevelopmental condition characterized by differences in social communication, interaction, and sensory processing. Many autistic individuals use a coping strategy known as camouflaging to navigate social environments. This practice involves suppressing natural behaviors, such as avoiding eye contact or repetitive physical movements, while mimicking the speech patterns and gestures of people who are not autistic.
Psychologists divide camouflaging into three distinct categories. Compensation involves actively developing techniques to manage social interactions, such as practicing scripted conversations. Masking refers to deliberate efforts to hide autistic traits. Assimilation involves adapting behaviors to blend into a group, often by avoiding situations where differences might be noticed.
People camouflage for various reasons, including a desire to avoid discrimination, reduce stigma, and foster a sense of belonging in social groups. This effort often comes at a high personal cost. Previous research has consistently linked camouflaging to physical exhaustion, identity confusion, and elevated rates of depression and anxiety.
These established associations prompted researchers to ask a more specific question. Bruna B. Roisenberg, a researcher at the University of Sydney, along with senior author Adam J. Guastella and their colleagues, wanted to know if camouflaging independently predicts poor mental health. They suspected that the negative outcomes often attributed to camouflaging might actually stem from overlapping issues, such as social anxiety or broader difficulties with social responsiveness.
Social anxiety involves an intense fear of being judged or evaluated negatively in social situations. Social responsiveness refers to how an individual perceives, interprets, and reacts to social cues. The researchers theorized that because camouflaging involves intense self-monitoring and a fear of negative evaluation, it shares many fundamental features with social anxiety.
To investigate this relationship, the research team analyzed data from 113 autistic adults. The participants ranged in age from 17 to 75. All of them were experiencing social anxiety and had expressed interest in receiving therapeutic interventions for their anxiety symptoms.
The participants completed a series of standardized questionnaires. These surveys measured their levels of camouflaging, social anxiety, and social responsiveness. The participants also completed assessments evaluating their current levels of depression, psychological distress, and daily disability.
In addition to these mental health metrics, the researchers assessed the participants’ overall quality of life. This evaluation covered four distinct areas. The surveys measured physical health, psychological well-being, the quality of social relationships, and environmental factors like access to resources and daily safety.
The researchers used a statistical method called hierarchical regression to evaluate the data. This technique allowed them to test the variables in a step-by-step manner. By controlling for basic demographic factors like age and sex assigned at birth, they could observe the isolated effects of social responsiveness, social anxiety, and finally, camouflaging.
The goal was to see if camouflaging added any unique explanatory power to the mental health outcomes. If camouflaging was an independent driver of poor mental health, it would predict higher levels of depression or distress even after the other variables were taken into account.
The results told a different story. In the initial analyses, camouflaging was indeed associated with greater psychological distress, more severe depression, and increased disability. Those who reported higher levels of masking their traits also reported worse overall mental health.
This relationship vanished in the step-by-step statistical models. The researchers found that social responsiveness and social anxiety strongly predicted depression, psychological distress, and disability. Once the models accounted for these two factors, camouflaging did not explain any additional differences in the participants’ mental health.
The same pattern emerged when looking at quality of life. Higher levels of social anxiety and social challenges were associated with a lower quality of life. Camouflaging provided no independent predictive value for a person’s physical health, psychological well-being, social relationships, or environmental satisfaction.
The findings held true even when the researchers broke down camouflaging into its specific components. None of the individual strategies, compensation, masking, or assimilation, independently predicted negative mental health outcomes beyond the effects of social anxiety and social impairments.
The results imply that the questionnaires currently used to measure camouflaging might be capturing the same psychological processes as tools used to measure social anxiety. Because both concepts involve a heightened focus on how one is perceived by others, they are difficult to untangle with standard surveys. The emotional and functional costs attributed to camouflaging may largely reflect a broader fear of negative evaluation.
The study provides an updated perspective on how autistic adults experience mental health challenges, but it relies on cross-sectional data. This means the researchers measured all variables at a single point in time. Because of this design, the study cannot determine whether social anxiety leads to increased camouflaging, or if the effort of camouflaging exacerbates social anxiety.
The researchers also noted that the study relied entirely on self-reported questionnaires. This type of data can be influenced by a participant’s level of self-awareness or their interpretation of the questions. Relying solely on self-reporting increases the likelihood that overlapping concepts will blend together in the final data.
The study participants were all actively seeking treatment for social anxiety, which means the group may not represent the broader autistic population. Autistic individuals who do not experience high levels of social anxiety, or who are not actively seeking mental health support, might exhibit different patterns of well-being.
Future research will need to track autistic individuals over extended periods to see how camouflaging and mental health interact as people age. Expanding the ways in which researchers measure camouflaging, perhaps through observational methods or interviews, could help isolate its specific effects on an individual’s quality of life.
The study, “Does Camouflaging Predict Functioning, Distress, and Quality of Life for Autistic Adults?” was authored by Bruna B. Roisenberg, Kelsie A. Boulton, Emma E. Thomas, and Adam J. Guastella.