Laura Hull1, Lily Levy1,2, Meng-Chuan Lai3,4,5, K V Petrides6, Simon Baron-Cohen4, Carrie Allison4, Paula Smith4, Will Mandy7. 1. Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. 2. Homerton University Hospital NHS Foundation Trust, London, UK. 3. Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Toronto, Canada. 4. Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK. 5. Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. 6. London Psychometrics Laboratory, University College London, London, UK. 7. Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. w.mandy@ucl.ac.uk.
Abstract
BACKGROUND: There is inconsistent evidence for a clear pattern of association between 'camouflaging' (strategies used to mask and/or compensate for autism characteristics during social interactions) and mental health. METHODS: This study explored the relationship between self-reported camouflaging and generalised anxiety, depression, and social anxiety in a large sample of autistic adults and, for the first time, explored the moderating effect of gender, in an online survey. RESULTS: Overall, camouflaging was associated with greater symptoms of generalised anxiety, depression, and social anxiety, although only to a small extent beyond the contribution of autistic traits and age. Camouflaging more strongly predicted generalised and social anxiety than depression. No interaction between camouflaging and gender was found. LIMITATIONS: These results cannot be generalised to autistic people with intellectual disability, or autistic children and young people. The sample did not include sufficient numbers of non-binary people to run separate analyses; therefore, it is possible that camouflaging impacts mental health differently in this population. CONCLUSIONS: The findings suggest that camouflaging is a risk factor for mental health problems in autistic adults without intellectual disability, regardless of gender. We also identified levels of camouflaging at which risk of mental health problems is highest, suggesting clinicians should be particularly aware of mental health problems in those who score at or above these levels.
BACKGROUND: There is inconsistent evidence for a clear pattern of association between 'camouflaging' (strategies used to mask and/or compensate for autism characteristics during social interactions) and mental health. METHODS: This study explored the relationship between self-reported camouflaging and generalised anxiety, depression, and social anxiety in a large sample of autistic adults and, for the first time, explored the moderating effect of gender, in an online survey. RESULTS: Overall, camouflaging was associated with greater symptoms of generalised anxiety, depression, and social anxiety, although only to a small extent beyond the contribution of autistic traits and age. Camouflaging more strongly predicted generalised and social anxiety than depression. No interaction between camouflaging and gender was found. LIMITATIONS: These results cannot be generalised to autistic people with intellectual disability, or autistic children and young people. The sample did not include sufficient numbers of non-binary people to run separate analyses; therefore, it is possible that camouflaging impacts mental health differently in this population. CONCLUSIONS: The findings suggest that camouflaging is a risk factor for mental health problems in autistic adults without intellectual disability, regardless of gender. We also identified levels of camouflaging at which risk of mental health problems is highest, suggesting clinicians should be particularly aware of mental health problems in those who score at or above these levels.
Entities:
Keywords:
Adults; Camouflaging; Gender; Mental health
Authors: T Hirvikoski; M Boman; Q Chen; B M D'Onofrio; E Mittendorfer-Rutz; P Lichtenstein; S Bölte; H Larsson Journal: Psychol Med Date: 2019-06-26 Impact factor: 7.723
Authors: Meng-Chuan Lai; Caroline Kassee; Richard Besney; Sarah Bonato; Laura Hull; William Mandy; Peter Szatmari; Stephanie H Ameis Journal: Lancet Psychiatry Date: 2019-08-22 Impact factor: 27.083