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Cited by 90Autism Spectrum Disorder ResearchFamily and Disability Support ResearchPsychology and Mental Health

Psychosocial factors associated with camouflaging in autistic people and its relationship with mental health and well-being: A mixed methods systematic review

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Zhuang, Sici, Tan, Diana Weiting, Reddrop, Susan, Dean, Lydia, Maybery, Murray, Magiati, Iliana·2023·Clinical Psychology Review
DOI 10.1016/j.cpr.2023.102335
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Abstract

Camouflaging involves hiding one's autistic characteristics in social situations. This mixed methods systematic review synthesized research on psychosocial factors associated with camouflaging and its relationship with mental well-being. Six databases were searched. The 58 included studies (40 qualitative, 13 quantitative, five mixed methods), encompassed 4808 autistic and 1780 non-autistic participants, and predominantly featured White, female, and late-diagnosed autistic adults with likely at least average intellectual and/or verbal abilities. Following a convergent integrated approach, quantitative data were transformed and synthesized with qualitative data for thematic synthesis. We identified three themes on psychosocial correlates of camouflaging: (1) social norms and pressures of a largely non-autistic world, (2) social acceptance and rejection, and (3) self-esteem and identity; and four themes on psychosocial consequences of camouflaging for well-being: (1) a pragmatic way of exerting individual agency and control; (2) overlooked, under-supported, and burnt out; (3) impact on social relationships; and (4) low self-esteem and identity confusion. Camouflaging emerges as primarily a socially motivated response linked to adverse psychosocial outcomes. A whole society approach towards acceptance and support for autistic individuals to express their authentic selves is needed. Future studies examining psychosocial influences on camouflaging should include participants who m…

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  • Social camouflaging is a known risk factor for depression, generalised and social anxiety, autistic burnout, stress, lower self-esteem, diminished authenticity, and poorer mental health outcomes.

    “Social camouflaging is a known risk factor for developing conditions such as depression, generalised and social anxiety, autistic burnout, as well as stress, lower self-esteem, diminished authenticity, and poorer mental health outcomes (Field et al., 2024;Zhuang et al., 2023).”

    From Rethinking psychological interventions in autism: Toward a neurodiversity‐affirming approach. (2025) · cites this paper as Zhuang et al., 2023

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Authors
Zhuang, S., Tan, D. W., Reddrop, S., Dean, L., Maybery, M., & Magiati, I.
Affiliations
The University of Western Australia (AU)
Corresponding author
Zhuang, Sici
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2023-11
Volume
105
Pages
102335
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2023.102335
OpenAlex
W4386701157
Cited by
90
References
122
Citations by year
2026: 38 · 2025: 32 · 2024: 20
FWCI
3.33
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Psychology Review (publishedVersion, cc-by)
  • UWA Profiles and Research Repository (UWA) (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Macquarie University (MQRF0001113)
  • University of Western Australia
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
  • Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Keywords
camouflaging, autism spectrum disorder, psychosocial factors, mental health, well-being, social acceptance, social rejection, self-esteem, autistic identity, social norms, burnout, interpersonal relationships, authenticity, autistic adults
MeSH terms
Autistic Disorder, Humans, Interpersonal Relations, Mental Health, Self Concept, Psychological Distance

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