Cited by 339Autism Spectrum Disorder ResearchFamily and Disability Support ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Is social camouflaging associated with anxiety and depression in autistic adults?

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Hull, Laura, Levy, Lily, Lai, Meng-Chuan, Petrides, K. V., Baron-Cohen, Simon, Allison, Carrie, Smith, Paula, Mandy, Will·2021·Molecular Autism

DOI 10.1186/s13229-021-00421-1PMC PMC7885456

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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.

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Authors: Hull, L., Levy, L., Lai, M.-C., Petrides, K. V., Baron-Cohen, S., Allison, C., Smith, P., & Mandy, W.
Affiliations: University College London (GB)
Homerton University Hospital NHS Foundation Trust (GB)
Centre for Addiction and Mental Health (CA)
University of Cambridge (GB)
ORCID: Hull, Laura
Lai, Meng-Chuan
Petrides, K. V.
Baron-Cohen, Simon
Allison, Carrie
Smith, Paula
Mandy, Will
Venue: Molecular Autism
Publisher: Springer Science and Business Media LLC
Published: 2021-02-16
Volume: 12
Issue: 1
Pages: 13-13
ISSN: 2040-2392 (ISSN-L)
DOI: 10.1186/s13229-021-00421-1
PMC: PMC7885456
OpenAlex: W3132619758
Cited by: 337
References: 65
Citations by year: 2026: 69 · 2025: 74 · 2024: 81 · 2023: 59 · 2022: 34 · 2021: 19
FWCI: 25.63
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Molecular Autism (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Explore Bristol Research (publishedVersion, cc-by)
TSpace (University of Toronto) (submittedVersion, cc-by)
Apollo (University of Cambridge) (submittedVersion, cc-by)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
UCL Discovery (University College London) (submittedVersion)
Bristol Research (University of Bristol) (submittedVersion, cc-by)
Apollo (cc-by)
Funders: Medical Research Council (RG46450)
Wellcome Trust (RG58828)
Innovative Medicines Initiative 2 Joint Undertaking (777394)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: social camouflaging, autism spectrum disorder, autistic adults, anxiety, depression, social anxiety, mental health, gender differences, autistic traits, masking, intellectual disability
MeSH terms: Adolescent, Adult, Aged, Anxiety, Autistic Disorder, Depression, Disease Susceptibility, Female, Humans, Male, Mental Health, Middle Aged, Surveys and Questionnaires, Social Behavior, Young Adult, Self Report, Public Health Surveillance

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Is social camouflaging associated with anxiety and depression in autistic adults?

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