Social Camouflaging in Adolescence: Are There Differences across Sex?

Background: Social camouflaging is hypothesized to be used by individuals on the autism spectrum as means of masking or compensating for their autistic traits (Hull et al., 2017). Results from existing research suggest that autistic females may be more likely to engage in social camouflaging, and that it may have a negative impact on their mental health and well-being. However, much of this research is qualitative and few quantitative studies have sought to examine these hypotheses. In addition, few studies have included analysis of camouflaging in neurotypical (NT) populations.

Objectives: The aim of this pilot study is to compare levels of camouflaging and internalizing symptomology in autistic and NT adolescent males and females. The following research questions were addressed: Do autistic and NT males and females report different levels of camouflaging? Do autistic and NT males and females report different reasons for and consequences of camouflaging? Do autistic and NT males and females report different levels of internalizing symptoms?

Methods: 84 adolescents ages 13-18 years completed an online survey including the Camouflaging Autistic Traits Questionnaire (CAT-Q; Hull et al., 2018), Subthreshold Autism Traits Questionnaire (SAT-Q; Kanne et al., 2012), and Depression, Anxiety, and Stress Scales-21 (DASS-21; Lovibond & Lovibond, 1995). Twenty-five participants were on the autism spectrum (14 females and 11 males) and 59 were NT (34 females and 25 males). In addition, 9 adolescents on the autism spectrum and 8 NT adolescents completed follow-up interviews. The interviews were conducted to obtain richer information about participant motivations for and consequences of camouflaging.

Results: Autistic females report the highest levels of camouflaging (M=87.23, SD=21.58), followed by NT females (M=76.75, SD=21.23). Autistic males (M=70.91, SD=20.99l) and NT males (M=70.91, SD=22.95) report the same level of camouflaging. Trends have also emerged in the subscales of the CAT-Q. Autistic females report the highest levels of anxiety, while autistic males report the highest levels of depression and stress. Trends are also emerging in the interview data, with most participants describing camouflaging to some degree, but females on the autism spectrum reporting it to be more necessary, difficult, and exhausting than other participants.

Conclusions: The preliminary results of this study support and add to the existing literature. Females on the autism spectrum report the highest levels of camouflaging and the most detrimental effects. While camouflaging may be beneficial for all groups in some social situations, the negative effects these behaviors can have on well-being suggest that they may also be problematic. Further analyses of this data will (a) examine whether scores on the CAT-Q are associated with scores on the DASS-21 and (b) compare participant groups on subscales of the CAT-Q (compensation, masking, and assimilation).