Social camouflaging and mental health in adolescence: differences by sex and diagnosis

Abstract

Camouflaging is a term used to describe the set of strategies that autistic individuals use to hide or mask autistic traits. Importantly, nonautistic individuals can also camouflage, as autistic traits are distributed throughout the general population. Some studies suggest that autistic females camouflage more than autistic males, and many studies have found that camouflaging is negatively associated with mental health and wellbeing in autistic individuals. However, research in this area has mainly focused on adults and has included few comparisons between autistic and nonautistic individuals. The goals of the two studies included in this thesis were to 1) compare levels of camouflaging by sex and diagnosis in autistic and neurotypical adolescents and 2) to examine age, sex, autism diagnosis, and camouflaging as predictors of depression, anxiety, and stress levels in autistic and non-autistic adolescents. The first study found that females reported higher levels of camouflaging when not accounting for age, but that an age-by-diagnosis interaction effect emerged. This interaction showed that older nonautistic adolescents reported significantly higher levels of camouflaging than younger nonautistic adolescents, but the reported camouflaging levels of older and younger autistic adolescents did not differ significantly across the age groups. Findings of the second study suggest that level of camouflaging is an important predictor of depression, anxiety, and stress in autistic and non-autistic adolescents and that camouflaging may be particularly distressing for females, regardless of diagnosis. These findings inform our understanding of camouflaging, how it may develop differently across autistic and nonautistc individuals, and its consequences in adolescence.