Fake It Till It Hurts

Wendy Wu ’22

Figure 1 Autistic individuals tend to mask their autism which has been associated with mental health disorders.

Studies have shown that individuals with autism spectrum disorder have a higher risk of developing mental health issues. Despite these difficulties, the causes of mental health problems in autistic people are poorly understood. Importantly, risks of mental health issues for autistic people are different from those of non-autistic populations. Laura Hull, a postdoctoral researcher at East London NHS Foundation Trust, sought to study one such autism-specific risk factor: social camouflaging. Autistic people use social camouflaging to mask their autism in social situations. This behavior, however, is linked to mental health risks. 

Researchers recruited 305 participants with official autism diagnosis from the Cambridge Autism Research Database as well as from social media and adverts spread by autism charities. In their literature research, Hull et. al found there were gender differences regarding mental health in autistic adults. In order to control for the effect of gender on the relationship between camouflaging behaviors and mental health, participants were asked their gender identity. Analyses were performed based on self-identified gender instead of assigned gender. Participants were also asked to complete a series of self-report questionnaires. These questionnaires, like the Camouflaging of Autistic Traits Questionnaire and the Social Anxiety Scale, measured the extent of a participant’s camouflaging behavior as well as quantified their mental health problems, if any. The researchers then used hierarchical linear regression to analyze the relationships between gender, camouflaging, and mental health. 

No significant associations between gender and camouflaging behavior were noted. Although the team could not determine a causative relationship between camouflaging behavior and mental health, they nonetheless found a strong correlation between the two. Greater camouflaging scores predicted greater mental health issues, particularly, generalised social anxiety. Hull et. al explains that camouflaging is not only exhausting, but also lowers self-esteem and increases suicidal ideations; participants felt they cannot be accepted as they are. Thus, Hull et. al suggests that autistic individuals showing camouflaging behavior should undergo a mental health assessment. Because this was a cross-sectional study, causal relationships could not be confirmed. Future studies should be conducted in a clinical setting and track participants’ behavior and mental health over time. 

Works Cited:

[1] L. Hull, et. al, Is social camouflaging associated with anxiety and depression in autistic adults? Molecular Autism 12, (2021). doi: 10.1186/s13229-021-00421-1.

[2] Image retrieved from: https://commons.wikimedia.org/wiki/File:Autism_Aspect_Masking_1.png


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