Camouflaging Autistic Traits Questionnaire: Cultural Adaptation, Reliability, and Validity in Autistic and Non-Autistic from Spain

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Zubizarreta, S. C. P., Lois Mosquera, M., Fungueiriño, M. T., Navarro, M. A., Hull, L., Carracedo, A., Gafo, B. G., & Prieto, M. F. (2025). Camouflaging Autistic Traits Questionnaire: Cultural Adaptation, Reliability, and Validity in Autistic and Non-Autistic from Spain. Autism in Adulthood. https://doi.org/10.1089/aut.2024.0003

Publication date: 29 Apr 2025 Added to AutiHub: 7 Aug 2026 Type: Article Article language: English
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Authors

Publication authors
8
Publication authors identified as autistic
1 / 8 (12.5%)
  1. Sabela Conde-Pumpido Zubizarreta
  2. Miguel Lois Mosquera *
  3. María Tubío Fungueiriño
  4. María Alemany Navarro
  1. Laura Hull
  2. Angel Carracedo
  3. Berta Gándara Gafo
  4. Montse Fernández Prieto

Abstract

Background: Researchers have proposed that camouflaging contributes to delayed or absent diagnosis and mental health problems in autistic individuals. Therefore, there is a need for validated measures of this construct. This study aimed to culturally adapt the Camouflaging Autistic Traits Questionnaire (CAT-Q) for the Spanish population (Spain) and assess its psychometric properties, addressing the need for camouflage assessment tools in Spain. Methods: We conducted a cultural adaptation process, which involved direct-back translation and pretest with autistic individuals. We tested internal consistency, test–retest reliability, construct validity, including structural validity (confirmatory factor analysis), measure invariance, and hypothesis testing for construct validity with a larger sample of 490 participants, including 379 non-autistic individuals and 111 autistic individuals. We assessed a subsample of 32 non-autistic participants for test–retest reliability. Results: The cultural adaptation process yielded the CAT-Q–Spanish version (ES), culturally adapted for the Spanish population. Autistic volunteers identified minor comprehension issues in three items and the researchers revised them. The CAT-Q-ES showed excellent internal consistency among non-autistic (McDonald’s omega [ω] = 0.95) and autistic individuals (ω = 0.89). The subscales (Compensation, Masking, Assimilation) demonstrated internal consistencies ranging from adequate to excellent. Test–retest reliability showed a strong relationship (r = 0.99, p < 0.001). Associations between CAT-Q-ES scores and related constructs, including autistic traits, and symptoms of anxiety and depression confirmed its validity, with autistic individuals scoring higher on the test. Conclusion: The CAT-Q-ES is conceptually and semantically equivalent to the original instrument, offering a valid and reliable measure of camouflage for Spanish adults. These findings enhance the assessment and understanding of camouflage within the Spanish context, addressing a crucial gap in the field.

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Cited references
69
Total cited references integrated for this publication.
Cited references with an identified autistic author
5 / 69 (7.2%)
Cited author occurrences identified as autistic
7 / 349 (2.0%)
Among occurrences linked to AutiHub author records: 7 / 125 (5.6%). Distinct cited authors identified as autistic: 6 / 298 (2.0%).
Cited author occurrences linked to AutiHub author records
125 / 349 (35.8%)
Distinct linked cited authors: 79 / 298 (26.5%)
Linked cited-author occurrences not identified as autistic
118 / 125 (94.4%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 118 / 349 (33.8%). Distinct linked cited authors not identified as autistic: 73 / 79 (92.4%).
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