The Associations Between Camouflaging, Autistic Traits, and Mental Health in Nonautistic Adults

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Somerville, M., MacPherson, S. E., & Fletcher-Watson, S. (2023). The Associations Between Camouflaging, Autistic Traits, and Mental Health in Nonautistic Adults. Autism in Adulthood, 6(1), 106-113. https://doi.org/10.1089/aut.2023.0018

Publication date: 5 Jul 2023 Added to AutiHub: 17 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
3
Publication authors identified as autistic
1 / 3 (33.3%)
  1. Mark Somerville *
  2. Sarah E. MacPherson
  3. Sue Fletcher-Watson

Abstract

Background: Camouflaging is frequently reported in autistic people and entails the disguising of autistic traits in social situations. Camouflaging is associated with poor mental health in autistic people. This study examined the manifestation of camouflaging in a nonautistic sample, examining the relationship between autistic traits, self-reported camouflaging, gender, and mental health. Method: In total 110 nonautistic adults completed standardized self-report questionnaires that measured autistic traits, mental health symptoms, and camouflaging behaviors. Hierarchical multiple linear regression models were used to analyze data and examine the unique contributions of autistic traits and camouflaging to mental health. Results: Self-reported autistic traits were associated with increased symptoms of poor mental health. However, autistic traits were not associated with mental health symptoms when controlling for self-reported camouflaging, and self-reported camouflaging predicted increased mental health symptoms over and above the effects of autistic traits. Women had poorer mental health than men in our sample, and in women there was a stronger relationship between camouflaging and mental health than in men. Conclusions: Camouflaging may contribute to poor mental health outcomes in the general population, just as it does for autistic people, to the extent that camouflaging more clearly relates to mental health profile than self-reported autism traits. This suggests camouflaging is an important construct for understanding mental health in general, and for exploring the complex relationship between autism and autistic traits.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 20 Sep 2026 01:01.

Cited references
59
With a DOI
51
Without a DOI, from raw bibliography text
8
8 / 59 (13.6%) cited references include at least one author identified as autistic.
References with data to complete
6 / 59 (10.2%)
References with detected author names
57 / 59 (96.6%)
Without detected author names
2
Without a structured title
6
Without a stable identifier
8
References with raw author names still to review
2
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
167
From DOI or external metadata
167
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
2
69 / 167 (41.3%) names are linked to an author already present in AutiHub. 98 / 167 (58.7%) names are not yet linked.
Names linked to a person identified as autistic
9 / 167 (5.4%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 9 / 69 (13.0%). Distinct people identified as autistic: 7 / 144 (4.9%).
  1. Heather Westwood , Ivan Eisler , Will Mandy , Jenni Leppanen , Janet Treasure , Kate Tchanturia (2016). Using the Autism-Spectrum Quotient to Measure Autistic Traits in Anorexia Nervosa: A Systematic Review and Meta-Analysis . Journal of Autism and Developmental Disorders, 46(3), 964-977. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-015-2641-0 OpenAlex: https://openalex.org/W1960334827
    Crossref OpenAlex OpenCitations
  2. Simon Baron-Cohen (2009). Autism: The Empathizing–Systemizing (E‐S) Theory . Annals of the New York Academy of Sciences, 1156(1), 68-80. Wiley.
    Type: Article DOI: 10.1111/j.1749-6632.2009.04467.x OpenAlex: https://openalex.org/W2028758511
    Crossref OpenAlex OpenCitations
  3. Felicity Sedgewick , Vivian Hill , Rhiannon Yates , Leanne Pickering , Elizabeth Pellicano (2016). Gender Differences in the Social Motivation and Friendship Experiences of Autistic and Non-autistic Adolescents . Journal of Autism and Developmental Disorders, 46(4), 1297-1306. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-015-2669-1 OpenAlex: https://openalex.org/W2199714476
    Crossref OpenAlex OpenCitations
  4. DANIEL S. PINE , AMANDA E. GUYER , MICHELLE GOLDWIN , KENNETH A. TOWBIN , ELLEN LEIBENLUFT (2008). Autism Spectrum Disorder Scale Scores in Pediatric Mood and Anxiety Disorders . Journal of the American Academy of Child & Adolescent Psychiatry, 47(6), 652-661. Elsevier BV.
    Type: Article DOI: 10.1097/chi.0b013e31816bffa5 OpenAlex: https://openalex.org/W1966977185
    Crossref OpenAlex OpenCitations
  5. Coralie Chevallier , Gregor Kohls , Vanessa Troiani , Edward S. Brodkin , Robert T. Schultz (2012). The social motivation theory of autism . Trends in Cognitive Sciences, 16(4), 231-239. Elsevier BV.
    Type: Article DOI: 10.1016/j.tics.2012.02.007 OpenAlex: https://openalex.org/W2091028497
    Crossref OpenAlex OpenCitations
  6. John E. Pachankis (2007). The psychological implications of concealing a stigma: A cognitive-affective-behavioral model. Psychological Bulletin, 133(2), 328-345. American Psychological Association (APA).
    Type: Article DOI: 10.1037/0033-2909.133.2.328 OpenAlex: https://openalex.org/W1992657881
    Crossref OpenAlex OpenCitations
  7. Yael Kimhi (2014). Theory of Mind Abilities and Deficits in Autism Spectrum Disorders . Topics in Language Disorders, 34(4), 329-343. Ovid Technologies (Wolters Kluwer Health).
    Type: Article DOI: 10.1097/tld.0000000000000033 OpenAlex: https://openalex.org/W2002722895
    Crossref OpenAlex OpenCitations
  8. P.F. Lovibond , S.H. Lovibond (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories . Behaviour Research and Therapy, 33(3), 335-343. Elsevier BV.
    Type: Article DOI: 10.1016/0005-7967(94)00075-u OpenAlex: https://openalex.org/W2141674457
    Crossref OpenAlex OpenCitations
  9. Neil Brewer , Robyn L. Young , Emily Barnett (2017). Measuring Theory of Mind in Adults with Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 47(7), 1927-1941. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-017-3080-x OpenAlex: https://openalex.org/W2591658426
    Crossref OpenAlex OpenCitations
  11. Winnie Yu Pow Lau , Adrian B. Kelly , Candida Peterson (2013). Further Evidence on the Factorial Structure of the Autism Spectrum Quotient (AQ) for Adults With and Without a Clinical Diagnosis of Autism . Journal of Autism and Developmental Disorders, 43(12), 2807-2815. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-013-1827-6 OpenAlex: https://openalex.org/W2008465991
    Crossref OpenAlex OpenCitations
  12. Sue Fletcher-Watson , Susan Leekam , John M. Findlay (2013). Social Interest in High-Functioning Adults With Autism Spectrum Disorders . Focus on Autism and Other Developmental Disabilities, 28(4), 222-229. SAGE Publications.
    Type: Article DOI: 10.1177/1088357613480829 OpenAlex: https://openalex.org/W2037993886
    Crossref OpenAlex OpenCitations
  13. Francisca J. A. van Steensel , Susan M. Bögels , Jeffrey J. Wood (2013). Autism Spectrum Traits in Children with Anxiety Disorders . Journal of Autism and Developmental Disorders, 43(2), 361-370. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-012-1575-z OpenAlex: https://openalex.org/W2107623226
    Crossref OpenAlex OpenCitations
  14. Jaswal VK (2019). Being vs . Appearing socially uninterested: Challenging assumptions about social motivation in autism. Behav Brain Sci, 42(82), 1.
    Type: Other
    Crossref
  15. Siobhan Tierney , Jan Burns , Elizabeth Kilbey (2016). Looking behind the mask: Social coping strategies of girls on the autistic spectrum . Research in Autism Spectrum Disorders, 23(Suppl. C), 73-83. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2015.11.013 OpenAlex: https://openalex.org/W2252057154
    Crossref OpenAlex OpenCitations
  16. Sue Fletcher-Watson , Geoffrey Bird (2020). Autism and empathy: What are the real links? Autism, 24(1), 3-6. SAGE Publications.
    Type: Article DOI: 10.1177/1362361319883506 OpenAlex: https://openalex.org/W2977702811
    Crossref OpenAlex OpenCitations
  17. Ellen D. B. Riggle , Sharon S. Rostosky , Whitney W. Black , Danielle E. Rosenkrantz (2017). Outness, concealment, and authenticity: Associations with LGB individuals’ psychological distress and well-being. Psychology of Sexual Orientation and Gender Diversity, 4(1), 54-62. American Psychological Association (APA).
    Type: Article DOI: 10.1037/sgd0000202 OpenAlex: https://openalex.org/W2522694007
    Crossref OpenAlex OpenCitations
  18. Ainslie Rosbrook , Koa Whittingham (2010). Autistic traits in the general population: What mediates the link with depressive and anxious symptomatology? Research in Autism Spectrum Disorders, 4(3), 415-424. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2009.10.012 OpenAlex: https://openalex.org/W2047719012
    Crossref OpenAlex OpenCitations
  19. Milton DEM (2012). Milton DEM. On the ontological status of autism: The “double empathy problem.” Disabil Soc. 2012;27(6):883–887. https://doi.org/10 . 1080/09687599. 2012. 710008. Disabil Soc.
    Type: Other
    Crossref
  20. Patricia H. Kloosterman , Kateryna V. Keefer , Elizabeth Kelley , Laura J. Summerfeldt , James D.A. Parker (2011). Evaluation of the factor structure of the Autism-Spectrum Quotient . Personality and Individual Differences, 50(2), 310-314. Elsevier BV.
    Type: Article DOI: 10.1016/j.paid.2010.10.015 OpenAlex: https://openalex.org/W2059386717
    Crossref OpenAlex OpenCitations
  21. Shi Min Liew , Nishta Thevaraja , Ryan Y. Hong , Iliana Magiati (2015). The Relationship Between Autistic Traits and Social Anxiety, Worry, Obsessive–Compulsive, and Depressive Symptoms: Specific and Non-specific Mediators in a Student Sample . Journal of Autism and Developmental Disorders, 45(3), 858-872. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-014-2238-z OpenAlex: https://openalex.org/W2068932275
    Crossref OpenAlex OpenCitations
  22. Rebecca S. Vine Foggo , Amanda A. Webster (2017). Understanding the social experiences of adolescent females on the autism spectrum . Research in Autism Spectrum Disorders, 35, 74-85. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2016.11.006 OpenAlex: https://openalex.org/W2564364624
    Crossref OpenAlex OpenCitations
  23. Colin J. Palmer , Bryan Paton , Peter G. Enticott , Jakob Hohwy (2015). ‘Subtypes’ in the Presentation of Autistic Traits in the General Adult Population . Journal of Autism and Developmental Disorders, 45(5), 1291-1301. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-014-2289-1 OpenAlex: https://openalex.org/W2076323263
    Crossref OpenAlex OpenCitations
  24. Laura Hull , K.V. Petrides , Carrie Allison , Paula Smith , Simon Baron-Cohen , Meng-Chuan Lai et al. (2017). Putting on my best normal”: social camouflaging in adults with autism spectrum conditions . Journal of Autism and Developmental Disorders, 47(8), 2519. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-017-3166-5 OpenAlex: https://openalex.org/W2616560149
    Crossref OpenAlex OpenCitations
  26. Livingston LA (2019). Livingston LA,, Shah P,, Happé F. Compensatory strategies below the behavioural surface in autism: A qualitative study. Lancet Psychiatry. 2019. https://doi.org/10 . 1016/S2215-0366(19)30224-X. Lancet Psychiatry.
    Type: Other
    Crossref
  27. Simon Baron-Cohen , Sally Wheelwright , Richard Skinner , Joanne Martin , Emma Clubley (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/High-Functioning Autism, Males and Females, Scientists and Mathematicians . Journal of Autism and Developmental Disorders, 31(1), 5-17. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1023/a:1005653411471 OpenAlex: https://openalex.org/W2100254283
    Crossref OpenAlex OpenCitations
  28. Laura Hull , Will Mandy , Meng-Chuan Lai , Simon Baron-Cohen , Carrie Allison , Paula Smith et al. (2019). Development and validation of the camouflaging autistic traits questionnaire (CAT-Q) . Journal of Autism and Developmental Disorders, 49(3), 819. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-018-3792-6 OpenAlex: https://openalex.org/W2898221520
    Crossref OpenAlex OpenCitations
  29. Lucy A Livingston , Francesca Happé (2017). Conceptualising compensation in neurodevelopmental disorders: Reflections from autism spectrum disorder . Neuroscience & Biobehavioral Reviews, 80, 729-742. Elsevier BV.
    Type: Article DOI: 10.1016/j.neubiorev.2017.06.005 OpenAlex: https://openalex.org/W2714476989
    Crossref OpenAlex OpenCitations
  31. Mary E. Stewart , Elizabeth J. Austin (2009). The structure of the Autism-Spectrum Quotient (AQ): Evidence from a student sample in Scotland . Personality and Individual Differences, 47(3), 224-228. Elsevier BV.
    Type: Article DOI: 10.1016/j.paid.2009.03.004 OpenAlex: https://openalex.org/W2115614799
    Crossref OpenAlex OpenCitations
  32. Lucy A Livingston , Punit Shah , Francesca Happé (2019). Compensatory strategies below the behavioural surface in autism: a qualitative study . The Lancet Psychiatry, 6(9), 766-777. Elsevier BV.
    Type: Article DOI: 10.1016/s2215-0366(19)30224-x OpenAlex: https://openalex.org/W2963462665
    Crossref OpenAlex OpenCitations
  34. Megan Freeth , Tom Bullock , Elizabeth Milne (2013). The distribution of and relationship between autistic traits and social anxiety in a UK student population . Autism, 17(5), 571-581. SAGE Publications.
    Type: Article DOI: 10.1177/1362361312445511 OpenAlex: https://openalex.org/W2124516038
    Crossref OpenAlex OpenCitations
  35. Eilidh Cage , Zoe Troxell-Whitman (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults . Journal of Autism and Developmental Disorders, 49(5), 1899. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-018-03878-x OpenAlex: https://openalex.org/W2909219349
    Crossref OpenAlex OpenCitations
  36. Phil Reed , Ashleigh Giles , Martha Gavin , Neil Carter , Lisa A. Osborne (2016). Loneliness and Social Anxiety Mediate the Relationship between Autism Quotient and Quality of Life in University Students . Journal of Developmental and Physical Disabilities, 28(5), 723-733. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10882-016-9504-2 OpenAlex: https://openalex.org/W2516246199
    Crossref OpenAlex OpenCitations
  37. Sarah Cassidy , Louise Bradley , Rebecca Shaw , Simon Baron-Cohen (2018). Risk markers for suicidality in autistic adults . Molecular Autism, 9(1), 42. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1186/s13229-018-0226-4 OpenAlex: https://openalex.org/W2887488849
    Crossref OpenAlex OpenCitations
  38. Scott L.J. Jackson , Barbara Dritschel (2016). Modeling the impact of social problem-solving deficits on depressive vulnerability in the broader autism phenotype . Research in Autism Spectrum Disorders, 21, 128-138. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2015.10.002 OpenAlex: https://openalex.org/W2179283496
    Crossref OpenAlex OpenCitations
  39. Vikram K. Jaswal , Nameera Akhtar (2019). Being versus appearing socially uninterested: Challenging assumptions about social motivation in autism . Behavioral and Brain Sciences, 42, 1-84. Cambridge University Press (CUP).
    Type: Article DOI: 10.1017/s0140525x18001826 OpenAlex: https://openalex.org/W2809138493
    OpenAlex OpenCitations
  41. Noriko Kitazoe , Naofumi Fujita , Yuji Izumoto , Shin-ichi Terada , Yuhei Hatakenaka (2017). Whether the Autism Spectrum Quotient consists of two different subgroups? Cluster analysis of the Autism Spectrum Quotient in general population . Autism, 21(3), 323-332. SAGE Publications.
    Type: Article DOI: 10.1177/1362361316638787 OpenAlex: https://openalex.org/W2343442128
    Crossref OpenAlex OpenCitations
  42. Goffman E (n.d.). Stigma: Notes on the Management of Spoiled Identity . Stigma: Notes on the Management of Spoiled Identity.
    Type: Other
    Crossref
  43. John E. Pachankis , Conor P. Mahon , Skyler D. Jackson , Benjamin K. Fetzner , Richard Bränström (2020). Sexual orientation concealment and mental health: A conceptual and meta-analytic review. Psychological Bulletin, 146(10), 831-871. American Psychological Association (APA).
    Type: Article DOI: 10.1037/bul0000271 OpenAlex: https://openalex.org/W3044954344
    Crossref OpenAlex OpenCitations
  44. Sana Flynn , Nathan Grant Smith (2021). Interactions between blending and identity concealment: Effects on non-binary people’s distress and experiences of victimization . PLOS ONE, 16(3), e0248970. Public Library of Science (PLoS).
    Type: Article DOI: 10.1371/journal.pone.0248970 OpenAlex: https://openalex.org/W3137173907
    Crossref OpenAlex OpenCitations
  45. Martina Radtke , Denisa Wieczoreková , Claus Normann , Pavel Humpolicek , Eva-Lotta Brakemeier , Emanuel Bubl et al. (2019). Exploring autistic traits in adults with chronic depression: A clinical study . Research in Autism Spectrum Disorders, 65, 34-45. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2019.04.006 OpenAlex: https://openalex.org/W2947341209
    OpenCitations
  46. Monique Botha * (2018). Botha M,, Frost DM. Extending the minority stress model to understand mental health problems experienced by the autistic population. Soc Ment Health. 2018:1–15. https://doi.org/10 . 1177/2156869318804297. Soc Ment Health, 1.
    Type: Other
    Crossref
  47. Noah J. Sasson , Kristen Bottema-Beutel (2022). Studies of autistic traits in the general population are not studies of autism . Autism, 26(4), 1007-1008. SAGE Publications.
    Type: Article DOI: 10.1177/13623613211058515 OpenAlex: https://openalex.org/W3215418232
    Crossref OpenAlex OpenCitations
  48. Lars-Olov Lundqvist , Helen Lindner (2017). Is the Autism-Spectrum Quotient a Valid Measure of Traits Associated with the Autism Spectrum? A Rasch Validation in Adults with and Without Autism Spectrum Disorders . Journal of Autism and Developmental Disorders, 47(7), 2080-2091. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-017-3128-y OpenAlex: https://openalex.org/W2606557386
    Crossref OpenAlex OpenCitations
  50. Mirabel Pelton , Sarah Cassidy (2017). Are autistic traits associated with suicidality? A test of the interpersonal‐psychological theory of suicide in a non‐clinical young adult sample . Autism Research, 10(11), 1891-1904. Wiley.
    Type: Article DOI: 10.1002/aur.1828 OpenAlex: https://openalex.org/W2727577692
    Crossref OpenAlex OpenCitations
  51. Ron Johnston , Kelvyn Jones , David Manley (2018). Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour . Quality & Quantity, 52(4), 1957-1976. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s11135-017-0584-6 OpenAlex: https://openalex.org/W2769972173
    Crossref OpenAlex OpenCitations
  52. Radtke M (2019). Radtke M,, Wieczoreková D,, Normann C, et al. Exploring autistic traits in adults with chronic depression: A clinical study. Res Autism Spectr Disord. 2019. https://doi.org/10 . 1016/j.rasd. 2019. 04. 006. Res Autism Spectr Disord.
    Type: Other
    Crossref
  53. Lauren VanderBroek Stice , Justin A. Lavner (2019). Social Connectedness and Loneliness Mediate the Association Between Autistic Traits and Internalizing Symptoms Among Young Adults . Journal of Autism and Developmental Disorders, 49(3), 1096-1110. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-018-3812-6 OpenAlex: https://openalex.org/W2899675478
    Crossref OpenAlex OpenCitations
  54. Lucy A Livingston , Punit Shah , Victoria Milner , Francesca Happé (2020). Quantifying compensatory strategies in adults with and without diagnosed autism . Mol Autism, 11(15), 1. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1186/s13229-019-0308-y OpenAlex: https://openalex.org/W2995930586
    Crossref OpenAlex
  55. Éric Fombonne (2020). Camouflage and autism . Journal of Child Psychology and Psychiatry, 61(7), 735-738. Wiley.
    Type: Article DOI: 10.1111/jcpp.13296 OpenAlex: https://openalex.org/W3043705882
    Crossref OpenAlex OpenCitations
  56. (n.d.). R Core Team. R: A language and environment for statistical computing. 2013. http://www.r-project.org [Last accessed: May 11 2023].
    Type: Other
    Crossref
  57. (n.d.). Navarro D. Learning Statistics with R: A Tutorial for Psychology Students and Other Beginners. Version 0. 2015. https://learningstatisticswithr.com [Last accessed: May 11 2023].
    Type: Other
    Crossref
  59. Melvin Seeman , Erving Goffman (1964). Stigma: Notes on the Management of Spoiled Identity. American Sociological Review, 29(5), 770. SAGE Publications.
    Type: Article DOI: 10.2307/2091442 OpenAlex: https://openalex.org/W4297361601
    OpenAlex