Introduction
Camouflaging is the use of (un)conscious strategies to appear as non-autistic, such as hiding or masking autistic traits, or mimicking non-autistic behaviors. Camouflaging is thought to be an important reason for late autism diagnoses and mental health difficulties. However, it is not clear whether only autistic people camouflage or whether people with other neurodevelopmental or mental health conditions also use similar camouflaging strategies. Therefore, in this study, the researchers investigated if adults with attention-deficit/hyperactivity-disorder (ADHD) also camouflage.
Methods
The researchers used the Dutch Camouflaging Autistic Traits Questionnaire (CAT-Q-NL), which measures the frequency and reasons for camouflaging, as well as the perceived benefits and costs of camouflaging. They also used the ADHD Self-Report (ADHD-SR) and the Autism Spectrum Quotient (AQ) to measure ADHD and autism traits, respectively. They recruited 477 adults with an autism and/or ADHD diagnosis, and 105 adults without any diagnosis, who were matched by age and sex. They compared the camouflaging scores between the groups, and explored the relationship between camouflaging and autism and ADHD traits.
Results
The results showed that adults with ADHD scored higher on total camouflaging and assimilation (the extent to which one tries to fit in with others) than the comparison group, but lower than autistic adults. However, there was no significant difference between adults with ADHD and the comparison group on compensation (the extent to which one tries to compensate for difficulties in social situations) and masking (the extent to which one tries to hide or suppress autistic traits). Autism traits, but not ADHD traits, were a important predictor of camouflaging, independent of diagnosis.
Discussion
The findings suggest that camouflaging is not unique to autistic adults, since adults with ADHD also show camouflaging behavior, even though not as much as autistic adults. However, as the CAT-Q-NL specifically measures camouflaging of autistic traits, it is important to develop more general measures of camouflaging, to compare camouflaging more reliably in people with different mental health conditions. Furthermore, focusing on camouflaging in adults with ADHD, including potential consequences for late diagnoses and mental health, appears a promising future research opportunity.
Conclusion
Camouflaging is a common phenomenon among adults with autism and ADHD, but it is more prevalent and influenced by autism traits. Camouflaging may have negative impacts on mental health and wellbeing, and therefore, it is important to provide support and acceptance for people who camouflage, regardless of their diagnosis.
Faq
What is camouflaging and why do people do it?
Camouflaging is the use of (un)conscious strategies to appear as non-autistic, such as hiding or masking autistic traits, or mimicking non-autistic behaviors. People may camouflage for various reasons, such as:
- To avoid stigma, discrimination, or bullying
- To fit in, belong, or make friends
- To achieve personal, academic, or professional goals
- To cope with social expectations or demands
What are some examples of camouflaging strategies and behaviors?
Some examples of camouflaging strategies and behaviors are:
- Hiding or masking autistic traits, such as stimming, avoiding eye contact, or speaking in a monotone voice
- Mimicking or copying non-autistic behaviors, such as smiling, nodding, or using gestures
- Learning or rehearsing social scripts, such as greetings, compliments, or jokes
- Preparing or planning for social situations, such as researching topics, choosing outfits, or setting goals
- Avoiding or escaping social situations, such as declining invitations, making excuses, or leaving early
What is the difference between assimilation, compensation, and masking?
Assimilation, compensation, and masking are three subscales of the CAT-Q-NL, which measure different aspects of camouflaging. Assimilation measures the extent to which one tries to fit in with others by adopting their behaviors, opinions, or interests. Compensation measures the extent to which one tries to compensate for difficulties in social situations by using learned rules, scripts, or cues. Masking measures the extent to which one tries to hide or suppress autistic traits by avoiding, concealing, or modifying them.
How does camouflaging differ between autism and ADHD?
Camouflaging is not unique to autistic people, as people with ADHD also show camouflaging behavior, even though not as much as autistic people. However, there are some differences in how camouflaging is manifested and measured between autism and ADHD. For example:
- Autistic people tend to camouflage more on social communication and interaction, while ADHD-ers tend to camouflage more on attention and impulsivity
- Autistic people tend to camouflage more by masking (hiding or suppressing autistic traits), while ADHD-ers tend to camouflage more by assimilation (trying to fit in with others)
- Autistic people tend to camouflage more for internal reasons (such as self-protection or self-expression), while ADHD-ers tend to camouflage more for external reasons (such as social pressure or expectations)
- Autistic traits, but not ADHD traits, are a significant predictor of camouflaging, independent of diagnosis
What are the effects of camouflaging on mental health and well-being?
Camouflaging can have both positive and negative effects on mental health and well-being. On the one hand, camouflaging can help people to achieve social success, acceptance, and satisfaction. On the other hand, camouflaging can also lead to physical, emotional, and intellectual exhaustion, anxiety, depression, poor self-image, negative self-perception, identity loss, burnout, and suicidality.
What are the ethical and social implications of camouflaging?
Camouflaging has ethical and social implications for both individuals and society. For individuals, camouflaging may involve:
- A loss of authenticity and identity, as they have to hide or change who they are
- A trade-off between social success and personal well-being, as they have to balance the benefits and costs of camouflaging
- A risk of harm or exploitation, as they may be exposed to stigma, discrimination, or abuse
For society, camouflaging may involve:
- A loss of diversity and innovation, as the unique perspectives and contributions of neurominorities are suppressed or ignored
- A perpetuation of inequality and injustice, as the dominant norms and expectations of neurotypicality are enforced and privileged
- A responsibility and accountability, as the social and environmental factors that influence camouflaging are acknowledged and addressed
How can camouflaging be reduced or prevented?
Camouflaging can be reduced or prevented by increasing the awareness, understanding, and acceptance of autism and neurodiversity in society. This can be done by:
- Providing accurate and positive information and education about autism and neurodiversity
- Challenging the stereotypes and stigma associated with autism and neurodiversity
- Promoting the rights and inclusion of autistic and neurodiverse people in all aspects of life
- Supporting the self-advocacy and empowerment of autistic and neurodiverse people
- Celebrating the diversity and strengths of autistic and neurodiverse people
What are some of the practical tips or advice for autistic and ADHD-ers who camouflage?
Some of the practical tips or advice for autistic and ADHD-ers who camouflage are:
- Be aware and mindful of your camouflaging behavior, and the reasons and consequences of camouflaging, and try to balance the benefits and costs of camouflaging
- Be selective and strategic about when, where, how, and with whom you camouflage, and try to avoid or minimize camouflaging in situations or with people that are not safe, supportive, or rewarding
- Be authentic and confident about your identity and strengths, and try to embrace and express your autistic or ADHD traits in ways that are comfortable and meaningful for you
- Be proactive and assertive about your needs and rights, and try to seek and access the support and resources that can help you cope and thrive
- Be connected and involved with your community and peers, and try to find and join the groups and networks that can offer you information, guidance, and solidarity
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