Camouflaging in autism: A cause or a consequence of mental health difficulties?

The study only had two time points, which limits the ability to establish true directionality or causality. The effect sizes were small, and the unexpected finding (camouflaging predicting decreased distress) may be influenced by regression to the mean. The sample consisted of highly educated, mostly white autistic adults aged 30–90, so findings may not generalize to younger adults, teenagers, or those with intellectual disabilities. Data collection occurred partly during the COVID-19 pandemic, which may have altered social demands and camouflaging needs. The CAT-Q-NL measures the frequency of strategies, not the effort or sophistication, which may miss nuanced changes.

The authors declared no potential conflicts of interest. The study was funded by non-U.S. government sources.

Do not interpret the small decrease in mental health difficulties among high-camouflagers as evidence that camouflaging is therapeutic or protective. The effect was small, inconsistent across anxiety and depression, and the study design cannot rule out regression to the mean or other confounding factors. It does not prove camouflaging causes improved mental health.