Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q).

The study used self-report only, so it measured people's own descriptions of camouflaging, not observed social behaviour. The BAPQ was developed for relatives of autistic people, so it may not be the best measure of autistic traits in this sample. Depression and general anxiety were measured only in autistic participants, so the paper cannot say how these relate to camouflaging in non-autistic adults. Test-retest reliability was based on 30 autistic participants who were older than the main autistic sample, so stability over 3 months is preliminary. The questionnaire was developed and validated in adults, and many autistic participants were diagnosed in adulthood, so it may not hold for children, adolescents, or people with intellectual disability or language difficulties. No objective validation of autism diagnosis was done; participants reported their diagnosis and who gave it. The results are correlations, not cause and effect, so they do not show that camouflaging causes anxiety, depression, or poor wellbeing. The confirmatory sample had more males than females, so the gender comparison needs replication in a sample with balanced male and female numbers. The paper says clinical utility for diagnosis, formulation, and support planning requires further research.

Do not use a high CAT-Q score as a diagnosis of autism or as proof that camouflaging causes anxiety or depression. The study validated a self-report questionnaire in adults and found correlations, but it did not test the questionnaire against clinical diagnostic outcomes, and the authors say clinical utility needs more research.