Does Camouflaging Predict Functioning, Distress, and Quality of Life for Autistic Adults?
Camouflaging scores do not improve prediction of depression or distress beyond social anxiety and social responsiveness measures.
01Research in Context
What this study did
The team gave autistic adults three short forms: the CAT-Q camouflaging scale, a social anxiety scale, and a social responsiveness scale.
They then checked whether camouflaging scores could predict depression, distress, or daily-life problems after social anxiety and social responsiveness were already counted.
What they found
Camouflaging scores added no new information. Once social anxiety and social responsiveness were in the model, camouflaging did not explain extra variance in depression, distress, or disability.
How this fits with other research
Andersen et al. (2023) tracked the same group across ten years and showed that adolescent anxiety and depression fully explain later quality-of-life drops. Together, the two studies point to social anxiety as the active ingredient, not the masking behavior itself.
Carter et al. (2016) screened college students and also found that social anxiety, not autism traits alone, drove mental-health risk. The pattern repeats: social anxiety predicts distress; camouflaging does not add predictive power.
Archibald et al. (2024) validated the AQ-10 for quick autism screening. Their work and the present paper both test whether a new scale gives extra clinical value. The AQ-10 passed that test; the CAT-Q, used alone, did not.
Why it matters
You can skip the 25-item CAT-Q if you already measure social anxiety and social responsiveness. Target treatment at social anxiety and social skills, not at reducing camouflaging itself. This saves assessment time and keeps your treatment plan focused on variables that clearly link to adult well-being.
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02At a glance
03Original abstract
It has been proposed that autistic individuals adopt camouflaging strategies to mask their autistic traits and conform to social norms, and that these camouflaging strategies have been linked to adverse mental health outcomes. This study examined whether camouflaging, measured by the Camouflaging Autistic Traits Questionnaire (CAT-Q), predicted functioning, distress, and quality of life beyond standard clinical measures of social responsiveness and social anxiety. We analysed data from 113 autistic adults experiencing social anxiety who expressed interest in anxiety interventions. Hierarchical regression analyses assessed the unique contribution of camouflaging after accounting for social responsiveness and social anxiety. Results indicated that social responsiveness and social anxiety significantly predicted depression, psychological distress, and disability, whereas camouflaging did not explain additional variance in these outcomes. Although camouflaging correlated with poorer mental health and reduced quality of life, it did not independently predict these outcomes beyond social anxiety and responsiveness. These findings suggest current camouflaging measures may capture overlapping constructs, highlighting the need for more precise conceptualization and measurement tools.
Autism research : official journal of the International Society for Autism Research, 2026 · doi:10.1002/aur.70199