Associations between social camouflaging and internalizing symptoms in autistic and non-autistic adolescents.
Camouflaging boosts depression and anxiety in autistic teens, especially girls, so swap masking goals for self-acceptance plans.
01Research in Context
What this study did
Day et al. (2021) asked 103 teens to fill out three short forms. One form measured how much they hide or fake social behaviors. The other two forms measured depression, anxiety, and stress.
Half of the teens had an autism diagnosis. Half were neurotypical. Ages ranged from 12 to 18. Girls and boys took part.
What they found
The more a teen tried to camouflage, the higher their depression, anxiety, and stress scores. This link showed up in both autistic and non-autistic teens.
Girls felt the impact more. A one-point jump in camouflaging raised girls' internalizing scores twice as much as boys' scores.
How this fits with other research
Eussen et al. (2016) already showed that early-teen girls with autism report more depression than boys. J et al. now add the reason: girls also mask more, and masking drives the mood jump.
Bravo Balsa et al. (2024) found that autistic teens with social struggles have flatter daytime cortisol slopes, a sign of chronic stress. Camouflaging is one clear social struggle, so the new study fits like a puzzle piece.
Lievore et al. (2026) used lab speeches and heart-rate belts. They saw that autistic youth under social-evaluative stress show low heart reactivity yet high self-rated anxiety. J et al. show the same group feels pressured to mask, linking the outside behavior to the inside feeling.
Why it matters
Stop teaching masking skills. Replace them with self-advocacy and peer groups that value neurodiverse behavior. Screen girls with autism for mood problems early, even if they seem socially fine. A quick Monday move: open your next social-skills session by asking, "What part of you did you hide today?" Praise honest answers instead of quiet hands.
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02At a glance
03Original abstract
Autistic individuals have more mental health difficulties than non-autistic individuals. It is important to understand why this might be. Research has shown that camouflaging, or strategies used to hide autistic traits, might contribute to mental health difficulties in autistic adults. We examined whether this was also the case for autistic adolescents. This study included 140 adolescents ages 13-18 years (62 non-autistic, 58 female). All participants answered questions about camouflaging, autistic traits, and mental health difficulties. We found that autistic and non-autistic adolescents who reported higher levels of camouflaging also reported higher levels of depression, anxiety, and stress. We also found that camouflaging might be particularly stressful for females. These findings improve our understanding of camouflaging during adolescence and point to potential ways to support autistic adolescents, such as help with social skills, self-acceptance, and self-esteem. The findings also support the importance of increasing autism acceptance in the general population.
Autism : the international journal of research and practice, 2021 · doi:10.1177/1362361321997284