Associations between Social Camouflaging and Internalizing Symptoms in Autistic and Non-Autistic Adolescents

Autistic individuals experience higher rates of psychiatric comorbidities than their peers. Camouflaging, the process through which individuals hide autistic traits, can be detrimental to mental health. This may be particularly true for autistic females, although research on sex differences in the relationship between camouflaging and mental health has focused on adults. The purpose of this study was to extend previous research on camouflaging and mental health through examining age, sex, autism diagnosis, and camouflaging as predictors of depression, anxiety, and stress levels in autistic and non-autistic adolescents. One hundred forty adolescents ages 13-18 years (62 non-autistic, 58 female) completed an online survey including measures of camouflaging, autistic traits, and internalizing symptoms. Hierarchical linear regression was used to examine age, sex, diagnosis, and camouflaging as predictors of internalizing symptoms. Findings suggest that level of camouflaging is an important predictor of depression, anxiety, and stress in autistic and non-autistic adolescents and that camouflaging may be particularly distressing for females, regardless of diagnosis. These findings inform our understanding of camouflaging and its consequences and point to future directions for support for autistic and non-autistic adolescents. Clinicians may consider interventions targeting social skills, self-acceptance, and self-esteem to reduce possible negative effects of camouflaging.