There is inconsistent evidence for a clear pattern of association between ‘camouflaging’ (strategies used to mask and/or compensate for autism characteristics during social interactions) and mental health. This study explored the relationship between self-reported camouflaging and generalised anxiety, depression, and social anxiety in a large sample of autistic adults and, for the first time, explored the moderating effect of gender, in an online survey. Overall, camouflaging was associated with greater symptoms of generalised anxiety, depression, and social anxiety, although only to a small extent beyond the contribution of autistic traits and age. Camouflaging more strongly predicted generalised and social anxiety than depression. No interaction between camouflaging and gender was found. These results cannot be generalised to autistic people with intellectual disability, or autistic children and young people. The sample did not include sufficient numbers of non-binary people to run separate analyses; therefore, it is possible that camouflaging impacts mental health differently in this population. The findings suggest that camouflaging is a risk factor for mental health problems in autistic adults without intellectual disability, regardless of gender. We also identified levels of camouflaging at which risk of mental health problems is highest, suggesting clinicians should be particularly aware of mental health problems in those who score at or above these levels.

中文翻译：

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社交伪装与自闭症成人的焦虑和抑郁有关吗？

没有不一致的证据表明“伪装”（在社交互动过程中用于掩盖和/或补偿自闭症特征的策略）与心理健康之间存在明确的关联模式。这项研究探讨了大量自闭症成人样本中自我报告的伪装与广泛性焦虑、抑郁和社交焦虑之间的关系，并首次通过在线调查探讨了性别的调节作用。总体而言，伪装与更严重的广泛性焦虑、抑郁和社交焦虑症状相关，尽管其影响程度仅比自闭症特征和年龄的影响小。伪装比抑郁更能预测普遍焦虑和社交焦虑。没有发现伪装和性别之间存在相互作用。这些结果不能推广到患有智力障碍的自闭症患者或自闭症儿童和青少年。样本中没有足够数量的非二元性别人群来进行单独的分析；因此，伪装可能会对这一人群的心理健康产生不同的影响。研究结果表明，对于无智力障碍的自闭症成年人来说，无论性别如何，伪装都是导致心理健康问题的一个危险因素。我们还确定了心理健康问题风险最高的伪装水平，建议临床医生应特别注意得分等于或高于这些水平的人的心理健康问题。