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.

Lay 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.

中文翻译：

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自闭症和非自闭症青少年社会伪装和内化症状之间的关联

自闭症患者比同龄人患精神疾病的几率更高。伪装，即个体隐藏自闭症特征的过程，可能对心理健康有害。对于自闭症女性来说尤其如此，尽管关于伪装和心理健康之间关系的性别差异的研究主要集中在成年人身上。本研究的目的是通过检查年龄、性别、自闭症诊断和伪装作为自闭症和非自闭症青少年抑郁、焦虑和压力水平的预测因子，扩展先前关于伪装和心理健康的研究。140 名 13-18 岁的青少年（62 名非自闭症，58 名女性）完成了一项在线调查，包括伪装、自闭症特征和内化症状的测量。分层线性回归用于检查年龄、性别、诊断和伪装作为内化症状的预测因子。研究结果表明，伪装水平是自闭症和非自闭症青少年抑郁、焦虑和压力的重要预测因素，无论诊断如何，伪装对女性来说可能特别痛苦。这些发现有助于我们理解伪装及其后果，并指出支持自闭症和非自闭症青少年的未来方向。临床医生可能会考虑针对社交技能、自我接纳和自尊的干预措施，以减少伪装可能带来的负面影响。自闭症和非自闭症青少年的压力和压力，无论诊断如何，伪装对女性来说可能特别痛苦。这些发现有助于我们理解伪装及其后果，并指出支持自闭症和非自闭症青少年的未来方向。临床医生可能会考虑针对社交技能、自我接纳和自尊的干预措施，以减少伪装可能带来的负面影响。自闭症和非自闭症青少年的压力和压力，无论诊断如何，伪装对女性来说可能特别痛苦。这些发现有助于我们理解伪装及其后果，并指出支持自闭症和非自闭症青少年的未来方向。临床医生可能会考虑针对社交技能、自我接纳和自尊的干预措施，以减少伪装可能带来的负面影响。

摘要

自闭症患者比非自闭症患者有更多的心理健康问题。了解为什么会这样很重要。研究表明，伪装或用于隐藏自闭症特征的策略可能会导致自闭症成年人的心理健康困难。我们检查了自闭症青少年是否也是这种情况。这项研究包括 140 名 13-18 岁的青少年（62 名非自闭症，58 名女性）。所有参与者都回答了有关伪装、自闭症特征和心理健康困难的问题。我们发现，表现出较高伪装水平的自闭症和非自闭症青少年也表现出较高水平的抑郁、焦虑和压力。我们还发现伪装对女性来说可能特别有压力。这些发现提高了我们对青春期伪装的理解，并指出了支持自闭症青少年的潜在方法，例如帮助提高社交技能、自我接纳和自尊。研究结果还支持提高普通人群对自闭症的接受度的重要性。