Quantifying and exploring camouflaging in men and women with autism

Meng-Chuan Lai, Michael V. Lombardo, Amber N. V. Ruigrok, Bhismadev Chakrabarti, Bonnie Auyeung, MRC AIMS Consortium, Peter Szatmari, Francesca Happé, Simon Baron-Cohen

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Autobiographical descriptions and clinician observations suggest that some individuals with autism, particularly females, ‘camouflage’ their socialcommunication difficulties, which may require considerable cognitive effort and lead to increased stress, anxiety and depression. Using data from 60 age- and IQ-matched men and women with autism (without intellectual disability) we operationalized camouflaging in adults with autism for the first time, as the quantitative discrepancy between the person’s ‘external’ behavioural presentation in social-interpersonal contexts (measured by the Autism Diagnostic Observation Schedule) and the person’s ‘internal’ status (dispositional traits measured by the Autism Spectrum Quotient and social cognitive capability measured by the ‘Reading the Mind in the Eyes’ Test). We found that the operationalized camouflaging measure was not significantly correlated with age or IQ. On average, women with autism had higher camouflaging scores than men with autism (Cohen’s d=0.98), with substantial variability in both groups. Greater camouflaging was associated with more depressive symptoms in men, and better signaldetection sensitivity in women with autism. The neuroanatomical association with camouflaging score was largely sex/gender-dependent and significant only in women: from reverse inference the most correlated cognitive terms were about emotion and memory. The underlying constructs, measurement, mechanisms, consequences, and heterogeneity of camouflaging in autism warrant further investigation.
Original languageEnglish
Pages (from-to)690-702
Issue number6
Early online date29 Nov 2016
Publication statusE-pub ahead of print - 29 Nov 2016


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