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评论:自闭症患者的“伪装”——对丰博内(2020年)的思考

Commentary: 'Camouflaging' in autistic people - reflection on Fombonne (2020).

作者信息

Lai Meng-Chuan, Hull Laura, Mandy William, Chakrabarti Bhismadev, Nordahl Christine Wu, Lombardo Michael V, Ameis Stephanie H, Szatmari Peter, Baron-Cohen Simon, Happé Francesca, Livingston Lucy Anne

机构信息

The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.

出版信息

J Child Psychol Psychiatry. 2021 Aug;62(8). doi: 10.1111/jcpp.13344. Epub 2020 Dec 2.

Abstract

Fombonne's (2020) editorial is a thought-provoking appraisal of the literature on 'camouflaging', whereby some autistic people mask or compensate for their autistic characteristics as an attempt to fit in and to cope with disabilities under neurotypical social norms. Fombonne (2020) highlights three issues of contention: (a) construct validity and measurement of camouflaging; (b) camouflaging as a reason for late autism diagnosis in adolescence/adulthood; and (c) camouflaging as a feature of the 'female autism phenotype'. Here, we argue that (a) establishing construct validity and measurement of different aspects of camouflaging is warranted; (b) subjective experiences are important for the differential diagnosis of autism in adolescence/adulthood; and (c) camouflaging is not necessarily a feature of autism in female individuals - nevertheless, taking into account sex and gender influences in development is crucial to understand behavioural manifestations of autism. Future research and clinical directions should involve clarification of associated constructs and measurements, demography, mechanisms, impact (including harms and benefits) and tailored support.

摘要

丰博内(2020年)的社论对有关“伪装”的文献进行了发人深省的评估,即一些自闭症患者会掩盖或补偿自身的自闭症特征,试图在典型神经社会规范下融入并应对残疾问题。丰博内(2020年)强调了三个有争议的问题:(a)伪装的结构效度和测量;(b)伪装作为青少年/成年期自闭症诊断延迟的一个原因;(c)伪装作为“女性自闭症表型”的一个特征。在此,我们认为:(a)有必要确立伪装不同方面的结构效度和测量方法;(b)主观体验对于青少年/成年期自闭症的鉴别诊断很重要;(c)伪装不一定是女性自闭症患者的一个特征——然而,考虑到发育过程中的性别影响对于理解自闭症的行为表现至关重要。未来的研究和临床方向应包括相关结构和测量方法的澄清、人口统计学、机制、影响(包括危害和益处)以及针对性的支持。

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