Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Research Department of Clinical, Educational, and Health Psychology, University College London, London, UK.
Autism Res. 2023 Mar;16(3):580-590. doi: 10.1002/aur.2873. Epub 2022 Dec 9.
Camouflaging describes masking or compensating for autistic traits and/or related difficulties. Some evidence suggests autistic females camouflage more than autistic males, potentially contributing to delayed or missed diagnosis. Studies predominantly adopt self-report measures of camouflaging, potentially reflecting a person's intent to camouflage without accurately measuring effectiveness (i.e., success in fulfilling the intended effect of minimizing the appearance of autistic traits) of camouflaging. Discrepancy scores between underlying cognitive difficulties (e.g., theory of mind) and observed autistic traits (henceforth camo ), or between self-reported autistic traits and observed autistic traits (henceforth camo ), may provide a more accurate measure of camouflaging effectiveness. Three measures of camouflaging administered to autistic males (n = 46) and females (n = 40), and adults with equally high levels of autistic traits but no diagnosis (n = 45 males, n = 43 females) recruited from a large population-based sample were compared. Self-report measures of camouflaging were significantly correlated with camo scores only. Both discrepancy scores were correlated with each other. Adults with high autistic traits, but no diagnosis, had higher discrepancy camouflaging scores than diagnosed adults, but self-reported scores were similar. Diagnosed females scored higher than diagnosed males across all camouflaging measures, but no sex difference occurred in the high trait group. This might indicate that autistic females have higher intentions and greater effectiveness when camouflaging, compared with autistic males. For camo only, high trait males scored significantly higher than diagnosed males; no group difference occurred for females. These results suggest that, despite all participants intending to camouflage to some extent, effective camouflaging as measured by discrepancy scores is higher in undiagnosed high autistic trait individuals. One interpretation is that effective camouflaging reduces the likelihood of autism diagnosis in males and females with high autistic traits.
伪装是指掩盖或补偿自闭症特征和/或相关困难。有证据表明,女性自闭症患者比男性自闭症患者更倾向于伪装,这可能导致诊断延迟或漏诊。研究主要采用自我报告的伪装措施,这可能反映了一个人有意伪装,而没有准确衡量伪装的有效性(即成功实现最小化自闭症特征出现的预期效果)。潜在认知困难(例如,心理理论)与观察到的自闭症特征(以下简称伪装)之间的差异评分,或自我报告的自闭症特征与观察到的自闭症特征(以下简称伪装)之间的差异评分,可能提供更准确的伪装有效性衡量标准。对来自大型基于人群样本的自闭症男性(n=46)和女性(n=40)以及具有同等高水平自闭症特征但无诊断的成年人(男性 n=45,女性 n=43)进行了三种伪装措施的评估。伪装的自我报告措施仅与伪装得分显著相关。两个差异评分相互相关。具有高自闭症特征但无诊断的成年人的差异伪装得分高于被诊断的成年人,但自我报告的得分相似。所有伪装措施中,被诊断为女性的得分均高于被诊断为男性的得分,但在高特征组中没有出现性别差异。这可能表明,与自闭症男性相比,女性自闭症患者在伪装时的意图和效果更高。仅对于伪装,高特征男性的得分明显高于被诊断为男性的得分;女性没有出现组间差异。这些结果表明,尽管所有参与者都有意在某种程度上伪装,但通过差异评分衡量的有效伪装在未被诊断的高自闭症特征个体中更高。一种解释是,有效的伪装降低了具有高自闭症特征的男性和女性被诊断为自闭症的可能性。