Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
South London and Maudsley NHS Trust, London, UK.
J Child Psychol Psychiatry. 2024 Mar;65(3):285-297. doi: 10.1111/jcpp.13884. Epub 2023 Aug 26.
Social camouflaging (hereafter camouflaging) in autism includes factors such as masking and compensating for one's neurodevelopmental differences, and to assimilate or 'fit in' with non-autistic peers. Efforts to hide one's authentic self and autism traits (masking) resemble impression management (IM) in safety behaviours identified in Clark and Wells' (1995) cognitive model of social anxiety (SA). This study explores the relationship between camouflaging in autism and safety behaviours in SA among autistic and non-autistic adolescents.
One hundred fifteen adolescents (14-19 years) with (n = 61; 36 female) and without (n = 54; 37 female) a clinical diagnosis of autism matched on age and SA symptom severity were recruited from clinics, schools and online. Adolescents completed online measures including autism traits, SA symptoms, camouflaging behaviours, SA-related safety behaviours and SA-related negative cognitions. Partial and bivariate Pearson's correlations and structural equation modelling were used to understand the relationship between camouflaging, safety behaviours, autism traits and SA in both groups. Exploratory factor analysis assessed item-level factor cross-loadings between camouflaging and safety behaviours.
Across both groups, masking and IM were significantly associated with SA symptom severity, not autism traits, via SA-related social cognitions. Exploratory factor analysis indicated construct overlap across masking, assimilation, IM and avoidance behaviours and identified factors analogous to self-focused attention, social avoidance and mental rehearsal identified in the Clark and Wells' (1995) model of SA.
This is the first study using group-matched design to identify that masking (factor in social camouflaging) and IM both relate to SA in autistic and non-autistic adolescents. Assessment and formulation of construct overlap between masking and IM may inform psychoeducation and adaptation of SA treatment for autistic adolescents.
自闭症中的社交伪装（以下简称伪装）包括掩盖和弥补神经发育差异、同化或“融入”非自闭症同龄人等因素。隐藏真实自我和自闭症特征的努力（伪装）类似于 Clark 和 Wells（1995 年）社交焦虑认知模型中安全行为中识别的印象管理（IM）。本研究探讨了自闭症中伪装与自闭症和非自闭症青少年社交焦虑症（SA）中的安全行为之间的关系。
从诊所、学校和网上招募了 115 名年龄在 14-19 岁的青少年（有临床诊断的自闭症患者 n=61；女性 36 名）和没有临床诊断的自闭症患者 n=54；女性 37 名），并根据年龄和 SA 症状严重程度进行匹配。青少年在线完成了包括自闭症特征、SA 症状、伪装行为、SA 相关安全行为和 SA 相关消极认知在内的量表。使用偏相关和双变量 Pearson 相关以及结构方程模型来理解两组中伪装、安全行为、自闭症特征和 SA 之间的关系。探索性因子分析评估了伪装和安全行为之间的项目级因子交叉负荷。
在两组中，通过与 SA 相关的社会认知，掩饰和 IM 与 SA 症状严重程度显著相关，而与自闭症特征无关。探索性因子分析表明，在掩蔽、同化、IM 和回避行为之间存在结构重叠，并确定了类似于 Clark 和 Wells（1995 年）SA 模型中自我关注、社交回避和心理演练的因素。
这是第一项使用组匹配设计来确定掩蔽（社交伪装的因素）和 IM 在自闭症和非自闭症青少年中与 SA 相关的研究。对掩蔽和 IM 之间的结构重叠进行评估和制定可能会为自闭症青少年的 SA 治疗提供心理教育和适应。
