Zhuang Sici, Tan Diana Weiting, Reddrop Susan, Dean Lydia, Maybery Murray, Magiati Iliana
School of Psychological Science, The University of Western Australia, Australia.
School of Psychological Science, The University of Western Australia, Australia; Macquarie School of Education, Macquarie University, Australia.
Clin Psychol Rev. 2023 Nov;105:102335. doi: 10.1016/j.cpr.2023.102335. Epub 2023 Sep 14.
Camouflaging involves hiding one's autistic characteristics in social situations. This mixed methods systematic review synthesized research on psychosocial factors associated with camouflaging and its relationship with mental well-being. Six databases were searched. The 58 included studies (40 qualitative, 13 quantitative, five mixed methods), encompassed 4808 autistic and 1780 non-autistic participants, and predominantly featured White, female, and late-diagnosed autistic adults with likely at least average intellectual and/or verbal abilities. Following a convergent integrated approach, quantitative data were transformed and synthesized with qualitative data for thematic synthesis. We identified three themes on psychosocial correlates of camouflaging: (1) social norms and pressures of a largely non-autistic world, (2) social acceptance and rejection, and (3) self-esteem and identity; and four themes on psychosocial consequences of camouflaging for well-being: (1) a pragmatic way of exerting individual agency and control; (2) overlooked, under-supported, and burnt out; (3) impact on social relationships; and (4) low self-esteem and identity confusion. Camouflaging emerges as primarily a socially motivated response linked to adverse psychosocial outcomes. A whole society approach towards acceptance and support for autistic individuals to express their authentic selves is needed. Future studies examining psychosocial influences on camouflaging should include participants who more broadly represent the autistic population.
伪装涉及在社交场合中隐藏自己的自闭症特征。这项混合方法的系统综述综合了关于与伪装相关的心理社会因素及其与心理健康关系的研究。检索了六个数据库。纳入的58项研究(40项定性研究、13项定量研究、5项混合方法研究)涵盖了4808名自闭症参与者和1780名非自闭症参与者,主要研究对象是白人、女性、成年后被诊断为自闭症且可能至少具备平均智力和/或语言能力的人。采用收敛性综合方法,对定量数据进行转换,并与定性数据进行综合以进行主题综合。我们确定了关于伪装的心理社会相关因素的三个主题:(1)主要由非自闭症世界构成的社会规范和压力;(2)社会接纳与排斥;(3)自尊与身份认同;以及关于伪装对幸福感的心理社会后果的四个主题:(1)发挥个人能动性和控制力的务实方式;(2)被忽视、支持不足和疲惫不堪;(3)对社会关系的影响;(4)自卑和身份认同混乱。伪装主要表现为一种与不良心理社会结果相关的社会动机反应。需要一种全社会接纳和支持自闭症个体展现真实自我的方法。未来研究心理社会因素对伪装的影响时,应纳入更广泛代表自闭症群体的参与者。