“Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions
Camouflaging of autistic characteristics in social situations is hypothesised as a common social coping strategy for adults with autism spectrum conditions (ASC). Camouflaging may impact diagnosis, quality of life, and long-term outcomes, but little is known about it. This qualitative study examined...
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| Published in | Journal of autism and developmental disorders Vol. 47; no. 8; pp. 2519 - 2534 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York
Springer US
01.08.2017
Springer Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0162-3257 1573-3432 1573-3432 |
| DOI | 10.1007/s10803-017-3166-5 |
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| Abstract | Camouflaging of autistic characteristics in social situations is hypothesised as a common social coping strategy for adults with autism spectrum conditions (ASC). Camouflaging may impact diagnosis, quality of life, and long-term outcomes, but little is known about it. This qualitative study examined camouflaging experiences in 92 adults with ASC, with questions focusing on the nature, motivations, and consequences of camouflaging. Thematic analysis was used to identify key elements of camouflaging, which informed development of a three-stage model of the camouflaging process. First, motivations for camouflaging included fitting in and increasing connections with others. Second, camouflaging itself comprised a combination of masking and compensation techniques. Third, short- and long-term consequences of camouflaging included exhaustion, challenging stereotypes, and threats to self-perception. |
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| AbstractList | Camouflaging of autistic characteristics in social situations is hypothesised as a common social coping strategy for adults with autism spectrum conditions (ASC). Camouflaging may impact diagnosis, quality of life, and long-term outcomes, but little is known about it. This qualitative study examined camouflaging experiences in 92 adults with ASC, with questions focusing on the nature, motivations, and consequences of camouflaging. Thematic analysis was used to identify key elements of camouflaging, which informed development of a three-stage model of the camouflaging process. First, motivations for camouflaging included fitting in and increasing connections with others. Second, camouflaging itself comprised a combination of masking and compensation techniques. Third, short- and long-term consequences of camouflaging included exhaustion, challenging stereotypes, and threats to self-perception. Camouflaging of autistic characteristics in social situations is hypothesised as a common social coping strategy for adults with autism spectrum conditions (ASC). Camouflaging may impact diagnosis, quality of life, and long-term outcomes, but little is known about it. This qualitative study examined camouflaging experiences in 92 adults with ASC, with questions focusing on the nature, motivations, and consequences of camouflaging. Thematic analysis was used to identify key elements of camouflaging, which informed development of a three-stage model of the camouflaging process. First, motivations for camouflaging included fitting in and increasing connections with others. Second, camouflaging itself comprised a combination of masking and compensation techniques. Third, short- and long-term consequences of camouflaging included exhaustion, challenging stereotypes, and threats to self-perception.Camouflaging of autistic characteristics in social situations is hypothesised as a common social coping strategy for adults with autism spectrum conditions (ASC). Camouflaging may impact diagnosis, quality of life, and long-term outcomes, but little is known about it. This qualitative study examined camouflaging experiences in 92 adults with ASC, with questions focusing on the nature, motivations, and consequences of camouflaging. Thematic analysis was used to identify key elements of camouflaging, which informed development of a three-stage model of the camouflaging process. First, motivations for camouflaging included fitting in and increasing connections with others. Second, camouflaging itself comprised a combination of masking and compensation techniques. Third, short- and long-term consequences of camouflaging included exhaustion, challenging stereotypes, and threats to self-perception. |
| Audience | Academic |
| Author | Petrides, K. V. Hull, Laura Mandy, William Smith, Paula Lai, Meng-Chuan Allison, Carrie Baron-Cohen, Simon |
| Author_xml | – sequence: 1 givenname: Laura orcidid: 0000-0002-8289-2158 surname: Hull fullname: Hull, Laura email: laura.hull.14@ucl.ac.uk organization: Research Department of Clinical, Educational & Health Psychology, University College London, Department of Psychology, University College London – sequence: 2 givenname: K. V. surname: Petrides fullname: Petrides, K. V. organization: London Psychometric Laboratory, University College London – sequence: 3 givenname: Carrie surname: Allison fullname: Allison, Carrie organization: Autism Research Centre, Department of Psychiatry, University of Cambridge – sequence: 4 givenname: Paula surname: Smith fullname: Smith, Paula organization: Autism Research Centre, Department of Psychiatry, University of Cambridge – sequence: 5 givenname: Simon surname: Baron-Cohen fullname: Baron-Cohen, Simon organization: Autism Research Centre, Department of Psychiatry, University of Cambridge – sequence: 6 givenname: Meng-Chuan surname: Lai fullname: Lai, Meng-Chuan organization: Autism Research Centre, Department of Psychiatry, University of Cambridge, Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Department of Psychiatry, National Taiwan University Hospital and College of Medicine – sequence: 7 givenname: William surname: Mandy fullname: Mandy, William organization: Research Department of Clinical, Educational & Health Psychology, University College London |
| BackLink | http://eric.ed.gov/ERICWebPortal/detail?accno=EJ1148015$$DView record in ERIC https://www.ncbi.nlm.nih.gov/pubmed/28527095$$D View this record in MEDLINE/PubMed |
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| Issue | 8 |
| Keywords | Autism Coping Gender Social adapation Camouflaging Sex |
| Language | English |
| License | Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
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| PublicationTitle | Journal of autism and developmental disorders |
| PublicationTitleAbbrev | J Autism Dev Disord |
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| PublicationYear | 2017 |
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| References | BargielaSStewardRMandyWThe experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotypeJournal of Autism and Developmental Disorders2016274573645040731 LaiM-CLombardoMVPascoGRuigrokANVWheelwrightSJSadekSAA behavioral comparison of male and female adults with high functioning autism spectrum conditionsPloS ONE201166e2083510.1371/journal.pone.0020835216951473113855 LugnegårdTHallerbäckMUGillbergCPsychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndromeResearch in Developmental Disabilities20113251910191710.1016/j.ridd.2011.03.02521515028 KreiserNLWhiteSWASD in females: are we overstating the gender difference in diagnosis?Clinical Child and Family Psychology Review2014171678410.1007/s10567-013-0148-923836119 LaiM-CBaron-CohenSBIdentifying the lost generation of adults with autism spectrum conditionsThe Lancet Psychiatry20152111013102710.1016/S2215-0366(15)00277-126544750 AttwoodTThe complete guide to Asperger’s syndrome2007LondonJessica Kingsley DeanMHarwoodRKasariCThe art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorderAutism201627899709 TierneySBurnsJKilbeyELooking behind the mask: Social coping strategies of girls on the autistic spectrumResearch in Autism Spectrum Disorders201623738310.1016/j.rasd.2015.11.013 HowlinPMawhoodLRutterMAutism and developmental receptive language disorder—a follow-up comparison in early adult life. II: Social, behavioural, and psychiatric outcomesJournal of Child Psychology and Psychiatry, and Allied Disciplines200041556157810.1111/1469-7610.0064310946749 MayTCornishKRinehartNJGender profiles of behavioral attention in children with autism spectrum disorderJournal of Attention Disorders201222912506 SunXAllisonCAuyeungBBaron-CohenSBrayneCParental concerns, socioeconomic status, and the risk of autism spectrum conditions in a population-based studyResearch in Developmental Disabilities201435123678368810.1016/j.ridd.2014.07.03725262013 ConstantinoJNThe quantitative nature of autistic social impairmentPediatric Research2011695 Pt 255R62R10.1203/PDR.0b013e318212ec6e212895373086844 DworzynskiKRonaldABoltonPHappéFHow different are girls and boys above and below the diagnostic threshold for autism spectrum disorders?Journal of the American Academy of Child and Adolescent Psychiatry201251878879710.1016/j.jaac.2012.05.01822840550 ElliottJFischerCRennieDEvolving guidelins for publication of qualitative reseach studies in psychology ans related fieldsJournal of Clinical Psychology19993821522910.1348/014466599162782 American Psychiatric AssociationDSM 52013WashingtonAmerican Psychiatric Association OswaldTMWinter-MessiersMAGibsonBSchmidtAMHerrCMSolomonMSex differences in internalizing problems during adolescence in autism spectrum disorderJournal of Autism and Developmental Disorders201646262463610.1007/s10803-015-2608-126438640 GliddenDBoumanWPJonesBAGender dysphoria and autism spectrum disorder: A systematic review of the literatureSexual Medicine Review20164131410.1016/j.sxmr.2015.10.003 StrunzSSchermuckCBallersteinSAhlersCJDziobekIRoepkeSRomantic relationships and relationship satisfaction among adults with asperger syndrome and high-functioning autismJournal of Clinical Psychology201600113 MandyWChilversRChowdhuryUSalterGSeigalASkuseDSex differences in autism spectrum disorder: Evidence from a large sample of children and adolescentsJournal of Autism and Developmental Disorders20124271304131310.1007/s10803-011-1356-021947663 WilligCIntroducing qualitative research in psychology2013MaidenheadMcGraw-Hill Education LaiM-CLombardoMVAuyeungBChakrabartiBBaron-CohenSSex/gender differences and autism: Setting the scene for future researchJournal of the American Academy of Child and Adolescent Psychiatry2015541112410.1016/j.jaac.2014.10.003255247864284309 HullLPetridesKVMandyWBehavioural and cognitive sex/gender differences in autism spectrum condition and typically developing males and femalesAutism2016 BaldwinSCostleyDThe experiences and needs of female adults with high-functioning autism spectrum disorderAutism: The International Journal of Research and Practice201520448349510.1177/1362361315590805 Gould, J., & Ashton-Smith, J. (2011). Missed diagnosis or misdiagnosis? Girls and women on the autism spectrum. Good Autism Practice (GAP), 12(1), 34–41. Retrieved from http://docserver.ingentaconnect.com/deliver/connect/bild/14662973/v12n1/s5.pdf?expires=1458573512&id=86436442&titleid=75007062&accname=UCL+LIBRARY&checksum=67DD45F10B3BC0F23C260A42F5F40513. Van Wijngaarden-CremersPJMvan EetenEGroenWBVan DeurzenPAOosterlingIJVan der GaagRJGender and age differences in the core triad of impairments in autism spectrum disorders: A systematic review and meta-analysisJournal of Autism and Developmental Disorders201444362763510.1007/s10803-013-1913-923989936 Baron-CohenSWheelwrightSSkinnerRMartinJClubleyEThe autism-spectrum quotient (AQ): Evidence from Asperger Syndrome/high-functioning autism, malesand females, scientists and mathematiciansJournal of Autism and Developmental Disorders200131151710.1023/A:100565341147111439754 FarleyMAMcMahonWMFombonneEJensonWRMillerJGardnerMTwenty-year outcome for individuals with autism and average or near-average cognitive abilitiesAutism Research20092210911810.1002/aur.6919455645 RobinsonEBLichtensteinPAnckarsäterHHappéFRonaldAExamining and interpreting the female protective effect against autistic behaviorProceedings of the National Academy of Sciences of the United States of America2013110135258526210.1073/pnas.1211070110234311623612665 ShattuckPTDurkinMMaennerMNewschafferCMandellDSWigginsLTiming of identification among children with an autism spectrum disorder: Findings from a population-based surveillance studyJournal of the American Academy of Child and Adolescent Psychiatry200948547448310.1097/CHI.0b013e31819b3848193189923188985 FombonneEEpidemiology of pervasive developmental disordersPediatric Research200965659159810.1203/PDR.0b013e31819e720319218885 RussellGSteerCGoldingJSocial and demographic factors that influence the diagnosis of autistic spectrum disordersSocial Psychiatry and Psychiatric Epidemiology201146121283129310.1007/s00127-010-0294-z20938640 LaiM-CLombardoMVRuigrokANVChakrabartiBAuyeungBConsortiumMAQuantifying and exploring camouflaging in men and women with autismAutism201627899710 KirkovskiMEnticottPGFitzgeraldPBA review of the role of female gender in autism spectrum disordersJournal of Autism and Developmental Disorders201343112584260310.1007/s10803-013-1811-123525974 DuvekotJVan der EndeJVerhulstFCSlappendelGVan DaalenEMarasAGreaves-LordKFactors influencing the probability of a diagnosis of Autism Spectrum Disorder in girls versus boysAutism201627940569 BarkerCPistrangNQuality criteria under methodological pluralism: Implications for conducting and evaluating researchAmerican Journal of Community Psychology2005353–420121210.1007/s10464-005-3398-y15909795 Holliday WilleyLPretending to be normal: Living with Asperger’s Syndrome (Autism Spectrum Disorder) (Expanded Edition)2015LondonJessica Kingsley RitchieJLewisJMcNaughton NichollsCOrmstonRQualitative Research practice: A guide for social science students and researchers2014LondonSAGE AttwoodTAsperger’s and girls2006Arlington, TXFuture Horizons, Inc KimYSLeventhalBLKohY-JFombonneELaskaELimE-CPrevalence of autism spectrum disorders in a total population sampleThe American Journal of Psychiatry2011168990491210.1176/appi.ajp.2011.1010153221558103 SassonNJFasoDJNugentJLovellSKennedyDPGrossmanRBNeurotypical peers are less willing to interact with those with autism based on thin slice judgmentsScientific Reports2017281454115286449 BraunVClarkeVUsing thematic analysis in psychologyQualitative Research in Psychology2006327710110.1191/1478088706qp063oa MandyWTchanturiaKDo women with eating disorders who have social and flexibility difficulties really have autism? A case seriesMolecular Autism201561610.1186/2040-2392-6-6260565604459459 KoppSGillbergCThe autism spectrum screening questionnaire (ASSQ)-revised extended version (ASSQ-REV): an instrument for better capturing the autism phenotype in girls? A preliminary study involving 191 clinical cases and community controlsResearch in Developmental Disabilities20113262875288810.1016/j.ridd.2011.05.01721664105 KoppSGillbergCGirls with social deficits and learning problems: Autism, atypical Asperger syndrome or a variant of these conditionsEuropean Child and Adolescent Psychiatry199212899910.1007/BF02091791 CageEPellicanoEShahPBirdGReputation management: Evidence for ability but reduced propensity in autismAutism Research20136543344210.1002/aur.131323836550 RivetTTMatsonJLReview of gender differences in core symptomatology in autism spectrum disordersResearch in Autism Spectrum Disorders201123395797610.1016/j.rasd.2010.12.003 ChevallierCMolesworthCHappéFDiminished social motivation negatively impacts reputation management: Autism spectrum disorders as a case in pointPLoS ONE2012711610.1371/journal.pone.0031107 Van BourgondienMEReichleNCPalmerASexual behavior in adults with autismJournal of Autism and Developmental Disorders199727211312510.1023/A:10258836224529105963 ShattuckPTNarendorfSCCooperBSterzingPRWagnerMTaylorJLPostsecondary education and employment among youth with an autism spectrum disorderPediatrics201212961042104910.1542/peds.2011-2864225857663362908 WingLSex ratios in early childhood autism and related conditionsPsychiatry Research19815212913710.1016/0165-1781(81)90043-36945608 IzumaKMatsumotoKCamererCFAdolphsRInsensitivity to social reputation in autismProceedings of the National Academy of Sciences of the United States of America201110842173021730710.1073/pnas.1107038108219877993198313 D Glidden (3166_CR17) 2016; 4 L Hull (3166_CR21) 2016 M-C Lai (3166_CR31) 2016 G Russell (3166_CR40) 2011; 46 S Baldwin (3166_CR4) 2015; 20 M-C Lai (3166_CR30) 2011; 6 E Cage (3166_CR8) 2013; 6 JN Constantino (3166_CR10) 2011; 69 T Attwood (3166_CR2) 2006 J Duvekot (3166_CR12) 2016 3166_CR18 TT Rivet (3166_CR38) 2011; 23 P Howlin (3166_CR20) 2000; 41 S Baron-Cohen (3166_CR7) 2001; 31 S Kopp (3166_CR26) 2011; 32 MA Farley (3166_CR15) 2009; 2 M Kirkovski (3166_CR24) 2013; 43 T Lugnegård (3166_CR32) 2011; 32 T Attwood (3166_CR3) 2007 W Mandy (3166_CR33) 2012; 42 S Kopp (3166_CR25) 1992; 1 M-C Lai (3166_CR29) 2015; 54 J Elliott (3166_CR14) 1999; 38 W Mandy (3166_CR34) 2015; 6 ME Bourgondien Van (3166_CR47) 1997; 27 C Barker (3166_CR6) 2005; 35 V Braun (3166_CR51) 2006; 3 M Dean (3166_CR11) 2016 K Izuma (3166_CR22) 2011; 108 X Sun (3166_CR45) 2014; 35 L Wing (3166_CR50) 1981; 5 (3166_CR37) 2014 K Dworzynski (3166_CR13) 2012; 51 American Psychiatric Association (3166_CR1) 2013 S Bargiela (3166_CR5) 2016 YS Kim (3166_CR23) 2011; 168 M-C Lai (3166_CR28) 2015; 2 PJM Wijngaarden-Cremers Van (3166_CR48) 2014; 44 TM Oswald (3166_CR36) 2016; 46 PT Shattuck (3166_CR43) 2012; 129 E Fombonne (3166_CR16) 2009; 65 EB Robinson (3166_CR39) 2013; 110 NJ Sasson (3166_CR41) 2017 PT Shattuck (3166_CR42) 2009; 48 C Chevallier (3166_CR9) 2012; 7 NL Kreiser (3166_CR27) 2014; 17 T May (3166_CR35) 2012 L Holliday Willey (3166_CR19) 2015 C Willig (3166_CR49) 2013 S Tierney (3166_CR46) 2016; 23 S Strunz (3166_CR44) 2016; 0 |
| References_xml | – reference: BarkerCPistrangNQuality criteria under methodological pluralism: Implications for conducting and evaluating researchAmerican Journal of Community Psychology2005353–420121210.1007/s10464-005-3398-y15909795 – reference: Holliday WilleyLPretending to be normal: Living with Asperger’s Syndrome (Autism Spectrum Disorder) (Expanded Edition)2015LondonJessica Kingsley – reference: ConstantinoJNThe quantitative nature of autistic social impairmentPediatric Research2011695 Pt 255R62R10.1203/PDR.0b013e318212ec6e212895373086844 – reference: KirkovskiMEnticottPGFitzgeraldPBA review of the role of female gender in autism spectrum disordersJournal of Autism and Developmental Disorders201343112584260310.1007/s10803-013-1811-123525974 – reference: BargielaSStewardRMandyWThe experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotypeJournal of Autism and Developmental Disorders2016274573645040731 – reference: LaiM-CLombardoMVPascoGRuigrokANVWheelwrightSJSadekSAA behavioral comparison of male and female adults with high functioning autism spectrum conditionsPloS ONE201166e2083510.1371/journal.pone.0020835216951473113855 – reference: American Psychiatric AssociationDSM 52013WashingtonAmerican Psychiatric Association – reference: DuvekotJVan der EndeJVerhulstFCSlappendelGVan DaalenEMarasAGreaves-LordKFactors influencing the probability of a diagnosis of Autism Spectrum Disorder in girls versus boysAutism201627940569 – reference: HullLPetridesKVMandyWBehavioural and cognitive sex/gender differences in autism spectrum condition and typically developing males and femalesAutism2016 – reference: SunXAllisonCAuyeungBBaron-CohenSBrayneCParental concerns, socioeconomic status, and the risk of autism spectrum conditions in a population-based studyResearch in Developmental Disabilities201435123678368810.1016/j.ridd.2014.07.03725262013 – reference: RitchieJLewisJMcNaughton NichollsCOrmstonRQualitative Research practice: A guide for social science students and researchers2014LondonSAGE – reference: BaldwinSCostleyDThe experiences and needs of female adults with high-functioning autism spectrum disorderAutism: The International Journal of Research and Practice201520448349510.1177/1362361315590805 – reference: Van BourgondienMEReichleNCPalmerASexual behavior in adults with autismJournal of Autism and Developmental Disorders199727211312510.1023/A:10258836224529105963 – reference: RivetTTMatsonJLReview of gender differences in core symptomatology in autism spectrum disordersResearch in Autism Spectrum Disorders201123395797610.1016/j.rasd.2010.12.003 – reference: RussellGSteerCGoldingJSocial and demographic factors that influence the diagnosis of autistic spectrum disordersSocial Psychiatry and Psychiatric Epidemiology201146121283129310.1007/s00127-010-0294-z20938640 – reference: KoppSGillbergCThe autism spectrum screening questionnaire (ASSQ)-revised extended version (ASSQ-REV): an instrument for better capturing the autism phenotype in girls? 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| Title | “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions |
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