Is camouflaging unique for autism? A comparison of camouflaging between adults with autism and ADHD

作者：W. J. van der Putten, A. J. J. Mol, A. P. Groenman, T. A. Radhoe, C. Torenvliet, J. A. Agelink van Rentergem, H. M. Geurts

摘要原文：Camouflaging (using (un)conscious strategies to appear as non-autistic) is thought to be an important reason for late autism diagnoses and mental health difficulties. However, it is unclear whether only autistic people camouflage or whether people with other neurodevelopmental or mental health conditions also use similar camouflaging strategies. Therefore, in this preregistered study (AsPredicted: #41811) study, we investigated if adults with attention-deficit/hyperactivity-disorder (ADHD) also camouflage. Adults aged 30–90 years filled in the Dutch Camouflaging Autistic Traits Questionnaire (CAT-Q-NL), the ADHD Self-Report (ADHD-SR) and the Autism Spectrum Quotient (AQ). We investigated differences in camouflaging between adults with ADHD, autism, and a comparison group in an age and sex-matched subsample (N = 105 per group). We explored if autism and ADHD traits explained camouflaging levels in adults with an autism and/or ADHD diagnosis (N = 477). Adults with ADHD scored higher on total camouflaging and assimilation subscale compared to the comparison group. However, adults with ADHD scored lower on total camouflaging, and subscales compensation and assimilation than autistic adults. Autism traits, but not ADHD traits, were a significant predictor of camouflaging, independent of diagnosis. Thus, camouflaging does not seem to be unique to autistic adults, since adults with ADHD also show camouflaging behavior, even though not as much as autistic adults. However, as the CAT-Q-NL specifically measures camouflaging of autistic traits it is important to develop more general measures of camouflaging, to compare camouflaging more reliably in people with different mental health conditions. Furthermore, focusing on camouflaging in adults with ADHD, including potential consequences for late diagnoses and mental health seems a promising future research avenue.

摘要翻译：伪装（使用（无）意识的策略表现为非自闭症患者）被认为是晚期自闭症诊断和心理健康困难的重要原因。然而，目前尚不清楚是否只有自闭症患者会伪装，或者患有其他神经发育或心理健康疾病的人是否也使用类似的伪装策略。因此，在这项预先注册的研究 （AsPredicted： #41811） 研究中，我们调查了患有注意力缺陷/多动障碍 （ADHD） 的成年人是否也会伪装。30-90 岁的成年人填写了荷兰伪装自闭症特质问卷 （CAT-Q-NL）、ADHD 自我报告 （ADHD-SR） 和自闭症谱商 （AQ）。我们调查了患有 ADHD、自闭症的成年人和对照组在年龄和性别匹配的子样本（每组 N = 105）中伪装的差异。我们探讨了自闭症和多动症特征是否解释了自闭症和/或多动症诊断的成年人的伪装水平（N = 477）。与对照组相比，患有 ADHD 的成年人在总伪装和同化分量表上的得分更高。然而，与自闭症成年人相比，患有 ADHD 的成年人在总伪装、分量表补偿和同化方面的得分较低。自闭症特征，但不是ADHD特征，是伪装的重要预测因子，与诊断无关。因此，伪装似乎并不是自闭症成年人所独有的，因为患有多动症的成年人也表现出伪装行为，尽管没有自闭症成年人那么多。然而，由于 CAT-Q-NL 专门测量自闭症特征的伪装，因此重要的是要开发更通用的伪装措施，以更可靠地比较具有不同心理健康状况的人的伪装。此外，专注于ADHD成人的伪装，包括对晚期诊断和心理健康的潜在后果，似乎是一个有前途的未来研究途径。