Camouflaging (also known asmasking) inautismandADHDrefers to the use of strategies to mask or hide traits associated with these conditions.
Camouflaging can lead to late or missed diagnoses, as the individual’s struggles may not be apparent. It can also result in exhaustion, stress, and mental health issues due to the constant effort required to maintain a façade.
Camouflaging may prevent individuals from receiving appropriate support and accommodations, negatively impacting their well-being and quality of life.
Key Points
Rationale
Camouflaging, the use of strategies to minimize the visibility of one’sautism traits, is thought to contribute to late autism diagnoses and mental health difficulties (Bargiela et al., 2016; Livingston et al., 2019).
However, it is unclear whether onlyautistic people camouflageor if people with other neurodevelopmental conditions, such as ADHD, also use similar strategies (Fombonne, 2020).
Investigatingcamouflaging in ADHDis important because, like autistic people, those with ADHD experience stigma, may receive late diagnoses, and report elevated levels of mental health difficulties (Asherson & Agnew-Blais, 2019; Franke et al., 2018; Mueller et al., 2012).
Method
Procedure
This preregistered study (AsPredicted #41811) used across-sectional design, with participants completing online questionnaires.
Sample
Measures
Statistical measures
ANOVAs, MANOVAs, and multiple regression analyses were used to compare camouflaging between groups and explore the relationship between camouflaging, autism traits, and ADHD traits.
Results
The study found that adults with ADHD reported more total camouflaging than the comparison group, but less than autistic adults.
Autistic adults scored higher on the compensation and assimilation subscales of the CAT-Q-NL compared to adults with ADHD. Autism traits, but not ADHD traits, significantly predicted camouflaging behavior, independent of diagnosis.
Insight
This study provides valuable insights into camouflaging behavior in adults with ADHD, revealing that they do engage in camouflaging, although to a lesser extent than autistic adults.
The findings suggest that camouflaging is not unique to autism and may be relevant to people with other neurodevelopmental conditions.
The study highlights the need for more general measures of camouflaging behavior, independent of diagnosis, to better understand and compare camouflaging across different groups.
Strengths
This study had several methodological strengths, including:
Limitations
However, there are many limitations to take into consideration, including:
Implications
This study’s findings have significant implications for understanding and supporting adults with ADHD.
Clinicians and researchers should be aware of the potential impact of camouflaging in people with ADHD, as it may contribute to late diagnoses and mental health difficulties.
By recognizing and addressing camouflaging in ADHD, appropriate mental health care and support can be provided more effectively.
References
Asherson, P., & Agnew-Blais, J. (2019). Annual research review: Does late-onset attention-deficit/hyperactivity disorder exist?Journal of Child Psychology and Psychiatry, 60(4), 333–352.https://doi.org/10.1111/jcpp.13020
Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotype.Journal of Autism and Developmental Disorders, 46(10), 3281–3294.https://doi.org/10.1007/s10803-016-2872-8
Fombonne, E. (2020). Camouflage and autism.Journal of Child Psychology and Psychiatry, 61(7), 735–738.https://doi.org/10.1111/jcpp.13296
Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K.-P., Ramos-Quiroga, J. A., Réthelyi, J. M., Ribases, M., & Reif, A. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan.European Neuropsychopharmacology, 28(10), 1059–1088.https://doi.org/10.1016/j.euroneuro.2018.08.001
Livingston, L. A., Shah, P., & Happé, F. (2019). Compensatory strategies below the Behavioural surface in autism: A qualitative study.The Lancet Psychiatry, 6(9), 766–777.https://doi.org/10.1016/S2215-0366(19)30224-X
Mueller, A. K., Fuermaier, A. B. M., Koerts, J., & Tucha, L. (2012). Stigma in attention deficit hyperactivity disorder.ADHD Attention Deficit and Hyperactivity Disorders, 4(3), 101–114.https://doi.org/10.1007/s12402-012-0085-3
Keep Learning
Here are some reflective questions related to this study that could prompt further discussion:
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
