Masking Autistic Symptoms May Not Cause Increased Mental Health Issues

Masking Autistic Symptoms May Not Cause Increased Mental Health Issues

In a groundbreaking study published in Autism (2023), researchers led by Wikke J. van der Putten have challenged the common belief that camouflaging in autistic individuals directly causes mental health difficulties. The research, which followed 332 autistic adults in the Netherlands aged 30 to 84 over a two-year period, found that **higher levels of camouflaging at the start of the study were actually associated with a small but statistically significant decrease in mental health difficulties over time**.

Camouflaging, a strategy used by autistic individuals to conceal their traits, involves mimicking social behaviours, suppressing natural responses, or masking signs of autism to appear more "neurotypical." However, the study's findings suggest that this behaviour may not be a primary factor influencing mental health difficulties among older autistic adults.

The study's author stresses that more research is needed to fully understand the relationship between camouflaging and mental health. Nevertheless, the findings offer a nuanced perspective on camouflaging, suggesting its psychological impact may depend on individual context, motivations, and outcomes.

One of the key findings was that while camouflaging was strongly associated with greater mental health difficulties at the beginning of the study, it did not predict worsening mental health over time. Conversely, autistic individuals who initially camouflaged less experienced a slight increase in mental health difficulties over the same period.

This suggests a more complex cause-and-effect relationship than previously thought: rather than camouflaging driving psychological harm, it may be that camouflaging can have some protective or mitigating effects on mental health for some autistic people. This counters the widespread assumption that camouflaging inherently contributes to anxiety, depression, or other psychological struggles.

The study also found that initial levels of anxiety, depression, or other mental health issues did not appear to predict changes in camouflaging behaviour. For some, camouflaging might be a pragmatic strategy to manage social expectations and avoid stigma, potentially reducing stress in the short term.

However, the study only included two time points, restricting the ability to draw firm conclusions about causality. Clinicians might instead explore when, how, and why individuals camouflage, and whether it helps or harms their well-being. The study also raises questions about how well current tools capture the complexity of camouflaging, suggesting future studies could benefit from exploring factors such as the emotional cost of camouflaging, the contexts in which it occurs, and whether it feels voluntary or forced.

By better understanding the relationship between camouflaging and mental health, professionals can better support autistic individuals in navigating social expectations while preserving their sense of self and mental health. The study underscores the need for personalized approaches in supporting autistic people's mental health.

1. The study's author emphasizes the necessity for further research to delve deeper into the connection between camouflaging and mental health, as the current findings offer a nuanced perspective.
2. The relationship between camouflaging and mental health difficulties may not be as straightforward as previously believed, suggesting a more complex cause-and-effect relationship.
3. Camouflaging, often associated with a decrease in mental health difficulties in older autistic individuals, might have protective or mitigating effects on mental health for some individuals.
4. The study revealed that initial levels of mental health issues did not seem to influence camouflaging behavior, implying that camouflaging could be a strategic response to manage social expectations and stigma, potentially alleviating stress temporarily.
5. To gain a comprehensive understanding of camouflaging, future studies should consider exploring factors such as the emotional cost, contexts, and perceived voluntariness of camouflaging, aiming to develop more effective strategies for health-and-wellness and mental-health support.
6. As the study underscores, understanding the intricate relationship between camouflaging and mental health is crucial for professionals to help autistic individuals maintain their identity and mental health while navigating social behaviors in a supported and personalized manner.

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