Camouflaging: psychopathological meanings and clinical relevance in autism spectrum conditions

Abstract

<jats:title>Abstract</jats:title> <jats:p>In the last decade, increasing literature focused on camouflaging as a strategy adopted to cope with social environment by patients with autism spectrum disorder (ASD). A better understanding of this phenomenon may shed more light on cognitive mechanisms and coping strategies of patients in the autism continuum, eventually leading to reconsider some previous “dogmas” in this field, such as the gender discrepancy in ASD diagnosis. Moreover, shared features can be observed in the camouflaging strategies adopted among the general population, among patients of the autism spectrum, and among patients with different kinds of psychiatric disorders, further challenging our perspectives. Camouflaging behaviors might be considered as a transdiagnostic element, closely associated with the continuous distribution of the autism spectrum among the general and the clinical population.</jats:p>

Investigating the Relationship between Autistic Traits, Ruminative Thinking, and Suicidality in a Clinical Sample of Subjects with Bipolar Disorder and Borderline Personality Disorder

“…The presence of difficulties in non verbal communication among the autism dimensions more linked to suicidality, is in line with previous studies that hypothesized, in individuals with autistic traits, a link between the presence of a greater suicidal ideation and the presence of social and interpersonal difficulties, which would eventually lead to a higher risk of isolation and depressive symptoms [ 13 , 20 , 56 ]. The higher association found between suicidality and AdAS Spectrum Non verbal communication domain scores among BPD subjects may also be considered in line with previous findings that stressed how individuals in the mild range of the autism spectrum may be more aware of their difficulties in communicating with others, often developing social anxiety symptoms and maladaptive coping strategies, which may lead to more distress [ 55 , 58 ]. In particular, the high awareness of social communication difficulties seems to be particularly represented in female autism phenotypes, which often are characterized by the presence of camouflaging strategies [ 55 , 58 ].…”

“…The higher association found between suicidality and AdAS Spectrum Non verbal communication domain scores among BPD subjects may also be considered in line with previous findings that stressed how individuals in the mild range of the autism spectrum may be more aware of their difficulties in communicating with others, often developing social anxiety symptoms and maladaptive coping strategies, which may lead to more distress [ 55 , 58 ]. In particular, the high awareness of social communication difficulties seems to be particularly represented in female autism phenotypes, which often are characterized by the presence of camouflaging strategies [ 55 , 58 ]. Noticeably, both BPD and social anxiety are disorders more represented among females, and they feature, as the autism spectrum, an impairment of the social brain [ 59 , 60 , 61 ].…”

“…In particular, while BD subjects scored very close to 70 (specifically, 69.45 ± 27.12), which is the AdAS Spectrum threshold for the presence of ASD clinical symptoms, BPD subjects scored around 51, which is far below that threshold but still beyond the AdAS Spectrum threshold of 43, which marks the presence of relevant autistic traits [ 54 ]. These findings may lead to hypothesize a greater load of autism spectrum features and, possibly, of neurodevelopmental alteration severity, in BD than in BPD [ 55 ]. However, in line with previous studies in this field, our results highlighted higher ruminative thinking and suicidality tendencies in both the clinical groups than in the CTL group, without significant differences between BD and BPD subjects [ 16 , 20 , 36 , 37 , 38 ].…”

What misdiagnoses do women with autism spectrum disorder receive in the DSM-5?

“…Subsequently ASD females, in particular those without language or intellectual impairment, would likely receive other kinds of diagnoses, with a consequent negative impact on the course of the disease and on the treatment outcome. 1,2 One of the first line of investigations in this field focused on Anorexia nervosa (AN). Intriguingly, AN shows an opposite gender ratio when compared to ASD, featuring a strikingly higher prevalence among females but also a familiar aggregation with ASD.…”

A Systematic Review of Passing as Non-autistic in Autism Spectrum Disorder

“…Future research should include 'neurotypical' comparison groups as well as samples of non-autistic individuals with other psychiatric and neurodevelopmental conditions (e.g., anxiety, ADHD) to better understand the relationship between PAN and its parallels in other marginalized groups (Dell'Osso, Lorenzi, & Carpita, 2020) and to explore its potential overlap with similar phenomena such as so-called "optimal outcomes" (Fein et al, 2013).…”