Jump to content

Autistic masking

From Wikipedia, the free encyclopedia

Autistic masking,also referred to ascamouflagingorneurodivergent masking,is the conscious or subconscious suppression ofautisticbehaviors and compensation of difficulties insocial interactionby autistic people with the goal of being perceived asneurotypical.[1][2]Maskingis a learnedcoping strategy[3][4]that can be successful from the perspective of autistic people, but can also lead to adversemental healthoutcomes.[1][5]

Terminology[edit]

There is no universally agreed-upon terminology for the concept.[1][5]: 16–17 [6]While some use the termsmaskingandcamouflagingsynonymously,[1][2][5]: 16–17 others distinguish betweenmasking(the suppression of behaviors) andcompensation(of social difficulties) as the two main forms ofcamouflaging.[1][3][7]Among autistic people,maskingis the most commonly usedumbrella term.[5]: 16 [8]

The process of consciously giving up masking, which some autistic people see as a desirable goal, is referred to asunmasking.[2][9][10]Motivations for unmasking include no longer hiding one's true identity and avoiding adverse mental health outcomes.[2][8][9]

Forms[edit]

Typical examples of autistic masking include the suppression ofstimmingand reactions tosensory overload.[3]To compensate difficulties in social interaction with neurotypical peers, autistic people might maintaineye contactdespite discomfort or mirror thebody languageandtoneof others.[1][2][3][11]

Autistic people with conversational difficulties may also use more complex strategies such as scripting a conversation outline, developing conscious "rules" for conversations, carefully monitoring if these are being followed.[3]Many autistic people learn conversational rules and social behaviors by watching television shows and other media and by observing and mimicking a character's behavior.[11]Masking may also include refraining from talking aboutpassionate interests.[2][3]

Autistic people have cited social acceptance, the need to get a job, and the avoidance of ostracism or verbal or physical abuse as reasons for masking.[12]

Consequences[edit]

Masking requires an exceptional effort[3][13]and is a main cause ofautistic burnout.[14][15]It is linked with adversemental healthoutcomes[16][17]such asstress,[18]anxiety,depression,and otherpsychological disorders,[18]loss of identity,[18]andsuicidality.[19][20][21]Some studies find that compensation strategies are seen as contributing to leading a successful and satisfactory life.[1][7][13]Since many studies on masking focus on autistic adults withoutcognitive impairments,it is questionable whether their findings generalize across the autism spectrum.[1]

Masking may conceal the person's need for support.[12]It can complicate a diagnosis ofautism spectrum disorder(ASD), particularly past childhood, as relevant symptoms are suppressed or compensated for.[22]: 60–62 The diagnostic criteria for ASD in theDSM-5published in 2013 explicitly state that while symptoms "must be present in the early developmental period", these "may be masked by learned strategies in later life", allowing for a diagnosis even if autistic behaviors and difficulties are successfully masked.[22]: 57 [23]Addition of such a formulation was proposed to the workgroup drafting the criteria by representatives of theAutistic Self Advocacy Network.[23]The diagnostic criteria for ASD in theICD-11(2022) contain a similar provision.[16]

It has been hypothesized that masking may play an important role in explaining why autisticwomenandnon-binary persons[2]are significantly less often recognized and diagnosed as autistic compared to men.[2][3][11]This hypothesis was put forward byLorna Wingas early as 1981[5]: 20 [24]: 134 and is recognized in theDSM-5-TRpublished in 2022.[22]: 65 

Research[edit]

While masking was written about and discussed among autistic people, it has only become a focus of academic research since the 2010s.[5]: 18 TheCamouflaging Autistic Traits Questionnaire(CAT-Q), a firstself-report measurefor camouflaging, was published in 2018.[25][26]Across 25 items, it measures the extent to which a person utilizes strategies to actively compensate for difficulties in social situations (Compensation, 9 items), uses strategies to hide autistic characteristics or portray a non-autistic persona (Masking, 8 items), and employs strategies to fit in with others in social situations (Assimilation, 8 items).[25]

In light of rising awareness of the adverse mental health outcomes of masking and insight into thedouble empathy problem,therapies and interventions with implicit or explicit targets of instilling neurotypical behavior in autistic people and suppression of autistic traits are controversial.[27][28]Some autistic adults subjected toapplied behavior analysistherapies as children describe being forced to behave like neurotypical peers, contrary to their true identity, with detrimental effects on their mental and overall well-being.[29][30]

There are some research studies centering around the experiences of masking by comparing different groups of people. In 2021, researchers conducted an online survey that compares the experiences of masking in people with autism, neurodivergent people without autism, and neurotypical people.[31]They found that the behavior of masking is shared across all types of people, but some aspects of masking are more specific to people with autism, such as sensory suppression and suppression of stimming. Researchers also situated this into a workplace context and examined workplace masking experiences for autistic, non-autistic, and neurotypical adults in the UK. They identified eight emerging themes from the survey and reported large overlap among three groups such as reasonings and perceptions of benefits and drawbacks: both neurodivergent and neurotypical people adopted masking strategies to achieve social goals, indicating that masking is more like a common rather exclusive experience.[32]

Some qualitative research focused more on the masking experiences specifically for autistic people. A study in 2022 conducted semi-structured interviews with twenty autistic teenagers and observed how masking is associated with mental health (but not necessarily in linear relationship) and how both of them are affected by social and environmental factors. They stressed the need of approaching masking, authenticity, and mental health through the context of people's identities and also the environment, additionally providing some implications to diagnostic services and interventions.[33]Across autism spectrum, there's also an overview of masking/camouflaging characterizations which explores the analogy between camouflaging and passing and argues how masking may be further different for understudied groups across the spectrum like children and adults with linguistic disabilities.[34]

In addition to masking, researchers investigated the 'authenticity' people with autism feel while socializing and observed how supportive environments like being around people who accept and understand them can lead to their self-awareness and bring more positive socializing experiences than camouflaging.[35]However, this doesn't imply that autistic 'masking' is equivalent to non-authenticity. Researchers proposed that the focus should not be encouraging masking, but promoting autistic authenticity which brings more positive self-image and better mental health.[33]

References[edit]

  1. ^abcdefghPetrolini, Valentina; Rodríguez-Armendariz, Ekaine; Vicente, Agustín (2023)."Autistic camouflaging across the spectrum".New Ideas in Psychology.68:100992.doi:10.1016/j.newideapsych.2022.100992.hdl:10810/59712.S2CID253316582.
  2. ^abcdefghPearson, Amy; Rose, Kieran (2021)."A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice".Autism in Adulthood.3(1): 52–60.doi:10.1089/aut.2020.0043.PMC8992880.PMID36601266.
  3. ^abcdefghHull, Laura; Petrides, K. V.; Allison, Carrie; Smith, Paula;Baron-Cohen, Simon;Lai, Meng-Chuan; Mandy, William (2017).""Putting on My Best Normal": Social Camouflaging in Adults with Autism Spectrum Conditions ".Journal of Autism and Developmental Disorders.47(8): 2519–2534.doi:10.1007/s10803-017-3166-5.PMC5509825.PMID28527095.
  4. ^Lawson, Wenn B. (2020)."Adaptive Morphing and Coping with Social Threat in Autism: An Autistic Perspective".Journal of Intellectual Disability - Diagnosis and Treatment.8(3): 519–526.doi:10.6000/2292-2598.2020.08.03.29.ISSN2292-2598.S2CID224896658.
  5. ^abcdefSedgewick, Felicity; Hull, Laura; Ellis, Helen (2021).Autism and Masking: How and Why People Do It, and the Impact It Can Have.London:Jessica Kingsley Publishers.ISBN978-1-78775-580-2.OCLC1287133295.
  6. ^Cook, Julia; Hull, Laura; Crane, Laura; Mandy, William (2021)."Camouflaging in autism: A systematic review".Clinical Psychology Review.89:102080.doi:10.1016/j.cpr.2021.102080.ISSN0272-7358.PMID34563942.S2CID237942158.
  7. ^abLivingston, Lucy Anne; Shah, Punit;Happé, Francesca(2019)."Compensatory strategies below the behavioural surface in autism: a qualitative study".The Lancet Psychiatry.6(9): 766–777.doi:10.1016/s2215-0366(19)30224-x.ISSN2215-0366.PMC6706698.PMID31350208.
  8. ^abCassidy, Elizabeth (2018-08-16)."Autistic Adults Start Campaign to Put an End to This 'Harmful' Behavior".The Mighty.Retrieved2023-05-08.Cited as an example inPetrolini, Valentina; Rodríguez-Armendariz, Ekaine; Vicente, Agustín (2023)."Autistic camouflaging across the spectrum".New Ideas in Psychology.68:100992.doi:10.1016/j.newideapsych.2022.100992.hdl:10810/59712.S2CID253316582.
  9. ^abPrice, Devon(2022).Unmasking Autism: The Power of Embracing Our Hidden Neurodiversity.London: Monoray.ISBN978-1-80096-054-1.OCLC1321047301.
  10. ^Mandy, Will (2019)."Social camouflaging in autism: Is it time to lose the mask?".Autism.23(8): 1879–1881.doi:10.1177/1362361319878559.PMID31552745.S2CID202762080.
  11. ^abcHull, Laura; Petrides, K. V.; Mandy, William (2020)."The Female Autism Phenotype and Camouflaging: a Narrative Review".Review Journal of Autism and Developmental Disorders.7(4): 306–317.doi:10.1007/s40489-020-00197-9.S2CID256402443.
  12. ^abHaelle, Tara (2018-04-18)."The Consequences of Compensation in Autism".Neurology Advisor.Haymarket Media Group.Retrieved2023-05-08.
  13. ^abMiller, Danielle; Rees, Jon; Pearson, Amy (2021-12-01).""Masking Is Life": Experiences of Masking in Autistic and Nonautistic Adults ".Autism in Adulthood.3(4): 330–338.doi:10.1089/aut.2020.0083.ISSN2573-9581.PMC8992921.PMID36601640.
  14. ^Deweerdt, Sarah (2020-03-30)."Autistic burnout, explained".Spectrum.Simons Foundation.doi:10.53053/bpzp2355.S2CID251634477.Retrieved2023-05-09.
  15. ^Arnold, Samuel RC; Higgins, Julianne M; Weise, Janelle; Desai, Aishani; Pellicano, Elizabeth; Trollor, Julian N (2023)."Confirming the nature of autistic burnout".Autism.27(7): 1906–1918.doi:10.1177/13623613221147410.PMID36637293.S2CID255773489.
  16. ^ab"6A02 Autism spectrum disorder".ICD-11 for Mortality and Morbidity Statistics.World Health Organization.2023.Retrieved2023-05-05.
  17. ^Russo, Francine (21 February 2018)."The Costs of Camouflaging Autism".Spectrum.Simons Foundation.Retrieved2023-05-08.
  18. ^abcRadulski, Elizabeth M. (2022)."Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of Neurodiversity".Human Development.66(2): 113–127.doi:10.1159/000524122.S2CID248864273.
  19. ^Cassidy, Sarah; Bradley, Louise; Shaw, Rebecca;Baron-Cohen, Simon(2018)."Risk markers for suicidality in autistic adults".Molecular Autism.9(1): 42.doi:10.1186/s13229-018-0226-4.ISSN2040-2392.PMC6069847.PMID30083306.
  20. ^Cassidy, S. A.; Gould, K.; Townsend, E.; Pelton, M.; Robertson, A. E.; Rodgers, J. (2020)."Is Camouflaging Autistic Traits Associated with Suicidal Thoughts and Behaviours? Expanding the Interpersonal Psychological Theory of Suicide in an Undergraduate Student Sample".Journal of Autism and Developmental Disorders.50(10): 3638–3648.doi:10.1007/s10803-019-04323-3.ISSN1573-3432.PMC7502035.PMID31820344.
  21. ^Cage, Eilidh (2017)."Experiences of Autism Acceptance and Mental Health in Autistic Adults".Journal of Autism and Developmental Disorders.49(2): 473–484.doi:10.1007/s10803-017-3342-7.PMC5807490.PMID29071566.
  22. ^abcAmerican Psychiatric Association(2022).Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision.Washington, DC: American Psychiatric Association.doi:10.1176/appi.books.9780890425787.ISBN978-0-89042-575-6.S2CID249488050.
  23. ^abKapp, Steven K.;Ne'eman, Ari(2020), Kapp, Steven K. (ed.),"Lobbying Autism's Diagnostic Revision in the DSM-5"(PDF),Autistic Community and the Neurodiversity Movement: Stories from the Frontline,Singapore: Palgrave Macmillan, pp. 167–194,doi:10.1007/978-981-13-8437-0_13,ISBN978-981-13-8437-0,S2CID209465381,retrieved2023-06-08
  24. ^Wing, Lorna(1981)."Sex ratios in early childhood autism and related conditions".Psychiatry Research.5(2): 129–137.doi:10.1016/0165-1781(81)90043-3.PMID6945608.S2CID41912698.
  25. ^abHull, Laura; Mandy, William; Lai, Meng-Chuan;Baron-Cohen, Simon;Allison, Carrie; Smith, Paula; Petrides, K. V. (2019) [Published 25 October 2018]."Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q)".Journal of Autism and Developmental Disorders.49(3): 819–833.doi:10.1007/s10803-018-3792-6.PMC6394586.PMID30361940.
  26. ^Williams, Zachary J. (2022)."Commentary: The construct validity of 'camouflaging' in autism: psychometric considerations and recommendations for future research ‐ reflection on Lai et al. (2020)".Journal of Child Psychology and Psychiatry.63(1): 118–121.doi:10.1111/jcpp.13468.PMC8678389.PMID34145574.
  27. ^Schuck, Rachel K.; Tagavi, Daina M.; Baiden, Kaitlynn M. P.; Dwyer, Patrick; Williams, Zachary J.; Osuna, Anthony; Ferguson, Emily F.; Jimenez Muñoz, Maria; Poyser, Samantha K.; Johnson, Joy F.; Vernon, Ty W. (2022)."Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework".Journal of Autism and Developmental Disorders.52(10): 4625–4645.doi:10.1007/s10803-021-05316-x.PMC9508016.PMID34643863.
  28. ^Dawson, Geraldine; Franz, Lauren; Brandsen, S. (2022)."At a Crossroads—Reconsidering the Goals of Autism Early Behavioral Intervention From a Neurodiversity Perspective".JAMA Pediatrics.176(9): 839–840.doi:10.1001/jamapediatrics.2022.2299.PMC10069446.PMID35816341.
  29. ^McGill, Owen; Robinson, Anna (2020).""Recalling hidden harms": autistic experiences of childhood applied behavioural analysis (ABA) "(PDF).Advances in Autism.7(4): 269–282.doi:10.1108/AIA-04-2020-0025.S2CID225282499– via Strathprints (University of Strathclyde).
  30. ^Anderson, Laura K (2023)."Autistic experiences of applied behavior analysis".Autism.27(3): 737–750.doi:10.1177/13623613221118216.ISSN1362-3613.PMID35999706.S2CID251766661.
  31. ^Miller, Danielle; Rees, Jon; Pearson, Amy (2021-12-01).""Masking Is Life": Experiences of Masking in Autistic and Nonautistic Adults ".Autism in Adulthood.3(4): 330–338.doi:10.1089/aut.2020.0083.ISSN2573-9581.PMC8992921.PMID36601640.
  32. ^Pryke-Hobbes, Amber; Davies, Jade; Heasman, Brett; Livesey, Adam; Walker, Amy; Pellicano, Elizabeth; Remington, Anna (2023-09-06). Rosenbaum, Janet E. (ed.)."The workplace masking experiences of autistic, non-autistic neurodivergent and neurotypical adults in the UK".PLOS ONE.18(9): e0290001.Bibcode:2023PLoSO..1890001P.doi:10.1371/journal.pone.0290001.ISSN1932-6203.PMC10482295.PMID37672533.
  33. ^abChapman, Louise; Rose, Kieran; Hull, Laura; Mandy, William (2022-11-01).""I want to fit in… but I don't want to change myself fundamentally": A qualitative exploration of the relationship between masking and mental health for autistic teenagers ".Research in Autism Spectrum Disorders.99:102069.doi:10.1016/j.rasd.2022.102069.ISSN1750-9467.S2CID253495529.
  34. ^Petrolini, Valentina; Rodríguez-Armendariz, Ekaine; Vicente, Agustín (2023-01-01)."Autistic camouflaging across the spectrum".New Ideas in Psychology.68:100992.doi:10.1016/j.newideapsych.2022.100992.hdl:10810/59712.ISSN0732-118X.S2CID253316582.
  35. ^Cook, Julia M; Crane, Laura; Mandy, William (2023-07-05)."Dropping the mask: It takes two".Autism.doi:10.1177/13623613231183059.ISSN1362-3613.PMID37403917.S2CID259335250.

Further reading[edit]

External links[edit]

Retrieved from "https://en.wikipedia.org/w/index.php?title=Autistic_masking&oldid=1233688437"