Continuity, change, and psychosocial predictors of camouflaging in autistic adults: a three-time point follow-up study over 2 years

Background: Many autistic people camouflage their autistic traits to fit into non-autistic environments. While psychosocial factors influence camouflaging, its development and relationship with these factors over time remain unclear due to limited prospective follow-up studies. This study examined (a) continuity and change in camouflaging over 2 years, and (b) whether sociocultural predictors at Time 1 (T1: perceived stigma, vulnerability events, cultural tightness-looseness, and independent and interdependent self-construal) and psychological factors at Time 2 (T2: fear of negative evaluation [FNE], self-esteem, and autistic identity) predicted camouflaging at Time 3 (T3). Methods: Participants completed self-report measures of camouflaging and psychosocial experiences online at three time points across 2 years. Of 231 T1 participants, 135 completed T2, and 104 completed T3. After data cleaning and addressing missing data, the final sample included 226 autistic adults (18–77 years; 60.6% female). We assessed continuity and change using mean scores, intraclass correlation coefficients (ICCs), and latent growth modeling, and conducted a path analysis of earlier (T1 and T2) psychosocial predictors of later (T3) camouflaging. Results: Camouflaging showed considerable stability in individual rankings (ICCs = 0.80–0.86) and at group mean levels, with growth modeling suggesting a slight overall decline. The path model of T1 sociocultural and T2 psychological factors explained 32.2% of the variance in T3 camouflaging. Earlier FNE, autistic identity, and self-construal variables predicted later camouflaging, directly or indirectly. Conclusion: This is the first prospective study examining camouflaging over 2 years. Findings highlight the overall stability of camouflaging in adulthood and the role of earlier psychosocial predictors in later camouflaging, emphasizing the need to address sociocultural and psychological pressures on autistic people. Future research could use ecological momentary assessment and longer term studies to explore camouflaging across different social contexts and life stages. Community Brief – Why is this an important issue? – Many autistic people adapt their behaviors to fit into non-autistic social environments, a process called camouflaging. While this can help build social connections and avoid stigma, it can often contribute to mental health issues such as anxiety, depression, and burnout. Although previous research shows that various psychological and social factors relate to camouflaging, we still do not fully understand how camouflaging changes over time or the extent to which it is affected by these factors, as there are no prospective studies with multiple time points to date. What was the purpose of this study? – This study explored how camouflaging behaviors change or remain stable over 2 years. It also looked at whether earlier sociocultural factors (such as perceived stigma, negative life events, cultural emphasis on conformity, and the desire to fit in or stand out) and psychological factors (such as fear of being negatively judged, self-esteem, and autistic identity) affect the extent to which individuals will engage in later camouflaging behaviors. What did the researchers do? – We asked participants to complete online measures of camouflaging, well-being, and psychosocial experiences at three time points across 2 years. We analyzed data from 226 autistic adults (18–77 years; 60.6% female), to understand how camouflaging behaviors changed over time. We also looked at the relationships between psychosocial factors and camouflaging across three time points. What were the results and conclusions of the study? – Camouflaging behaviors reported by participants were generally stable over 2 years. Earlier psychosocial factors, such as fear of negative judgment, autistic identity, and the desire to fit in or stand out, were linked to later camouflaging. What is new or controversial about these findings? – This study is the first to track changes in camouflaging across three time points. It shows that autistic adults’ camouflaging behaviors remain relatively stable over 2 years. It also shows that earlier psychological and social pressures predict later camouflaging behaviors, emphasizing the need to address and reduce these pressures in autistic people’s lives. What are potential weaknesses in the study? – Our investigation of stability in camouflaging across 2 years of adulthood may have missed substantial changes in camouflaging occurring over longer intervals or across significant developmental periods, such as adolescence. Also, participant demographics—mainly White, female, and highly educated—may limit how well the results apply to other groups of autistic people. Longer term studies could explore how camouflaging behaviors develop or change across different life stages and social contexts, as well as how they vary across cultures and among autistic people with diverse backgrounds. How will these findings help autistic adults now or in the future? – The findings show that it is important to understand and address the psychological and social pressures related to camouflaging. By promoting acceptance and fostering supportive environments, autistic individuals can feel safer expressing their authentic selves without fear of judgment, which will likely improve their mental health and well-being.