Camouflaging and autism: Conceptualisation and methodological issues, (2026). Arnold, W. M., Bitsika, V., & Sharpley, C. F.

Open access article: https://journals.sagepub.com/doi/10.1177/13623613261420085

Abstract

It has been suggested that there is poor clarity of the ‘camouflaging’ concept in autism research, and potential confounding of its measurement tools, such as the Camouflaging Autistic Traits Questionnaire (CAT-Q). A critical review of 389 studies was conducted to investigate these potential conceptual and methodological issues. The findings question whether the same construct has been investigated across studies, as there is inconsistency in: (a) which terms are used; (b) reference made to established conceptual literature; (c) how terms are used (e.g. interchangeably or distinctly); and (d) how terms are defined. Although the CAT-Q has excellent reliability, there is mixed support for its validity, which is evidenced by its confounding by other constructs (e.g. social anxiety) and its limited autism-specificity. The validity of informant discrepancy measures of camouflaging is also questioned due to insufficient reference to established methodology. Finally, the generalisability of camouflaging to the overall autistic population is unclear due to: (a) overrepresentation of autistic females diagnosed during adulthood; and (b) underrepresentation of autistic people with co-occurring intellectual or language difficulties, and those with greater support needs. These issues are considered both in terms of their clinical relevance and how future research might resolve them.

Citation: Arnold, W. M., Bitsika, V., & Sharpley, C. F. (2026). Camouflaging and autism: Conceptualisation and methodological issues. Autism, 0(0). https://doi.org/10.1177/13623613261420085