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      Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q)

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          Abstract

          There currently exist no self-report measures of social camouflaging behaviours (strategies used to compensate for or mask autistic characteristics during social interactions). The Camouflaging Autistic Traits Questionnaire (CAT-Q) was developed from autistic adults’ experiences of camouflaging, and was administered online to 354 autistic and 478 non-autistic adults. Exploratory factor analysis suggested three factors, comprising of 25 items in total. Good model fit was demonstrated through confirmatory factor analysis, with measurement invariance analyses demonstrating equivalent factor structures across gender and diagnostic group. Internal consistency (α = 0.94) and preliminary test–retest reliability (r = 0.77) were acceptable. Convergent validity was demonstrated through comparison with measures of autistic traits, wellbeing, anxiety, and depression. The present study provides robust psychometric support for the CAT-Q.

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          Construct validity in psychological tests.

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            Set Correlation and Contingency Tables

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              Quantifying and exploring camouflaging in men and women with autism

              Autobiographical descriptions and clinician observations suggest that some individuals with autism, particularly females, ‘camouflage’ their social communication difficulties, which may require considerable cognitive effort and lead to increased stress, anxiety and depression. Using data from 60 age- and IQ-matched men and women with autism (without intellectual disability), we operationalized camouflaging in adults with autism for the first time as the quantitative discrepancy between the person’s ‘external’ behavioural presentation in social–interpersonal contexts (measured by the Autism Diagnostic Observation Schedule) and the person’s ‘internal’ status (dispositional traits measured by the Autism Spectrum Quotient and social cognitive capability measured by the ‘Reading the Mind in the Eyes’ Test). We found that the operationalized camouflaging measure was not significantly correlated with age or IQ. On average, women with autism had higher camouflaging scores than men with autism (Cohen’s d = 0.98), with substantial variability in both groups. Greater camouflaging was associated with more depressive symptoms in men and better signal-detection sensitivity in women with autism. The neuroanatomical association with camouflaging score was largely sex/gender-dependent and significant only in women: from reverse inference, the most correlated cognitive terms were about emotion and memory. The underlying constructs, measurement, mechanisms, consequences and heterogeneity of camouflaging in autism warrant further investigation.
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                Author and article information

                Journal
                7904301
                4537
                J Autism Dev Disord
                J Autism Dev Disord
                Journal of autism and developmental disorders
                0162-3257
                1573-3432
                3 January 2019
                March 2019
                01 March 2019
                : 49
                : 3
                : 819-833
                Affiliations
                [1 ]Research Department of Clinical, Educational & Health Psychology, University College London, London, UK
                [2 ]Child and Youth Mental Health Collaborative, Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
                [3 ]Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
                [4 ]Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
                [5 ]London Psychometric Laboratory, University College London, London, UK
                [6 ]Department of Psychology, University College London, 26 Bedford Way, London WC1H 0AP, UK
                Author notes
                Article
                EMS81084
                10.1007/s10803-018-3792-6
                6394586
                30361940
                95d422af-9636-4baf-a252-5c644dd1d8c0

                This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                Categories
                Article

                Neurology
                autism,camouflaging,masking,compensation,coping strategies
                Neurology
                autism, camouflaging, masking, compensation, coping strategies

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