Social camouflaging and safety behaviours in autism and social anxiety
Research type
Research Study
Full title
Understanding the relationship between social camouflaging in autism and safety behaviours in social anxiety in autistic and neurotypical adolescents
IRAS ID
300879
Contact name
Matthew Hollocks
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 8 months, 31 days
Research summary
Research Summary
The prevalence rate for Social Anxiety Disorder (SAD) is considerably higher for autistic children and young people (29.2%-57%) than their neurotypical peers (7.1%-12.1%).
This study aims to compare and contrast the construct overlap in autistic and neurotypcial adolescents between:
1) social camouflaging behaviours used to ‘mask’ one’s autism/autisitc traits, in order to appear ‘normal’ and ‘fit in’ with neurotypical individuals in social situation, AND
2) safety behaviours used in social situations to prevent feared outcomes from happening, including avoidance (e.g., avoid eye contact, keep quiet, being more passive and standing on the edge of social groups) and impression management (e.g., putting on an appearance of being more sociable and normal, even if behaviours are not genuine)Understanding the construct overlap between safety behaviours and social camouflaging in relation to social anxiety and autistic traits has important implications for treating social anxiety in autistic young people, as the balance of potential social benefits and costs of social camouflaging behaviours need to be more carefully considered compared to safety behaviours. Clinicians in Child and Adolescent Mental Health Services (CAMHS) and Neurodevelopmental services can make use of this knowledge to inform assessment and formulation of how maintenance factors identified for SAD in neurotypical adolescents are shared by autistic adolescents, and to adapt interventions accordingly to improve the quality of personalised care.
Plan:
57 young people with a clinical diagnosis of Autism Spectrum Disorder (ASD) and 57 neurotypical young people will be recruited to complete a short online questionnaire session that assesses their:
- Level of autism symptom severity/autistic traits
- Level of social anxiety
- Social camouflaging behaviours in the context of autism/autistic traits
- Safety behaviours (in the context of social anxiety.
Parents will complete a complementary set of online questionnaires on the young person's autistic traits/autism symptoms and general level of internalising behaviours.Summary of Results
Background: Social camouflaging (hereafter camouflaging) in autism includes factors such as masking and compensating for one’s neurodevelopmental differences, and to assimilate or “fit in” with non-autistic peers. Efforts to hide one’s authentic self and autism traits (masking) resemble impression management (IM) in safety behaviours identified in Clark and Wells' (1995) cognitive model of social anxiety (SA). This study explores the relationship between camouflaging in autism and safety behaviours in SA amongst autistic and non-autistic adolescents.
Methods: 115 adolescents (14-19 years) with (n = 61; 36 female) and without (n = 54; 37 female) a clinical diagnosis of autism matched on age and SA symptom severity were recruited from clinics, schools and online. Adolescents completed online measures including autism traits, SA symptoms, camouflaging behaviours, SA-related safety behaviours and SA-related negative cognitions. Partial and bivariate Pearson’s correlations and structural equation modelling were used to understand the relationship between camouflaging, safety behaviours, autism traits, and SA in both groups. Exploratory factor analysis assessed item-level factor cross-loadings between camouflaging and safety behaviours.
Results: Across both groups, masking and IM were significantly associated with SA symptom severity, not autism traits, via SA related social cognitions. Exploratory factor analysis indicated construct overlap across masking, assimilation, IM and avoidance behaviours, and identified factors analogous to self-focused attention, social avoidance and mental rehearsal identified in the Clark and Wells’ (1995) model of SA.
Conclusions: This is the first study using group-matched design to identify that masking (factor in social camouflaging) and IM both relate to SA in autistic and non-autistic adolescents. Assessment and formulation of construct overlap between masking and IM may inform psychoeducation and adaptation of SA treatment for autistic adolescents.REC name
London - Brent Research Ethics Committee
REC reference
21/LO/0750
Date of REC Opinion
13 Dec 2021
REC opinion
Further Information Favourable Opinion