Camouflaging in autism: A cause or a consequence of mental health difficulties? / Audrey JJ MOL ; Tulsi A RADHOE ; Carolien TORENVLIET ; Joost A AGELINK VAN RENTERGEM ; Annabeth P GROENMAN ; Hilde M GEURTS in Autism, 29-10 (October 2025)  

Public ISBD [article]  inAutism > 29-10 (October 2025) . - p.2604-2617 Titre : Camouflaging in autism: A cause or a consequence of mental health difficulties? Type de document : texte imprimé Auteurs : Audrey JJ MOL, Auteur ; Tulsi A RADHOE, Auteur ; Carolien TORENVLIET, Auteur ; Joost A AGELINK VAN RENTERGEM, Auteur ; Annabeth P GROENMAN, Auteur ; Hilde M GEURTS, Auteur Article en page(s) : p.2604-2617 Langues : Anglais (eng) Mots-clés : autism  camouflaging  mental health difficulties Index. décimale : PER Périodiques Résumé : Camouflaging ([un]consciously hiding one?s autism traits) is hypothesized to be an underlying mechanism explaining elevated levels of mental health difficulties in autistic adults. As previous studies investigating this relationship were all cross-sectional, the direction of this association remains unclear. Therefore, we investigated whether (1) camouflaging predicts a change in mental health difficulties and (2) mental health difficulties predict a change in camouflaging. For this, 332 autistic adults aged 30 to 84 years (157 women) filled in the Dutch Camouflaging Autistic Traits Questionnaire, Symptom Checklist-90 Revised, and Autism Spectrum Quotient at two timepoints with an average time interval of 2 years. Preregistered multilevel analyses showed a negative interaction between initial camouflaging and time, indicating that people with higher initial levels of camouflaging showed a decrease in mental health difficulties, while for lower initial levels of camouflaging there was an increase. However, this effect was small. Initial mental health difficulties did not predict changes in camouflaging behavior, but findings were inconsistent across total camouflaging and assimilation. Thus, we did not find strong evidence for camouflaging to be associated with development of mental health difficulties. However, future research is needed before we can draw strong conclusions about directionality and causality.Plain Language Summary When autistic people use strategies to hide their autism traits, we refer to this as camouflaging. It has been thought that camouflaging could be a reason why autistic people develop mental health difficulties more often than non-autistic people. Research has shown that, in general, people who report more camouflaging behavior also report more mental health difficulties. However, we do not know whether camouflaging can be a reason for people to develop mental health difficulties or whether mental health difficulties may explain why autistic people use camouflaging strategies. Therefore, in this study we investigated whether (1) camouflaging is a predictor for a change in mental health difficulties and (2) mental health difficulties are a predictor for a change in camouflaging. For this study, 332 autistic adults aged 30 to 84 years (157 women) filled in questionnaires about camouflaging, mental health difficulties, and autism traits at two moments with an average of 2 years between measurements. We found that people with a higher level of initial camouflaging showed a decrease in mental health difficulties, while for people with lower levels of initial camouflaging behavior there was an increase in mental health difficulties. However, this effect was small. Initial mental health difficulties did not seem to predict a change in camouflaging behavior. Thus, we did not find evidence that camouflaging was followed by an increase in mental health difficulties. Therefore, future research is needed before we can draw strong conclusions about what comes first and what causes what, camouflaging or mental health. En ligne : https://dx.doi.org/10.1177/13623613251347104 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=567 [article] Camouflaging in autism: A cause or a consequence of mental health difficulties? [texte imprimé] / Audrey JJ MOL, Auteur ; Tulsi A RADHOE, Auteur ; Carolien TORENVLIET, Auteur ; Joost A AGELINK VAN RENTERGEM, Auteur ; Annabeth P GROENMAN, Auteur ; Hilde M GEURTS, Auteur . - p.2604-2617. Langues : Anglais (eng) in Autism > 29-10 (October 2025) . - p.2604-2617 Mots-clés : autism  camouflaging  mental health difficulties Index. décimale : PER Périodiques Résumé : Camouflaging ([un]consciously hiding one?s autism traits) is hypothesized to be an underlying mechanism explaining elevated levels of mental health difficulties in autistic adults. As previous studies investigating this relationship were all cross-sectional, the direction of this association remains unclear. Therefore, we investigated whether (1) camouflaging predicts a change in mental health difficulties and (2) mental health difficulties predict a change in camouflaging. For this, 332 autistic adults aged 30 to 84 years (157 women) filled in the Dutch Camouflaging Autistic Traits Questionnaire, Symptom Checklist-90 Revised, and Autism Spectrum Quotient at two timepoints with an average time interval of 2 years. Preregistered multilevel analyses showed a negative interaction between initial camouflaging and time, indicating that people with higher initial levels of camouflaging showed a decrease in mental health difficulties, while for lower initial levels of camouflaging there was an increase. However, this effect was small. Initial mental health difficulties did not predict changes in camouflaging behavior, but findings were inconsistent across total camouflaging and assimilation. Thus, we did not find strong evidence for camouflaging to be associated with development of mental health difficulties. However, future research is needed before we can draw strong conclusions about directionality and causality.Plain Language Summary When autistic people use strategies to hide their autism traits, we refer to this as camouflaging. It has been thought that camouflaging could be a reason why autistic people develop mental health difficulties more often than non-autistic people. Research has shown that, in general, people who report more camouflaging behavior also report more mental health difficulties. However, we do not know whether camouflaging can be a reason for people to develop mental health difficulties or whether mental health difficulties may explain why autistic people use camouflaging strategies. Therefore, in this study we investigated whether (1) camouflaging is a predictor for a change in mental health difficulties and (2) mental health difficulties are a predictor for a change in camouflaging. For this study, 332 autistic adults aged 30 to 84 years (157 women) filled in questionnaires about camouflaging, mental health difficulties, and autism traits at two moments with an average of 2 years between measurements. We found that people with a higher level of initial camouflaging showed a decrease in mental health difficulties, while for people with lower levels of initial camouflaging behavior there was an increase in mental health difficulties. However, this effect was small. Initial mental health difficulties did not seem to predict a change in camouflaging behavior. Thus, we did not find evidence that camouflaging was followed by an increase in mental health difficulties. Therefore, future research is needed before we can draw strong conclusions about what comes first and what causes what, camouflaging or mental health. En ligne : https://dx.doi.org/10.1177/13623613251347104 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=567

Mental health care use of autistic adults: Identifying longitudinal patterns using sequence analysis / Tim ZIERMANS ; Iris RAPOPORT ; Kim JONKMAN ; Hilde M GEURTS in Autism, 29-6 (June 2025)  

Public ISBD [article]  inAutism > 29-6 (June 2025) . - p.1431-1445 Titre : Mental health care use of autistic adults: Identifying longitudinal patterns using sequence analysis Type de document : texte imprimé Auteurs : Tim ZIERMANS, Auteur ; Iris RAPOPORT, Auteur ; Kim JONKMAN, Auteur ; Hilde M GEURTS, Auteur Article en page(s) : p.1431-1445 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  health services  interventions  pharmacologic  psychiatric comorbidity  psychosocial/behavioral Index. décimale : PER Périodiques Résumé : To improve mental health care for autistic adults, a better understanding of their real-world intervention use is required. The aim of this study is to investigate individual differences in the intervention trajectories of autistic adults, by examining longitudinal patterns of therapy, counseling, and medication use. Self-reported intervention use of 445 autistic adults (18-87 years) across at least five consecutive measurements (2015-2021) was collected to identify clusters using sequence analysis and hierarchical clustering. Sensitivity analyses and cross-method validation (group-based multivariate trajectory modeling) were used to verify the obtained clusters. Four out of five obtained clusters had sufficient internal consistency and were replicated. These four clusters had distinct intervention trajectories (least intervention, mostly counseling, mostly medication, mixed use) and differed on several demographic variables. Most notably, the "mixed cluster" contained relatively more females and individuals with self-reported co-occurring psychiatric conditions. Many autistic adults used interventions, although they varied in type and duration of intervention use. This reflects the clinical complexity of tailoring intervention approaches and highlights that accessible and multidisciplinary care is essential to adequately support autistic adults. An important next step is to investigate whether available interventions sufficiently support autistic females and those with co-occurring psychiatric conditions.Lay abstract Many autistic adults experience co-occurring mental health problems, which have a negative effect on their well-being and result in increased use of mental health services. To improve mental healthcare for autistic adults, a better understanding is needed of what type of support they use in real life. Clinical guidelines recommend three kinds of mental health interventions: therapy, counseling, and medication. We investigated the use of these types of interventions in a sample of 445 autistic adults (aged 18-87 years) across a 5-to-7-year period. We found evidence for four different patterns of intervention use, or so-called subgroups: (1) least intervention use, (2) mostly counseling, (3) mostly medication, and (4) mixed intervention use. The group with mixed intervention use consisted of relatively more females and individuals with co-occurring psychiatric conditions, especially compared to the subgroup with the least intervention use. It appeared that many, but not all, autistic individuals used mental health services for an extended period. However, there was considerable variability in the type, combination, and duration of intervention use. This means that determining the optimal support for autistic adults is often a complex task, which requires collaboration of clinical experts and autistic individuals themselves, to make informed decisions. En ligne : https://dx.doi.org/10.1177/13623613241304513 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=558 [article] Mental health care use of autistic adults: Identifying longitudinal patterns using sequence analysis [texte imprimé] / Tim ZIERMANS, Auteur ; Iris RAPOPORT, Auteur ; Kim JONKMAN, Auteur ; Hilde M GEURTS, Auteur . - p.1431-1445. Langues : Anglais (eng) in Autism > 29-6 (June 2025) . - p.1431-1445 Mots-clés : autism spectrum disorders  health services  interventions  pharmacologic  psychiatric comorbidity  psychosocial/behavioral Index. décimale : PER Périodiques Résumé : To improve mental health care for autistic adults, a better understanding of their real-world intervention use is required. The aim of this study is to investigate individual differences in the intervention trajectories of autistic adults, by examining longitudinal patterns of therapy, counseling, and medication use. Self-reported intervention use of 445 autistic adults (18-87 years) across at least five consecutive measurements (2015-2021) was collected to identify clusters using sequence analysis and hierarchical clustering. Sensitivity analyses and cross-method validation (group-based multivariate trajectory modeling) were used to verify the obtained clusters. Four out of five obtained clusters had sufficient internal consistency and were replicated. These four clusters had distinct intervention trajectories (least intervention, mostly counseling, mostly medication, mixed use) and differed on several demographic variables. Most notably, the "mixed cluster" contained relatively more females and individuals with self-reported co-occurring psychiatric conditions. Many autistic adults used interventions, although they varied in type and duration of intervention use. This reflects the clinical complexity of tailoring intervention approaches and highlights that accessible and multidisciplinary care is essential to adequately support autistic adults. An important next step is to investigate whether available interventions sufficiently support autistic females and those with co-occurring psychiatric conditions.Lay abstract Many autistic adults experience co-occurring mental health problems, which have a negative effect on their well-being and result in increased use of mental health services. To improve mental healthcare for autistic adults, a better understanding is needed of what type of support they use in real life. Clinical guidelines recommend three kinds of mental health interventions: therapy, counseling, and medication. We investigated the use of these types of interventions in a sample of 445 autistic adults (aged 18-87 years) across a 5-to-7-year period. We found evidence for four different patterns of intervention use, or so-called subgroups: (1) least intervention use, (2) mostly counseling, (3) mostly medication, and (4) mixed intervention use. The group with mixed intervention use consisted of relatively more females and individuals with co-occurring psychiatric conditions, especially compared to the subgroup with the least intervention use. It appeared that many, but not all, autistic individuals used mental health services for an extended period. However, there was considerable variability in the type, combination, and duration of intervention use. This means that determining the optimal support for autistic adults is often a complex task, which requires collaboration of clinical experts and autistic individuals themselves, to make informed decisions. En ligne : https://dx.doi.org/10.1177/13623613241304513 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=558

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