# Camouflaging in Autism: a Systematic Review

*Cook · Power & Equity, Critique & Boundary · Clinical Psychology Review · 2021 · Paywalled*

The systematic review that establishes the cost side of conformity, and the paper to cite when advice asks people to perform norms that are not theirs. Camouflaging (also masking or compensation) is the effortful suppression of autistic characteristics and the deliberate performance of non-autistic ones: forcing eye contact, rehearsing scripts, imitating expressions and postures, monitoring one's own behaviour continuously through a social interaction. Synthesising the literature, the review finds camouflaging widely practised, more commonly reported by women (which bears on late and missed diagnosis), and consistently associated with adverse mental health, including anxiety, depression, exhaustion, burnout and elevated suicide risk. The motivations reported are instrumental rather than pathological: people camouflage to gain employment, avoid hostility and be treated as competent, which places the behaviour squarely as a response to an environment rather than a symptom. The methodological limits are stated in the review itself and worth reproducing: most evidence is cross-sectional and self-reported, camouflaging is measured largely through one instrument, the causal direction between camouflaging and poor mental health is not established, and most samples are adults diagnosed late. Its use in this corpus is precise. Advice to adopt open postures, sustained eye contact and stillness is a request to camouflage, issued to those for whom compliance is costly, and this is the evidence of what the cost is.

- **This page:** https://explore.psychsafety.com/n/cook-et-al-2021/
- **View the source paper:** https://doi.org/10.1016/j.cpr.2021.102080
- **Interactive map:** https://explore.psychsafety.com/?mode=papers&node=cook-et-al-2021

## Neighbours (5)

- [Body Language & Non-Verbal Communication](https://explore.psychsafety.com/n/body-language-and-non-verbal-communication.md)
- [On the Ontological Status of Autism: the Double Empathy Problem](https://explore.psychsafety.com/n/milton-2012.md) (paper)
- [Neurotypical Peers are Less Willing to Interact with Those with Autism Based on Thin Slice Judgments](https://explore.psychsafety.com/n/sasson-et-al-2017.md) (paper)
- [Forced Vulnerability](https://explore.psychsafety.com/n/forced-vulnerability.md)
- [PS & Neurodiversity](https://explore.psychsafety.com/n/psychological-safety-and-neurodiversity.md)