Camouflaging in Autism: An Individualistic Strategy in Response to a Stigmatised Social Identity? What is the relationship between disability identity and psychological wellbeing?

Ella Perry

Research output: ThesisDoctoral Thesis

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Camouflaging in Autism: An Individualistic Strategy in Response to a Stigmatised Social Identity?

Camouflaging refers to strategies autistic people may use to mask or minimise features of autism in order to “pass” as non-autistic. Research has shown autistic people relate camouflaging to experiencing poorer psychological wellbeing. The present study draws on Social Identity Theory to explore the relationship between camouflaging and wellbeing. It examines the theory that camouflaging represents an individualistic strategy in response to the stigmatised social status of autism. Three-hundred and two (184 female, 61 male and 56 non-binary identifying) autistic adults (mean age = 34.36) completed an online survey relating to their experiences of stigma, coping strategies, camouflaging and wellbeing. Regression analyses found increases in camouflaging were positively predicted by autism-related stigma, female gender, older age at diagnosis, individualistic and collective strategy use. A mediation analysis found autism-related stigma had a negative effect on wellbeing, which was mediated by camouflaging, suggesting stigma influences wellbeing through its effect on camouflaging. The findings indicate camouflaging bears likeness to an individualistic strategy in its positive relation to stigmatisation and lower wellbeing. However, it differs in its positive relation to collective strategy use, indicating it may co-occur with embracing autistic identity and community. The results reinforce recommendations for clinicians to be aware of camouflaging and demonstrate the need for anti-autism-stigma interventions for the general population.

What is the relationship between disability identity and psychological wellbeing?

Disabled people are found to report lower psychological wellbeing than non-disabled people and wellbeing is found to reduce following disability onset. Understanding the factors that relate to disabled people’s wellbeing is key to the development of effective services for disabled people. The present study systematically reviewed the empirical evidence investigating the relationship between disability identity and wellbeing. Two reviewers conducted literature searches using PsychInfo and Web of Science, followed by manual searches of the included articles. The search algorithm included variants of identity, disability and psychological wellbeing. Child populations and qualitative methods were excluded. Forty-six articles were identified by the initial search and 17 studies were included in total. The included studies sampled a range of disabled populations including adults with brain injury, multiple sclerosis, acquired and congenital mobility difficulties, learning disabilities and post-colostomy surgery. A “bespoke” quality assessment tool found the overall quality of studies to be relatively good. A narrative synthesis of the results was performed. The combined results indicated that measures of disability identity positively correlated with measures that indicated higher psychological wellbeing (e.g. self-esteem) and negatively correlated with measures that indicated poorer psychological wellbeing (e.g. depression). Similarly, participants categorized as having higher disability identity demonstrated higher wellbeing and participants with lower wellbeing demonstrated lower disability identity. It was concluded that greater identification with being a disabled person is associated with greater psychological wellbeing across a range of disabled adult populations. The reviewed evidence would suggest that encouraging the development of a disability identity, that includes developing connections with disabled people and adopting non-devaluing values (as opposed to simply categorising oneself as disabled) could be beneficial to wellbeing.
Original languageEnglish
Awarding Institution
  • Royal Holloway, University of London
  • Cage, Eilidh, Supervisor
  • Mandy, William, Supervisor, External person
Publication statusUnpublished - 2019


  • camouflaging
  • wellbeing
  • mental health
  • Disability
  • social identity theory

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