Understanding camouflaging, stigma, and mental health for autistic people in Japan

Abstract

Abstract Background: Camouflaging refers to behaviors in which autistic individuals hide their autistic characteristics and “pass” as non-autistic people. It is postulated that camouflaging is a response to stigma, and preliminary evidence supports this hypothesis. However, there has been limited research on this topic outside of Western countries. This study sought to replicate and extend previous work examining the relationships between camouflaging, stigma, and mental health in Japanese autistic people. Methods: Two hundred eighty seven autistic people living in Japan completed an online survey on camouflaging, perceived stigma, individualistic and collective strategies, mental wellbeing, anxiety, social anxiety, and depression. We used multiple regression analysis, mediation analyses, and two-sample t-tests to analyze the collected data. Results: We found that higher camouflaging was predicted by higher perceived stigma and more individualistic and collective strategy use. Camouflaging mediates the association of stigma with depression, anxiety, and social anxiety (but not wellbeing). Furthermore, autistic people in Japan reported lower perceived stigma, camouflaging, wellbeing, and collective strategy use but more individualistic strategies than those in a Western sample. Conclusion: Our findings support the hypothesis that camouflaging is a response to stigma and can influence the impact of stigma on mental health. There are also cross-cultural differences worth attending to, and more work around supporting positive autistic identity in Japan would be beneficial.