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Background <p>Both camouflaging and social anxiety are adolescence-emerging phenomenon, rooted in social situations, and associated with mental health. The directionality between camouflaging and social anxiety in autistic versus non-autistic adolescents is underexplored. This study aims to investigate the inter-relations between camouflaging, social anxiety, and depression, and the moderating role of autism diagnosis on these inter-relations.</p> Methods <p>A total of 205 Taiwanese adolescents (100 autistic, 105 non-autistic) completed self-reported measures, including the Camouflaging Autistic Traits Questionnaire, Chinese version (CAT-Q-Ch), Social Interaction Anxiety Scale, Chinese version (SIAS-C), Generalized Anxiety Disorder 7-item (GAD-7), and Patient Health Questionnaire 9-item (PHQ-9). Network analysis was used to examine the inter-relations among items of the CAT-Q-Ch and SIAS-C. Moderated mediation models, adjusted for generalized anxiety, examined the inter-relations among camouflaging, social anxiety, and depression, and how these associations varied by autism diagnosis.</p> Results <p>Autistic adolescents reported significantly higher scores on camouflaging, depression, generalized anxiety, and social anxiety than non-autistic adolescents. A network analysis showed that items from the CAT-Q-Ch formed two communities, and most SIAS-C items formed a third community, supporting the interpretation that camouflaging and social anxiety are related yet distinct constructs. For both autistic and non-autistic adolescents, social anxiety and camouflaging showed bidirectional indirect associations with depression. Critically, having an autism diagnosis significantly weakened the link between camouflaging and depression, as part of the indirect association between social anxiety and depression via camouflaging.</p> Conclusion <p>The findings highlight the complex inter-relations among camouflaging, social anxiety, and depression, which may differ between autistic and non-autistic adolescents in Taiwan. Camouflaging may serve different functional roles and have different mental health implications for autistic and non-autistic adolescents. Future research should focus on teasing apart the complex conceptual, measurement, and causal mechanisms underlying the inter-relations between social anxiety and camouflaging in autistic versus non-autistic people.</p>

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The impact of autism on the relations between social anxiety, camouflaging, and depression in Taiwanese adolescents

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月13日

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  • Chun-Hao Liu,
  • Yi-Lung Chen,
  • Wei Ai,
  • Hsing-Chang Ni,
  • Meng-Chuan Lai

摘要

Background

Both camouflaging and social anxiety are adolescence-emerging phenomenon, rooted in social situations, and associated with mental health. The directionality between camouflaging and social anxiety in autistic versus non-autistic adolescents is underexplored. This study aims to investigate the inter-relations between camouflaging, social anxiety, and depression, and the moderating role of autism diagnosis on these inter-relations.

Methods

A total of 205 Taiwanese adolescents (100 autistic, 105 non-autistic) completed self-reported measures, including the Camouflaging Autistic Traits Questionnaire, Chinese version (CAT-Q-Ch), Social Interaction Anxiety Scale, Chinese version (SIAS-C), Generalized Anxiety Disorder 7-item (GAD-7), and Patient Health Questionnaire 9-item (PHQ-9). Network analysis was used to examine the inter-relations among items of the CAT-Q-Ch and SIAS-C. Moderated mediation models, adjusted for generalized anxiety, examined the inter-relations among camouflaging, social anxiety, and depression, and how these associations varied by autism diagnosis.

Results

Autistic adolescents reported significantly higher scores on camouflaging, depression, generalized anxiety, and social anxiety than non-autistic adolescents. A network analysis showed that items from the CAT-Q-Ch formed two communities, and most SIAS-C items formed a third community, supporting the interpretation that camouflaging and social anxiety are related yet distinct constructs. For both autistic and non-autistic adolescents, social anxiety and camouflaging showed bidirectional indirect associations with depression. Critically, having an autism diagnosis significantly weakened the link between camouflaging and depression, as part of the indirect association between social anxiety and depression via camouflaging.

Conclusion

The findings highlight the complex inter-relations among camouflaging, social anxiety, and depression, which may differ between autistic and non-autistic adolescents in Taiwan. Camouflaging may serve different functional roles and have different mental health implications for autistic and non-autistic adolescents. Future research should focus on teasing apart the complex conceptual, measurement, and causal mechanisms underlying the inter-relations between social anxiety and camouflaging in autistic versus non-autistic people.