Camouflage, Burnout-Exhaustion, and Depression in Autistic Adults

Autistic adults are at disproportionate risk for developing depression compared with the general population. Social camouflaging of autistic traits is a unique risk factor for depression among autistic people; however, the mechanisms of this association are still unclear. An additional potential risk factor for depression in this population is autistic burnout. The goal of the current study was to examine the role of burnout-exhaustion as a risk factor for depression among autistic adults and its potential role as a mediator in the association between camouflaging and depression.

We designed an online survey in partnership with autistic adults measuring camouflage (The Camouflaging Autistic Traits Questionnaire), depression (Patient Health Questionnaire-9), and burnout-exhaustion (adapted version of the exhaustion subscale of the Parental Burnout Assessment). We posted an invitation to take part in this study through autistic-led groups and forums, targeting autistic adults. We calculated correlations between the study variables and conducted a series of regression analysis to test mediation. We included the analysis of the responses of 92 autistic adults.

Over 70% of participants scored within the clinical range of depression. Social camouflaging and burnout-exhaustion positively correlated with depression. Burnout-exhaustion partially mediated the association between camouflage and depression.

Burnout is probably a risk factor for depression and may play a role in the association between camouflaging and depression in autistic adults. These findings highlight the importance of assessing the toll of camouflaging and burnout as risk factors to prevent potential escalation to depression and to develop targeted interventions aimed at preventing depression in this population.

Why is this an important issue?: Autistic individuals are at elevated risk of experiencing depression throughout the lifespan. This underscores the need to better understand which factors contribute to depression symptoms in autistic individuals.What was the purpose of this study?: The purpose was to examine the role of camouflaging (hiding one's autistic traits and trying to act in a neurotypical manner) and burnout-exhaustion (a sense of mental and physical exhaustion due to depletion of resources) as risk factors for depression in autistic individuals.What did the researchers do?: Ninety-two autistic adults living in Israel completed an online self-report questionnaire on their depressive symptoms, camouflage, and autistic burnout.What were the results of the study?: Over 70% of the participants scored in the clinical range of depression. We found that camouflaging and burnout-exhaustion are positively associated with depression. Burnout-exhaustion partially mediated the association between camouflage and depression.What do these findings add to what was already known?: These findings suggest that burnout-exhaustion is a risk factor for depression, and that it plays a role in the connection between social camouflage and depression.What are potential weaknesses in the study?: This study had a relatively small number of participants whom we recruited online. More studies are needed to replicate these findings with a more representative sample.