‘Struggling to appear normal’: A moderated mediational analysis of empathy and camouflaging in the association between autistic traits and depressive symptoms

Background: Camouflaging or camouflaging autistic traits—strategies that hide social impairments to match societal norms—has been linked to empathy and depressive symptoms in autism research. Much epidemiological evidence has further revealed that characteristics of autism and autistic traits are distributed continuously throughout the general population. Nonetheless, the relationship between these variables in the Chinese general population is unclear.

Method: The present study aimed to elucidate the relationships between autistic traits, empathy, camouflaging, and depressive symptoms in a subclinical sample of 1215 Chinese university students of ages 18–27, using self-report assessments.

Results: Correlational analysis revealed that autistic traits, camouflaging, and depressive symptoms were significantly intercorrelated. Empathy was significantly correlated with autistic traits and camouflaging. Mediation analysis revealed that camouflaging mediated the positive link between autistic traits and depressive symptoms. Moderated mediation analysis further indicated that the first stage mediated path (autistic traits → camouflaging) was weaker for students with lower levels of empathy.

Conclusions: The results suggest that camouflaging is a key contributor in the positive association between autistic traits and depressive symptoms, and that empathy help stimulate the development and maintenance of camouflaging. Copyright © 2023 The British Society of Developmental Disabilities.