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. 2023 Feb 28;70(8):1422-1432.
doi: 10.1080/20473869.2023.2181273. eCollection 2024.

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

Minghui Lu  1 , Feifan Pang  2 , Tianyu Peng  1 , Yong Liu  1 , Rong Wang  2
Affiliations

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

Minghui Lu et al. Int J Dev Disabil. .

Abstract

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.

Keywords: Autistic traits; camouflaging; depression; depressive symptoms; empathy.

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Conflict of interest statement

ML and RW conceived of the study, participated in its design and coordination, and drafted the manuscript; FP and TP participated in the interpretation of the data, performed the statistical analysis, and provided critical revisions; YL participated in data collection and provided critical revisions All authors read and approved the final manuscript.No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
The proposed model.
Figure 2.
Figure 2.
The standardized moderating effect of empathy.
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