A cross-neurotype analysis of camouflaging and illness perceptions in people with central sensitivity syndromes.

Central sensitivity syndromes (CSS) are a group of conditions thought to include an underlying sensitisation of the central nervous system. Evidence suggests autistic adults may be more vulnerable to developing CSS, and that autistic traits, sensory sensitivity and anxiety all contribute to this association. This study aimed to explore the relationship between camouflaging and CSS symptoms in autistic and non-autistic adults. In addition, an analysis of illness perceptions was completed to determine whether autistic and non-autistic people perceive their CSS differently. The sample comprised 504 adults (88 men, 416 women) with clinical diagnoses of autism, CSS, both conditions or neither, who completed online self-report questionnaires including autistic traits, sensory sensitivity, CSS, camouflaging, illness perceptions and mental health symptoms. Camouflaging significantly predicted CSS symptoms in this sample. Autistic people with a CSS had higher camouflaging scores (mean 130.28) than the other diagnostic groups, with a significant difference between controls and the CSS only group (p<.001). The autism only and CSS only groups had significantly higher camouflaging scores than the control group (p<001) but not from each other (119.35 vs 107.94). Autistic people reported a significantly more negative effect of chronic illness on their life (f (1,333) = 5.289 p =.022); there were few other differences in illness perceptions between autistic and non-autistic people with a CSS. Autistic camouflaging is associated with central sensitisation symptoms. Autistic people that receive a CSS diagnosis are particularly at risk for greater illness-related disability, including poorer quality of life and mental health.