Camouflage, Burnout-Exhaustion, and Depression in Autistic Adults

Background: 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. Method: 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. Results: 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. Conclusion: 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.