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

BackgroundCamouflaging 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.MethodThe 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.ResultsCorrelational 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.ConclusionsThe 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.

Automated summary

This study aimed to investigate the relationships between autistic traits, empathy, camouflaging, and depressive symptoms in a subclinical sample of Chinese university students. The results showed significant correlations between autistic traits, camouflaging, and depressive symptoms, as well as significant correlations between empathy and autistic traits, and empathy and camouflaging. Mediation analysis indicated that camouflaging mediated the positive link between autistic traits and depressive symptoms, and moderated mediation analysis showed that the mediating effect was weaker for students with lower levels of empathy.