Cook, Julia; (2022) Being Autistic in a Non-Autistic World: Autistic Adults’ Experiences of Adapting to and Coping Within Predominately Non-Autistic Social Environments. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Some autistic individuals modify their innate autistic social behaviour in order to adapt to, cope within, and/or influence the predominately non-autistic social environment; a phenomenon often termed ‘camouflaging’ (Attwood, 2007; Dean et al., 2017; Hull et al., 2017; Lai et al., 2017; Schuck et al., 2019). Camouflaging is one social coping strategy used by autistic people attempting to overcome social challenges within cross-neurotype social interactions and secure employment, develop friendships and romantic relationships, and avoid stigmatisation (Cage & Troxell-Whitman, 2019; Hull et al., 2017). Yet the act of camouflaging is thought to be cognitively effortful and taxing; prone to breakdown under increased social demands and complexity and/or psychological distress; and associated with increased mental health difficulties, misdiagnosis, and identity confusion (e.g., Beck et al., 2020; Cage & Troxell-Whitman, 2019; Cassidy et al., 2018; Hull et al., 2021; Lai et al., 2017; Livingston, Colvert, et al., 2019). Camouflaging research is in infancy; conceptualisations, definitions and measures of camouflaging are still emerging, and much is unknown about relationships between camouflaging and various constructs such as mental health, wellbeing, and the achievement of important social and employment outcomes. This thesis presents a combination of qualitative and quantitative methods to further current understanding of social coping in autistic people by furthering the current conceptualisation of camouflaging including camouflaging behaviours and processes; examining the relationships between camouflaging and social, employment, and mental health outcomes; and exploring social experiences that contrast with camouflaging. The first chapter provides a general introduction to, and overview of, the relevant background research and provides a rationale for the work presented in the thesis. Chapter 2 involves a discussion of methodological considerations involved in the design and analysis of research presented in the thesis. Chapter 3, a systematic review, provides a comprehensive and critical evaluation of the current quantitative camouflaging research base; identifying consistencies in the current evidence as well as issues that require further research. Chapters 4 and 5 describe an interpersonal recall study, using thematic analysis to detail the development, process, and consequences of camouflaging (Chapter 4) and content analysis to describe the behaviours exhibited, altered, or avoided by autistic adults when camouflaging (Chapter 5). Chapter 6, a quantitative cross-sectional study, details associations between camouflaging and social and employment outcomes and indicators of mental health difficulties/psychological distress. Chapter 7 involves a qualitative survey and uses thematic analysis to explore an alternative to camouflaging, specifically autistic adults’ experiences of socialising in ways that feel authentic to them. The final chapter (Chapter 8) provides an overarching discussion of the findings and implications of the thesis with consideration to strengths and limitations.

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