"I’m Not My True Self": A Systematic Review Exploring the Association Between Camouflaging and Self-Related Factors in Autistic Adults

Background: Camouflaging – the use of strategies to mask autistic traits in social contexts – has been linked to mental health challenges and lower self-esteem. While the relationship between camouflaging and mental health has been increasingly studied, its associations with self-related factors, including self-esteem, self-acceptance, and identity, remain underexplored. The aim of this systematic review was to examine existing research on the relationship between camouflaging and self-related factors in autistic adults. Methods: Following PRISMA guidelines, a comprehensive search was conducted across Web of Science, Scopus, and PubMed. The protocol was registered on PROSPERO (ID: CRD42024597257). Results: A total of 259 articles were identified. One hundred thirty articles were screened, and thirteen studies were included. Across studies, camouflaging was consistently associated with higher levels of depression and anxiety, lower self-esteem, and reduced authenticity in interpersonal relationships. Most studies showed associations between exhaustion, identity confusion, reduced self-acceptance and camouflaging. Conversely, receiving an autism diagnosis and developing self-acceptance were associated with reduced camouflaging and greater opportunities for authentic self-expression. Conclusions: Evidence suggests that camouflaging is closely tied to difficulties in self-related factors and well-being among autistic adults. These findings highlight the importance of supports and interventions that affirm autistic identity and reduce social pressures to camouflage.