To examine the relationship between social camouflage and mental health in Japanese autistic adults and make an international comparison with a sample from the UK. This study analysed secondary data of participants with a self-reported diagnosis of autism from Japan (N = 210; 123 men and 87 women) and the UK (N = 305; 181 women, 104, men, and 18 nonbinary). The relationships between the quadratic term of the Camouflaging Autistic Traits Questionnaire and mental health scales, including depression and anxiety, were assessed. The UK sample showed linear relationships, whereas the Japanese sample showed significant nonlinear relationships. The quadratic terms of the Camouflaging Autistic Traits Questionnaire slightly explained generalised anxiety (β = .168, p = .007), depression (β = .121, p = .045), and well-being (β = − .127, p = .028). However, they did not explain the association between social anxiety and the Camouflaging Autistic Traits Questionnaire. Participants had self-reported diagnoses, and while the autism-spectrum quotient provides a cut-off value for screening, it does not enable confirming diagnoses. Mean scores of the Japanese version of the Camouflaging Autistic Traits Questionnaire were lower as compared to the original CAT-Q, which implies that the social camouflage strategy types used by autistic people in Japan and the UK could differ. The cross-sectional design limits causal inferences. In the UK, more social camouflage was associated with poorer mental health scores, whereas too little or too much social camouflage was associated with a low mental health score in Japan. The Japanese population is seemingly less aware of and educated on autistic characteristics and considers ‘average’ behaviour a good thing. This could influence Japanese autistic people’s social camouflage use, differing from that of autistic people in the UK. The differences in the relationship between social camouflage and mental health between Japan and the UK could be associated with national-level divergence regarding the culture of autism.

中文翻译：

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日本和英国自闭症患者的社交伪装与心理健康之间的关系：一项跨文化研究

研究日本自闭症成人的社交伪装与心理健康之间的关系，并与英国的样本进行国际比较。本研究分析了来自日本（N = 210；123 名男性和 87 名女性）和英国（N = 305；181 名女性、104 名男性和 18 名非二元性别）的自我报告诊断为自闭症的参与者的二手数据。评估了伪装自闭症特征问卷的二次项与心理健康量表（包括抑郁和焦虑）之间的关系。英国样本显示出线性关系，而日本样本则显示出显着的非线性关系。伪装自闭症特质问卷的二次项稍微解释了广泛性焦虑 (β = .168, p = .007)、抑郁 (β = .121, p = .045) 和幸福感 (β = − .127, p =.028）。然而，他们没有解释社交焦虑与伪装自闭症特质问卷之间的关联。参与者有自我报告的诊断，虽然自闭症谱商提供了筛查的截止值，但它不能确认诊断。与原始 CAT-Q 相比，日本版伪装自闭症特质问卷的平均得分较低，这意味着日本和英国自闭症患者使用的社交伪装策略类型可能有所不同。横截面设计限制了因果推论。在英国，更多的社交伪装与较差的心理健康得分有关，而在日本，社交伪装太少或太多与较低的心理健康得分有关。日本人似乎对自闭症特征的认识和教育较少，并认为“平均”行为是一件好事。与英国自闭症患者不同，这可能会影响日本自闭症患者的社交伪装使用。日本和英国之间社会伪装与心理健康之间关系的差异可能与国家层面关于自闭症文化的差异有关。