# The association between autism, camouflaging and anxiety with suicidal ideation in women

## TL;DR

This study explores how autism, camouflaging behaviors, and anxiety are linked to suicidal thoughts in women, finding that anxiety plays a key role in this relationship.

## Contribution

The study identifies anxiety as a mediator between camouflaging and suicidal ideation in autistic women.

## Key findings

- Autistic women scored higher on measures of camouflaging, anxiety, and suicidal ideation compared to non-autistic women.
- Anxiety, depression diagnosis, and assimilation strategy were significantly linked to suicidal ideation.
- Anxiety was found to mediate the relationship between autism diagnosis and camouflaging with suicidal ideation.

## Abstract

Camouflaging behaviors in women have been associated with mental health outcomes, like anxiety and suicidality but the mechanisms underlying these relationships remain unclear. This study aimed to examine the relationship between autism, camouflaging and anxiety with suicidal ideation and to investigate the possible mediating role of anxiety in the relationship between camouflaging and suicidal ideation in women.

Four hundred and seventy-one women (72 autistic, aged 18–64 years, and 399 non-autistic, aged 18–66 years) participated in this study. The Camouflaging Autistic Traits Questionnaire (CAT-Q), the General Anxiety Disorder 7 (GAD-7) and item 9 of the Patient Health Questionnaire 9 (PHQ-9) were used to assess camouflaging, anxiety and suicidal ideation, respectively.

The results showed that autistic women scored higher than non-autistic women on all measures. In addition, anxiety, having a depression diagnosis and the assimilation strategy were significantly associated with suicidal ideation. Furthermore, anxiety mediated the relationship between autism diagnosis and camouflaging with suicidal ideation.

The results highlight the importance of considering anxiety in the relationship between camouflaging and suicidal ideation, particularly among autistic women, and to recognise it as a target for intervention approaches aimed at reducing the likelihood of suicidal ideation.