A cross-neurotype analysis of camouflaging and illness perceptions in people with central sensitivity syndromes.

TY - JOUR

T1 - A cross-neurotype analysis of camouflaging and illness perceptions in people with central sensitivity syndromes.

AU - Grant, Sarah

AU - Norton, Sam

AU - Hoekstra, Rosa

PY - 2025/2/19

Y1 - 2025/2/19

N2 - Background Central sensitivity syndromes (CSS) are a group of conditions, including fibromyalgia (FMS), migraine, and others, that are thought to share a common mechanism of central sensitisation – that is, pain and hypersensitivity that originate in the central nervous system. Research suggests autistic adults may be more likely to have a CSS, and that autistic traits, sensory sensitivity and anxiety all contribute to an association.  This study aimed to explore whether autistic camouflaging could also be related to CSS symptoms in autistic and non-autistic adults. In addition, we completed an analysis of illness perceptions to determine whether autistic and non-autistic people may experience chronic illness differently. Methods The sample comprised 504 adults (88 men, 416 women) with clinical diagnoses of autism, CSS, both diagnoses or neither (i.e. a comparison group), who completed online self-report validated questionnaires including the Autism Spectrum Quotient (AQ), Central Sensitization Inventory (CSI), Sensory Perception Quotient (SPQ), the Camouflaging Autistic Traits Questionnaire (CAT-Q), the Brief Illness Perceptions Questionnaire (B-IPQ), and the PHQ-9 and GAD-7. Results Camouflaging significantly predicted CSS symptoms in this sample. Autistic people with a CSS had higher camouflaging scores (mean 130.28) than the other diagnostic groups, with a significant difference between the comparison and the CSS only group (p<.001). The autism only and CSS only groups had significantly higher camouflaging scores than the comparison group (p<001) but not from each other (119.35 vs 107.94).  Autistic people reported a significantly more negative effect of chronic illness on their life (f (1,333) = 5.289 p =.022);  there were few other differences in illness perceptions between autistic and non-autistic people with a CSS.  Conclusion Autistic camouflaging is associated with CSS symptoms. Autistic people that receive a CSS diagnosis are particularly at risk for greater illness-related disability, including poorer quality of life and mental health. 

AB - Background Central sensitivity syndromes (CSS) are a group of conditions, including fibromyalgia (FMS), migraine, and others, that are thought to share a common mechanism of central sensitisation – that is, pain and hypersensitivity that originate in the central nervous system. Research suggests autistic adults may be more likely to have a CSS, and that autistic traits, sensory sensitivity and anxiety all contribute to an association.  This study aimed to explore whether autistic camouflaging could also be related to CSS symptoms in autistic and non-autistic adults. In addition, we completed an analysis of illness perceptions to determine whether autistic and non-autistic people may experience chronic illness differently. Methods The sample comprised 504 adults (88 men, 416 women) with clinical diagnoses of autism, CSS, both diagnoses or neither (i.e. a comparison group), who completed online self-report validated questionnaires including the Autism Spectrum Quotient (AQ), Central Sensitization Inventory (CSI), Sensory Perception Quotient (SPQ), the Camouflaging Autistic Traits Questionnaire (CAT-Q), the Brief Illness Perceptions Questionnaire (B-IPQ), and the PHQ-9 and GAD-7. Results Camouflaging significantly predicted CSS symptoms in this sample. Autistic people with a CSS had higher camouflaging scores (mean 130.28) than the other diagnostic groups, with a significant difference between the comparison and the CSS only group (p<.001). The autism only and CSS only groups had significantly higher camouflaging scores than the comparison group (p<001) but not from each other (119.35 vs 107.94).  Autistic people reported a significantly more negative effect of chronic illness on their life (f (1,333) = 5.289 p =.022);  there were few other differences in illness perceptions between autistic and non-autistic people with a CSS.  Conclusion Autistic camouflaging is associated with CSS symptoms. Autistic people that receive a CSS diagnosis are particularly at risk for greater illness-related disability, including poorer quality of life and mental health. 

KW - Autism

KW - central sensitisation

KW - camouflaging

KW - illness perceptions

KW - fibromyalgia

KW - fatigue

KW - chronic pain

M3 - Article

JO - Autism in Adulthood

JF - Autism in Adulthood

ER -