Camouflaging and suicide behavior in adults with autism spectrum condition: a mixed methods systematic review

Abstract

Different studies have identified that adults with Autism Spectrum Disorders (ASD) are at risk of suicidal thoughts and behaviors. However, the relationship between both variables is still understudied. This systematic review aims to examine the relationship between camouflaging—an adaptive strategy used by adults with Autism Spectrum Disorder to mask or modify their social behaviors—and suicidal thoughts and behaviors. Following PRISMA guidelines, a comprehensive search was conducted across multiple databases, including PubMed, ScienceDirect, Scopus, APA PsycArticles, Google Scholar, and APA PsycInfo, without restrictions on sample size, gender, or functionality level. Only studies in English were considered. A total of 6,901articles were identified, and after screening and applying the inclusion criteria, 11 articles were included in the final analysis. Camouflaging in adults with ASD is consistently associated with a higher risk of suicidal behavior. However, the causal mechanisms linking camouflaging to suicide remain unclear. Most studies highlight that the psychological burden of camouflaging may exacerbate mental health issues, contributing to elevated suicide risk. Given the limited evidence, future research should focus on elucidating the pathways through which camouflaging impacts suicidal behaviors.