Camouflaging Autistic Traits Questionnaire (CAT-Q)

Foundational Context

Camouflaging describes the strategies autistic individuals use—consciously or unconsciously—to fit into social environments. Examples include rehearsing social scripts, copying facial expressions, suppressing stimming, imitating peers, or actively concealing distress or confusion. Hull et al. (2019) highlighted that camouflaging is not inherently adaptive; while it can help individuals navigate social demands, it is also associated with anxiety, exhaustion, identity confusion, and autistic burnout.

The CAT-Q was developed through extensive qualitative interviews and psychometric modeling across autistic and non-autistic adult samples. Its design captures both surface-level behaviors (Masking) and deeper compensatory cognitive strategies (Compensation), as well as efforts to blend into social groups (Assimilation). Because camouflaging varies by gender, cultural expectations, and social context, the CAT-Q offers insight into lived experiences often overlooked by traditional autism measures.

What the Assessment Measures

The CAT-Q assesses three distinct dimensions of camouflaging:

• Compensation (8 items): Cognitive strategies used to compensate for perceived social or communication difficulties (e.g., preparing scripts, analyzing interactions).
• Masking (10 items): Behaviors aimed at concealing autistic traits, including hiding stimming, controlling facial expressions, or suppressing natural responses.
• Assimilation (7 items): Efforts to blend into social environments by adapting appearance, behavior, or interests to match peers.

Together, these domains offer a comprehensive picture of how an individual navigates social expectations and the mental effort required to do so.

Interpretation Guidelines

The CAT-Q yields:

• Total score: 25–175
• Three subscale scores: Compensation, Masking, Assimilation

Interpretation principles:

• Higher scores indicate more frequent or intense use of camouflaging behaviors
• Subscale patterns are often more informative than the total score
• There are no diagnostic thresholds or clinical cutoffs
• Normative group means (Hull et al., 2019) can support comparative interpretation

Interpretation Notes:

• Elevated camouflaging is associated with anxiety, stress, exhaustion, identity strain, and autistic burnout
• High scores do not confirm autism; non-autistic individuals may camouflage for different reasons (e.g., social anxiety)
• Camouflaging may vary across gender, culture, social contexts, and life stages
• The CAT-Q should not be used in isolation to make diagnostic or treatment decisions

Psychometric Properties

Reliability

• Excellent internal consistency for total and subscale scores
• Strong test–retest reliability reported across adult samples

Validity

• Strong convergent validity with autistic trait measures (e.g., AQ, RAADS-R)
• Distinguishes between autistic and non-autistic populations
• Correlated with measures of anxiety, depression, and autistic burnout in research
• Factor structure consistently replicated

Administration Considerations

• Particularly relevant in populations where masking is common: women, AFAB individuals, late-diagnosed autistic adults, and those who report social exhaustion
• Should be administered in environments where respondents feel safe to be candid
• Works well as part of autism assessment batteries or identity/mental health support contexts
• Not recommended as a standalone diagnostic tool
• Useful in guiding treatment discussions about masking, burnout, boundaries, and self-acceptance

Limitations

• Does not measure autistic traits themselves—only camouflaging behaviors
• High scores may reflect social anxiety, trauma, or cultural pressures rather than autism
• Self-report accuracy may vary depending on insight and emotional readiness
• Not validated extensively outside Western cultural contexts