Social camouflaging of autistic traits is associated with more severe symptoms among subjects with feeding and eating disorders

Purpose: Given the high prevalence of autistic traits among individuals with eating disorders (EDs), this study investigates the relationship between social camouflaging and eating disorder symptoms. It specifically examines how camouflaging behaviors may influence the manifestation and severity of disordered eating. Methods: A total of 70 patients with EDs and 50 healthy controls (HCs) were assessed using the Camouflaging Autistic Traits Questionnaire (CAT-Q) and the Eating Disorder Inventory-2 (EDI-2). Independent samples t tests were used to compare CAT-Q scores between groups. ANOVA followed by Bonferroni post-hoc tests examined differences across EED subtypes. Pearson correlation analyses assessed associations between CAT-Q and EDI-2 scores. Finally, a linear regression model was used to evaluate whether camouflaging (CAT-Q total score) significantly predicted eating disorder symptom severity (EDI-2 total score). Results: ED patients scored significantly higher than HCs across all CAT-Q domains and on the total score (all p <.001). No significant differences in camouflaging scores were observed among the different ED subtypes. CAT-Q domain and total scores were significantly positively correlated with all EDI-2 domains, with few exceptions. Linear regression analysis indicated that CAT-Q total score was a significant predictor of EDI-2 total score (β =.728, p <.001). Conclusions: Our findings reinforce the notion that social camouflaging, often used as a coping strategy, is associated with the presence and severity of eating disorder symptoms. Overall, the study underscores the complex interplay between autistic traits and disordered eating, highlighting the importance of further research into this connection. Level of evidence: Level III: Evidence obtained from well-designed cohort or case–control analytic studies.