CAT-Q Masking Assessment
The Camouflaging Autistic Traits Questionnaire (CAT-Q) measures social masking behaviors. High camouflaging is common in autistic adults, especially women, and can lead to exhaustion, burnout, and missed diagnoses.
I have learned to adjust my body language or facial expressions to make myself seem relaxed.
The Camouflaging Autistic Traits Questionnaire (CAT-Q) measures social camouflaging - the conscious or unconscious strategies people use to hide or compensate for autistic traits in social situations. Developed by researchers studying why autism is often missed in certain populations, particularly women and those assigned female at birth.
Why Camouflaging Matters: Many autistic adults have developed sophisticated masking behaviors that allow them to "pass" as neurotypical. While this can provide social advantages, sustained camouflaging is exhausting and strongly linked to anxiety, depression, and autistic burnout.
High CAT-Q scores combined with autistic traits (even subclinical scores on tools like AQ-10) often indicate autism that traditional screening tools miss. This is particularly important for late-diagnosed adults who may have been told they "do not seem autistic" because their masking is so effective.
This free assessment takes 5-7 minutes and provides immediate results with interpretation.
🫙 The Camouflaging-Burnout Connection
Research shows a direct link between high camouflaging and autistic burnout - a state of chronic exhaustion, skill loss, and reduced tolerance that can last months or years. Unlike regular burnout, autistic burnout specifically relates to the cognitive load of sustained masking.
Signs of autistic burnout include: loss of skills you previously had, increased sensory sensitivities, inability to mask even when you want to, extended recovery time after social events, and feeling like you cannot be yourself anywhere.
If your CAT-Q score is high and you experience these symptoms, exploring autism resources and potentially seeking diagnosis could provide valuable understanding and access to appropriate support.
Understanding the Three CAT-Q Subscales
The CAT-Q measures three distinct types of camouflaging behavior:
Compensation (Questions 1-9): Active strategies to make up for social difficulties, like practicing conversations beforehand, following scripts, copying others behaviors, or monitoring your own expressions. High compensation suggests you work hard to appear natural in social situations.
Masking (Questions 10-17): Hiding your authentic self and true feelings. High masking scores indicate you feel unable to be genuine around others, put on a "social mask," and present a different persona than your authentic self.
Assimilation (Questions 18-25): Trying to fit in by blending with others, changing yourself based on context, and watching others to learn social behavior. High assimilation suggests significant effort to seem "normal" or similar to those around you.
Different patterns can emerge - some people score high across all three, while others may score high on compensation but lower on masking, for example.
Why Autism Is Often Missed in High-Maskers
Traditional autism assessment tools were developed primarily with children and males in mind. The criteria often describe autism as it presents when NOT being masked - difficulties that high-maskers have learned to hide.
Factors that lead to missed diagnosis:
- Strong academic or professional success
- Having learned "appropriate" eye contact through practice
- Appearing socially competent (even if exhausted afterward)
- Having friends (even if friendships feel performative or draining)
- Being articulate and verbally fluent
- Presenting as anxious or depressed rather than autistic
Many autistic adults receive mental health diagnoses like anxiety, depression, OCD, or borderline personality disorder before (or instead of) autism - conditions that can actually be caused or exacerbated by undiagnosed autism and chronic masking.
The Cost of Camouflaging
While camouflaging provides short-term social benefits, research consistently shows long-term costs:
Mental Health Impact:
- Higher rates of anxiety and depression
- Increased suicidal ideation
- Greater psychological distress
- Identity confusion ("Who am I really?")
Physical Impact:
- Chronic fatigue and exhaustion
- Need for extensive recovery time after socializing
- Sensory overload from sustained masking
- Sleep disturbances
Social Impact:
- Feeling like a fraud in relationships
- Difficulty maintaining friendships (exhaustion)
- Partners may not know the "real" you
- Eventual breakdown of masking ability
Understanding that these experiences may relate to autism and camouflaging - rather than personal failure - can be profoundly validating for many late-diagnosed adults.
Interpreting Your Results
Low scores (25-75): You show minimal camouflaging behavior. This could mean: you are not autistic, you are autistic but in an environment where you feel safe to unmask, or you have not developed extensive masking strategies.
Moderate scores (76-100): Some camouflaging is present. This level is seen in both neurotypical and autistic populations. Consider whether this effort feels sustainable or draining.
High scores (101-124): Significant camouflaging. This level is commonly seen in autistic adults, especially those diagnosed later in life. If you also identify with autistic traits, professional evaluation may be valuable.
Very high scores (125+): Extensive camouflaging strongly associated with autism. Even if you score below threshold on traditional autism screens like AQ-10, this level of masking combined with any autistic traits warrants professional exploration.
Remember: The CAT-Q measures camouflaging behavior, not autism directly. High camouflaging can occur without autism, but the combination of high CAT-Q scores with autistic experiences is particularly significant.
Next Steps After This Assessment
If your score suggests high camouflaging:
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Take additional assessments: Complete the AQ-10 (quick screen) or AQ-50 (comprehensive). For adults who mask heavily, the RAADS-R may be more sensitive.
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Keep notes: Document specific autistic traits you experience, situations where masking is particularly difficult or when masking fails, and the impact on your energy and mental health.
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Explore resources: Books like "Unmasking Autism" by Devon Price or online communities for late-discovered autistic adults can provide validation and information.
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Consider professional assessment: Share your CAT-Q results and notes with a healthcare provider. Request referral to someone experienced with adult autism, particularly female presentation.
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Self-care while exploring: Whether or not you pursue formal diagnosis, acknowledging your masking patterns can help you make choices that preserve energy and prioritize authenticity.
Frequently Asked Questions
Yes, some neurotypical people do engage in social camouflaging, particularly those with social anxiety. However, research shows autistic people score significantly higher on average, and very high scores (125+) are strongly associated with autism. The key difference is often the degree, the exhaustion involved, and whether the behavior stems from not intuitively understanding social norms versus anxiety about them.