Social camouflaging and delayed diagnosis of autism on women: an integrative review

Abstract

Introduction. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by repetitive behaviors and deficits in communication and social interaction. Although the diagnosis commonly occurs at 4 to 5 years old, especially through questionnaires, only 1/5 of women have their diagnosis before 11 years old, a fact that, added to the lower proportion of women with the disorder, raises the search for the reason for this discrepancy, whose answer may permeate the predominance of the camouflage phenomenon in this group. Objective. this study aims to discuss the influence of social camouflage of being a woman on the late diagnosis of autism spectrum disorder, based on the hypothesis that this phenomenon is a significant promoter of late diagnosis in this group and justified by the lack of national studies on the subject. Method. An integrative review was carried out in the BVS and PUBMED databases, resulting in 36 articles selected after applying the defined inclusion and exclusion criteria. Results. camouflage is based on the masking of certain characteristics, and is most commonly practiced by people with ASD, implying severe consequences to the practitioners, such as exhaustion and anxiety. The phenomenon had its basic characteristics associated with the female autism phenotype as early as 1992 to explain the phenotype and underdiagnosis in this group. It is a practice more often performed by autistic women, according to studies, due, among other factors, to the greater social demands imposed by the inherent gender stereotyping. Conclusion. Besides the female autistic phenotype being different from the male, camouflage softens it, making it difficult to identify the disorder by specialists, diagnostic tools, and those who live with the individual.