Camouflaging Autistic Traits Questionnaire (CAT-Q)
Camouflaging Autistic Traits Questionnaire (CAT-Q) overview
Creator and Context
The Camouflaging Autistic Traits Questionnaire (CAT-Q) is a 25-item self-report instrument designed to assess the extent to which individuals employ camouflaging strategies to mask or compensate for autistic traits in social contexts.
Developed by Laura Hull and colleagues in 2018, the CAT-Q emerged from qualitative research involving autistic adults, aiming to quantify the phenomenon of social camouflaging—a set of behaviors used to conceal autistic characteristics to fit into social environments.
Presenting Conditions
The CAT-Q is particularly relevant for individuals who may not meet traditional diagnostic criteria for Autism Spectrum Disorder (ASD) due to their ability to mask symptoms, often leading to underdiagnosis, especially among females and gender-diverse populations.
Administration
The questionnaire is administered as a self-report measure, suitable for individuals aged 16 and above. It comprises 25 items rated on a 7-point Likert scale, ranging from “Strongly Disagree” to “Strongly Agree.”
Desired Audience
The CAT-Q is intended for use by clinicians, researchers, and individuals seeking to understand the extent of camouflaging behaviours in themselves or others, particularly in the context of autism assessments.
In clinical settings, the CAT-Q aids in identifying individuals who may be under diagnosed due to effective camouflaging. It provides insights into the strategies employed by individuals to navigate social situations, informing tailored interventions and support plans.
Considerations
While the CAT-Q offers valuable insights, it is essential to consider cultural, gender, and individual differences in camouflaging behaviours. Additionally, as a self-report measure, responses may be influenced by self-awareness and willingness to disclose behaviours.
How to score the Camouflaging Autistic Traits Questionnaire (CAT-Q)
Conducting the assessment
Respondents rate each of the 25 items on a 7-point Likert scale. The items are divided into three subscales:
Compensation: Strategies to compensate for social difficulties (9 items)
Masking: Behaviors aimed at hiding autistic traits (8 items)
Assimilation: Efforts to fit into social situations (8 items)
Interpretation
Scores for each subscale are summed, and a total score is calculated by adding all item scores. Higher scores indicate greater use of camouflaging strategies. While there is no definitive cutoff, scores above 100 suggest significant camouflaging behaviours.
Clinical Considerations
Clinicians should interpret CAT-Q scores in conjunction with comprehensive assessments, considering the individual’s context, history, and other diagnostic tools. High camouflaging scores may mask underlying autistic traits, necessitating a nuanced evaluation approach.
Camouflaging Autistic Traits Questionnaire (CAT-Q) use cases
The CAT-Q has demonstrated robust psychometric properties, including high internal consistency (Cronbach’s α = 0.94) and good test-retest reliability. Research indicates that camouflaging is associated with increased psychological distress, emphasising the importance of recognising and addressing these behaviours in assessments and interventions.
Category
Autism
Research Summary
Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q) (Hull et al., 2018)
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