Background
Autistic traits are distributed along a continuum ranging from clinical presentations to the general population, being associated with high-risk of mental health problems. However, the underlying mechanism remains unclear. Given that alexithymia, which contributes to emotional difficulties related to autistic traits, along with the utilization of social camouflaging as a potential mechanism for coping, may exacerbate mental health issues. This study aimed to examine the mediating effects of alexithymia and social camouflaging in the associations between autistic traits and symptoms of anxiety/depression.
Methods
A total of 1085 Chinese university students (age: 21.8 ± 2.7 years, 51.9% males) were recruited through an online survey which measured autistic traits, mental health problems (anxiety and depression), alexithymia, and social camouflaging. The mediator effects of alexithymia and social camouflaging on the associations of autistic traits with anxiety and depression were conducted, and two serial mediation models were verified by regression analysis.
Results
The findings revealed a significant positive association of autistic traits with symptoms of anxiety and depression. The manifestation of anxiety symptoms was found to be influenced by autistic traits, mediated sequentially by alexithymia and social camouflaging (β = 0.022, 95% confidence interval [CI]: 0.011–0.035). Differently, the depression symptoms were linked to autistic traits solely through alexithymia (β = 0.499, 95%CI: 0.423–0.578). According to the subgroup analysis, the results within the female group were consistent with the observations made in the overall sample. However, in the male group, the statistical significance of the mediating effect of social camouflaging between autistic traits and anxiety was no longer evident.
Limitations
This study can only identify associations between autistic traits and social camouflaging, not causal relationships. Neuroimaging research is necessary to unravel the neural mechanisms that underlie these associations.
Conclusions
Our findings found that alexithymia and social camouflaging play a serial mediating role in the relationship between autistic traits and mental health problems in Chinese university students, especially anxiety. The associations between autistic traits and mental health issues may vary between males and females. This study highlights a significant pathway that has the potential to improve mental well-being in individuals exhibiting high autistic traits.