Adaptação transcultural e validação do camouflaging autistic traits questionnaire (CAT-Q) para autistas adultos brasileiros

Abstract

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with a multifactorial etiology, including both genetic and environmental factors. Autistic individuals often adopt strategies aimed at masking their autistic traits in social environments, a phenomenon referred to in the literature as “social camouflaging” or simply “camouflaging.” Although camouflaging may provide a greater level of social adjustment and, in some cases, result in hyper-adaptive skills in specific domains, it has been associated with higher levels of cognitive and emotional stress, feelings of exhaustion, as well as symptoms of anxiety and depression. Therefore, the possibility of assessing this characteristic in autistic adults is of utmost relevance. The aim of this study is to carry out the cross-cultural adaptation of the Camouflaging Autistic Traits Questionnaire (CAT-Q), originally developed in 2019 by Laura Hull for British individuals, into Brazilian Portuguese and to evaluate its validity and reliability indicators for Brazilian autistic adults with support levels 1 and 2. This study is characterized as sequential quantitative, and accordingly, we followed the methodological recommendations of Beaton et al. (2000) and Swami & Baron (2019) for the translation and validation of psychometric instruments, including: translation, synthesis of translations, back-translation, expert committee review, and pretesting. A total of 384 autistic adults were recruited online (M = 32.7 years; SD = 9.4), of whom 74.1% identified as female, 23.3% as male, and 2.6% as other genders. Participants responded to questionnaires assessing: social camouflaging (CAT-Q), autistic traits (Brazilian version of the Broad Autism Phenotype Questionnaire – BAPQ-BR), anxiety and depression (Hospital Anxiety and Depression Scale – HADS), and body dissatisfaction (Body Shape Questionnaire-8 – BSQ-8). In addition, a sociodemographic questionnaire developed by the researchers was applied to collect personal and sample characterization data, as well as information regarding regular physical activity practices. The data were analyzed using descriptive statistics and psychometric procedures. Confirmatory factor analysis led to the exclusion of five items from the original instrument (items 10, 12, 16, 18, and 23), resulting in a final model with 20 items distributed across three factors: Compensation, Masking, and Assimilation. The model demonstrated good fit indices (CFI = 0.944; TLI = 0.933; RMSEA = 0.056; SRMR = 0.063) and satisfactory reliability (α ranging from 0.79 to 0.87; ω from 0.80 to 0.88). Validity analyses revealed expected correlations between the CAT-Q factors and measures of autistic traits, depression, and body image, with notable negative correlations between the Assimilation factor and depressive and linguistic symptoms. Significant differences in scores were observed as a function of sex and support level, indicating the instrument’s sensitivity to these variables. In conclusion, the Brazilian version of the CAT-Q demonstrates appropriate psychometric indicators and proves to be suitable for assessing social camouflaging strategies in Brazilian autistic adults with support levels 1 and 2.