Camouflaging Autistic Traits Questionnaire: Cultural Adaptation, Reliability, and Validity in Autistic and Non-Autistic from Spain

Background: Researchers have proposed that camouflaging contributes to delayed or absent diagnosis and mental health problems in autistic individuals. Therefore, there is a need for validated measures of this construct. This study aimed to culturally adapt the Camouflaging Autistic Traits Questionnaire (CAT-Q) for the Spanish population (Spain) and assess its psychometric properties, addressing the need for camouflage assessment tools in Spain.

Methods: We conducted a cultural adaptation process, which involved direct-back translation and pretest with autistic individuals. We tested internal consistency, test–retest reliability, construct validity, including structural validity (confirmatory factor analysis), measure invariance, and hypothesis testing for construct validity with a larger sample of 490 participants, including 379 non-autistic individuals and 111 autistic individuals. We assessed a subsample of 32 non-autistic participants for test–retest reliability.

Results: The cultural adaptation process yielded the CAT-Q–Spanish version (ES), culturally adapted for the Spanish population. Autistic volunteers identified minor comprehension issues in three items and the researchers revised them. The CAT-Q-ES showed excellent internal consistency among non-autistic (McDonald’s omega [ω] = 0.95) and autistic individuals (ω = 0.89). The subscales (Compensation, Masking, Assimilation) demonstrated internal consistencies ranging from adequate to excellent. Test–retest reliability showed a strong relationship (r = 0.99, p < 0.001). Associations between CAT-Q-ES scores and related constructs, including autistic traits, and symptoms of anxiety and depression confirmed its validity, with autistic individuals scoring higher on the test.

Conclusion: The CAT-Q-ES is conceptually and semantically equivalent to the original instrument, offering a valid and reliable measure of camouflage for Spanish adults. These findings enhance the assessment and understanding of camouflage within the Spanish context, addressing a crucial gap in the field.