The Camouflaging Autistic Traits Questionnaire (CAT-Q) 

What is the CAT-Q test

CAT-Q introduction

The Camouflaging Autistic Traits Questionnaire (CAT-Q) is a self-report assessment tool and questionnaire designed to measure social camouflaging behaviors in all adults, particularly those on the autism spectrum. Some people may hide their real behaviours, so the problem will not be found.

This tool was developed by Laura Hull and his colleagues in 2018, you can find the original paper on the website and then learn more details about the questionnaire and tool. The CAT-Q aims to help people to find out the issue earlier. Somebody will have fake feelings about themselves in life. We want to introduce this tool to help you.

This is especially relevant for women and individuals with higher intelligence, who often develop sophisticated strategies to navigate social situations while concealing their autistic characteristics.

Who can use this CAT-Q test?

For individuals of age 16 and above.

Details of the CAT-Q test

The CAT-Q consists of 25 statements that participants respond to using a 7-point Likert scale, it was very common, ranging from “strongly disagree” to “strongly agree.”

	Strongly Disagree	Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Agree	Strongly Agree
When I am interacting with someone…..	1	2	3	4	5	6	7

The questionnaire assesses three main areas of camouflaging:

1. Compensation
2. Masking
3. Assimilation

Compensation refers to strategies used to actively manage difficulties in social interactions, such as mimicking body language or learning social cues from media.

Masking involves hiding autistic traits or presenting oneself as neurotypical, which may include forcing eye contact or adjusting one’s demeanor to appear more confident.

Assimilation encompasses efforts to fit in socially, such as putting on an act or avoiding certain interactions.

Scoring for the CAT-Q ranges from 25 to 175, with a threshold score of 100 indicating significant camouflaging behavior.

Higher scores suggest a greater tendency to suppress autistic traits, which can lead to lower scores on other autism assessments.

How to get the CAT-Q score?

1. Complete the Questionnaire of the CAT-Q:

The CAT-Q includes 25 statements that all people will respond to using a 7-point Likert scale, so you can easily find out that 1 means “strongly disagree” and 7 means “strongly agree.”

Each option corresponds to a different score. The score will largely reflect your situation. The more you agree, the higher score you will get.

2. Reverse Scoring:

For specific items (statements 3, 12, 19, 22, and 24), you need to reverse the scores to get the right number,please careful. This means if you rated an item as a 1(strongly disagree), it will count as a 7 for scoring purposes. This rule will only work when you add the score in total, you don’t pay attention to when you choose the answer.

3. Total Score Calculation:

Finally, you need to add all scores from first to the end together, all 25 statements, including the adjusted scores from the special reversed items. The final total score will range from 25 to 175, with higher scores indicating greater levels of camouflaging.

4. Subscale Scores

Compensation score

• statements 1, 4, 5, 8, 11, 14, 17, 20, and 23.

Masking score

• statements 2, 6, 9, 12, 15, 18, 21, and 24. You can use a different color pen to circle it.
• Statements 12 and 24 need to be reversed.

Assimilation score

• statements 3, 7, 10, 13, 16, 19, 22, and 25.
• Statements 3, 19, and 22 need to be reversed.

5. Interpret Your Scores:

A total score of 100 or above suggests significant camouflaging of autistic traits. Higher scores may indicate that you are actively suppressing your autistic characteristics in social situations.

How to interpret your CAT-Q scores?

Understanding Your Total Score of the CAT-Q

1. Total Score Range: The CAT-Q total score is from 25 to 175. The median score here is 100. A higher score indicates greater levels of camouflaging behaviors. It means you may be actively suppressing or hiding your autistic traits in social situations. these scores will help you arrive at a more objective outcome.
2. Threshold for Camouflaging: As you get the score, a total score of 100 or above suggests that you engage in significant camouflaging of your autistic traits. You need to get a further diagnosis. This threshold is important as it can indicate how much you might be masking your true self in social interactions.

Subscale Scores of CAT-Q

The CAT-Q measures three specific aspects of camouflaging:

1. Compensation: This subscale assesses strategies used to compensate for social difficulties, such as mimicking body language or learning social cues from media. A higher score here indicates a greater reliance on compensatory strategies.
2. Masking: This subscale evaluates the extent to which you hide your autistic characteristics or present a non-autistic persona. High scores suggest that you may feel the need to conceal your true self significantly.
3. Assimilation: This measures attempts to blend in with others socially without revealing discomfort. Higher scores indicate a strong desire to fit in, even if it means suppressing personal feelings or behaviors.

Average Scores Comparison of CAT-Q

To gain further insight into your results, compare your scores against average scores from both autistic and non-autistic populations:

1. Autistic individuals will typically have a higher average scores across all subscales compared to non-autistic individuals.
2. For example, some studies and research papers have shown that autistic women tend to score significantly higher than male counterparts and non-autistic individuals in terms of camouflaging behaviors. It will have a more impressive difference.

Psychological Implications of CAT-Q

Higher CAT-Q scores are often associated with psychological distress and functional challenges. As such, while it may be beneficial and wonderful to deeply understand and know more about your camouflaging behaviors, it’s also essential to consider the emotional toll that such behaviors can take. Engaging in high levels of camouflaging can lead to increased anxiety and stress. So this questionnaire will help you to get a understanding of you camouflaging.

Is CAT-Q reliable and accurate?

The Camouflaging Autistic Traits Questionnaire (CAT-Q) has demonstrated strong reliability in identifying camouflaging behaviors among individuals on the autism spectrum.

There are so many esearch supporting its validity. If you want to know more about the details, you can read the paper online. Some studies and papers show robust psychometric properties, including high internal consistency and good test-retest reliability.

1. Internal Consistency of CAT-Q:

The CAT-Q exhibits a high internal consistency with a Cronbach’s alpha of 0.94 for the total scale. This indicates that the items in the questionnaire are measuring a cohesive construct related to camouflaging behaviors. It is a wonderful and outstanding data, it means the tool is professional.

The subscales also show strong internal consistency, with values of 0.91 for Compensation, 0.85 for Masking, and 0.92 for Assimilation, confirming that each aspect of camouflaging is reliably assessed.

2. Test-Retest Reliability of CAT-Q:

A longitudinal study involving 30 autistic individuals demonstrated good test-retest reliability, as participants who completed the CAT-Q again three months later showed no significant differences in their scores. This suggests that the CAT-Q consistently measures camouflaging behaviors over time.

3. Gender Differences of CAT-Q:

The questionnaire and tool also highlights significant gender differences in camouflaging behaviors, it will be crucial for accurate interpretation of scores, this is something you need to pay attention.

So many studies and paper have shown that autistic females tend to score higher on the CAT-Q compared to males. It indicates that they may engage in more camouflaging strategies.

The CAT-Q Test

Please read all the statements and choose the answer that fits your experiences.

1. When I am interacting with someone, I deliberately copy their body language or facial expressions.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

2. I monitor my body language or facial expressions so that I appear relaxed.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

3. I rarely feel the need to put on an act in order to get through a social situation.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

4. I have developed a script to follow in social situations.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

5. I will repeat phrases that I have heard others say in the exact same way that I first heard them.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

6. I adjust my body language or facial expressions so that I appear interested by the person I am interacting with.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

7. In social situations, I feel like I’m ‘performing’ rather than being myself.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

8. In my own social interactions, I use behaviours that I have learned from watching other people interacting.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

9. I always think about the impression I make on other people.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

10. I need the support of other people in order to socialise.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

11. I practice my facial expressions and body language to make sure they look natural.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

12. I don’t feel the need to make eye contact with other people if I don’t want to.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

13. I have to force myself to interact with people when I am in social situations.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

14. I have tried to improve my understanding of social skills by watching other people.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

15. I monitor my body language or facial expressions so that I appear interested by the person I am interacting with.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

16. When in social situations, I try to find ways to avoid interacting with others.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

17. I have researched the rules of social interactions to improve my own social skills.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

18. I am always aware of the impression I make on other people.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

19. I feel free to be myself when I am with other people.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

20. I learn how people use their bodies and faces to interact by watching television or films, or by reading fiction.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

21. I adjust my body language or facial expressions so that I appear relaxed.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

22. When talking to other people, I feel like the conversation flows naturally.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

23. I have spent time learning social skills from television shows and films, and try to use these in my interactions.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

24. In social interactions, I do not pay attention to what my face or body are doing.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree

25. In social situations, I feel like I am pretending to be ‘normal’.

1. Strongly Disagree
2. Disagree
3. Somewhat Disagree
4. Neither Agree nor Disagree
5. Somewhat Agree
6. Agree
7. Strongly Agree