New study finds online self-reports may not accurately reflect clinical autism diagnoses. Adults who report high levels of autistic traits through online surveys may not reflect the same social behaviors or clinical profiles as those who have been formally diagnosed with autism spectrum disorder.

[u/mvea]

https://www.psypost.org/new-study-finds-online-self-reports-may-not-accurately-reflect-clinical-autism-diagnoses/

[u/Dances28]

I mean isn't ability to mask a key issue? My social skills improved dramatically cause I worked years on it. I'm still awkward, but I imagine my results would be wildly different now than when I was a kid.

[u/ghoulthebraineater → u/Dances28]

Yeah. It's even mentioned in the DSM-V yet a lot of doctors seem to miss that part.

[u/roccmyworld → u/Dances28]

No. For masking to be relevant there would need to be a reason that people with clinical diagnoses don't mask. This is highly unlikely because people with actual diagnoses are more likely to have gotten assistance in learning social rules, not less likely.

In addition, the tests were designed to evaluate instinctual understanding of social manipulation. That's not something that can be learned.

[u/n-b-rowan → u/roccmyworld]

Maybe it's the other way around - the people with a clinical diagnosis showed more profound autistic traits, so they were noticed and evaluated. If they can't/didn't learn to mask these behaviours, then of course their autistic traits are going to be noticed more than someone who did learn to mask (and missed being diagnosed in childhood). Women often fall into this high masking category, making childhood diagnosis less common, and masking can lead to other mental health struggles (like anxiety).

The people with clinical diagnoses were the people where the autism traits were obvious, while people who weren't diagnosed might be high-masking autism (where you don't see the symptoms because they're internalized), or it might be social anxiety related, as the paper is suggesting. You can't say which it is until you also make all those undiagnosed people go through the clinical diagnosis process. 

(Until a couple of years ago, I would have fallen into the "not clinically diagnosed but with autistic traits" category, with me attempting to mask many of my autistic traits. I was diagnosed with social anxiety and generalized anxiety disorder at the time, but that was because I knew people were treating me badly because of autistic traits I was trying to mask. I thought that was how everyone experienced life and that I was broken for not being able to "handle it" like everyone else. I now have a clinical ASD diagnosis, but that doesn't mean I wasn't also autistic then!)

[u/DreamGirly_ → u/roccmyworld]

Actually, people with actual diagnoses are encouraged to mask less - if they receive any help at all that is - because masking takes up a tremendous amount of energy and leads to burnout.