A cross-cultural study of autism stigma and camouflage in the UK and China

The current PhD thesis is a cross-cultural study between China and the UK, comprising two quantitative studies and one qualitative study, aiming to explore how culture influences the autism stigma and camouflage.
Study 1 (Chapter 2) was a structural equation modelling study that used Chinese and English language versions of questionnaires to measure levels of stigma, cultural orientation and autism-related knowledge in Chinese and British participants. After examining questionnaires validity and cross-cultural consistency, the study's results showed that cultural orientation could influence levels of stigma. Chinese participants had higher levels of autism stigma than the UK (after PSM). More autism-related knowledge and experience can reduce stigma.
Study 2 (Chapter 3) also used two language versions of the questionnaires to measure autism camouflage, broad autism phenotypes and mental health in Chinese and UK participants. The CFA check of the questionnaires questioned the validity and cross-cultural consistency of the CAT-Q and BAPQ. However, subsequent analysis of cross-cultural differences still found that Chinese participants had higher levels of camouflage than in the UK and better mental health at the same camouflage Level (used PSM). Analysis of the mediating and moderating effects found that the camouflage level partially mediated the autistic traits influencing mental health. The cultural background had a moderating effect on autistic traits influencing camouflage.
Study 3 (Chapter 4) conducted a qualitative study on autism camouflage, exploring the differences in understanding of camouflage between Chinese and British participants. Four themes were generated from the content of the interviews: What is camouflage; Motivations for camouflage; Strategies for camouflage; and Consequences of camouflage. These themes and sub-themes are similar to previous British studies, but many differences suggest that the Chinese cultural context influences the understanding of camouflage.
Overall, cultural context plays a vital role in autism stigma and camouflage. Despite its questionable cross-cultural consistency between the English and Chinese versions of the CAT-Q, the current study still makes some valuable comparisons between Chinese and British participants. Subsequent qualitative research explored Chinese participants' experiences of camouflage. Cultural differences may have contributed to the lack of appropriateness of some CAT-Q items for Chinese participants.