Predicting autistic traits, anxiety and depression symptoms using camouflaging autistic traits questionnaire (CAT-Q-ES): A machine learning study

Research has linked camouflaging with compensating and hiding autistic traits during social interactions. Furthermore, these strategies have been linked to increased anxiety and depression symptoms and to greater reliance on camouflaging behaviors among individuals with more autistic traits, even in non-autistic populations. This study evaluated the viability of a machine learning algorithm to predict autistic traits and symptoms of depression and anxiety using camouflaging behaviors. The sample included 601 participants: 102 autistic adults (72 women, 18 men, and 12 non-binary individuals) and 499 non-autistic adults (399 women, 92 men, and eight non-binary individuals). The study predicted autistic traits measured with the Broader Autism Phenotype Questionnaire (BAPQ) subscales - Aloofness, Pragmatics, and Rigidity - as well as the total score of depressive (Patient Health Questionnaire - PHQ-9) and anxious symptoms (General Anxiety Disorder - GAD-7) using the individual items from the Camouflaging Autistic Traits Questionnaire Spanish version (CAT-Q-ES) as predictors. We developed fifty supervised learning models, including support vector machines, neural networks, linear regressors, decision trees, random forests, and Gaussian processes, among others. Correlation coefficients between true and predicted scores were strong for Aloofness (R=.85), Pragmatics (R=.82), and Rigidity (R=.74), being only moderate for Depression (R=.60) and Anxiety (R=.54). Autism diagnosis or gender identity did not improve the prediction’s accuracy. These results show the viability of machine learning algorithms to predict autistic traits (Aloofness, Pragmatics and Rigidity) and anxiety-depression symptoms, using the CAT-Q-ES. This suggests potential for developing a tool that may improve autistic traits and emotional problems screening in individuals whose diagnosis is unclear or not yet established, regardless of gender identity. • Machine learning predicts autistic traits from camouflaging behaviors (CAT-Q-ES). • Camouflaging behaviors moderately predict anxiety and depression symptoms. • Autism diagnosis and gender do not enhance predictive model accuracy. • Machine learning shows viability for CAT-Q-ES-based screening in primary care.