Camouflaging and self-esteem in neurodivergent women: A cross-sectional comparison across autism, ADHD, and dual diagnosis

Background Camouflaging of neurodivergent traits is increasingly recognized as a strategy used by women with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), yet comparative evidence across diagnostic groups remains limited. Objectives This study examined camouflaging levels and self-esteem in adult women with ASD, ADHD, dual diagnosis (ASD+ADHD), and those undergoing diagnostic assessment. We also explored associations between camouflaging subscales and self-esteem and examined the role of sociodemographic factors. Methods A total of 155 adult women (M = 33.9 years, SD = 9.15) completed an online survey including the Rosenberg Self-Esteem Scale and a Polish-language translation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Participants were recruited via social media support communities in Poland. Groups comprised women with self-reported diagnoses of ASD (n = 39), ADHD (n = 42), dual diagnosis (n = 45), and those in the diagnostic process (n = 29). Results Women with ASD and dual diagnosis reported significantly higher overall camouflaging, compensation, and assimilation scores than women with ADHD. No significant differences emerged between diagnosed women and those undergoing assessment. Self-esteem was negatively associated with overall camouflaging (r = −.29, p < .001) and most strongly with assimilation (r = −.45, p < .001); compensation showed no significant association. Descriptively, the strongest associations were observed in the dual diagnosis group. In exploratory analyses, older age and motherhood were associated with lower camouflaging; the association with motherhood remained significant after adjustment for age, although this finding should be interpreted with caution. The Polish CAT-Q demonstrated good internal consistency in this sample (α =.72–.90); full psychometric validation remains to be completed. Conclusions Assimilation strategies showed the strongest negative association with self-esteem in neurodivergent women. In descriptive terms, women with dual diagnosis reported the highest levels of camouflaging, although they did not differ significantly from women with ASD alone. Diagnosed women did not differ from women undergoing diagnostic assessment in camouflaging or self-esteem, suggesting that diagnostic status alone was not associated with these outcomes; post-diagnostic support focused on reducing camouflaging pressure and building self-acceptance may therefore be warranted.