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掩蔽

"Putting on my best normal" - Hull et al., 2017

掩飾（也稱為“偽裝”）是指自閉症患者“戴上面具”以表現出神經質和“不那麼自閉症”。當自閉症患者戴面具時，他們會抑制和隱藏他們的自閉症特徵，如刺激、迴聲症以及神經典型人士認為不可接受的溝通方式差異。掩飾在自閉症女孩和女性中很常見。掩飾通常會延遲自閉症的診斷。女孩和婦女經常被漏診或被延誤診斷。

Examples of masking:

A person is holding up a piece of paper with a smile drawn on it, in front of their mouth

掩碼示例：

  • 複製人的面部表情

  • 強迫目光接觸

  • 模仿人的行為

  • 學習社交腳本​

  • 模仿手勢

  • 準備笑話，排練它們

  • 在互動之前練習對話（在你的腦海中或大聲）

  • 抑制刺激、迴聲

  • 在互動之前花時間思考話題、問題

掩蔽成本

  • 燒完

  • 精疲力竭

  • 感覺超負荷（崩潰）

  • 預防自閉症診斷

  • 自傷/自殘

  • 社會隔離/排斥

  • 失業

  • 自尊心差

  • 焦慮

  • 沮喪

  • 自殺意念

  • 自殺未遂

"But everybody masks. I'm neurotypical and I mask too. It's the same" 

Nope. It's not the same. There's a huge difference between Autistic masking and neurotypical masking. Almost everyone masks to some extent. For example, a neurotypical person may adapt their behaviour, body language, and communication style in certain situations and contexts e.g. in the workplace whereby they will act more polite, 'professional' and more sociable. However, this is not costly to their mental, emotional, physical, and sensory health. Autistic people mask as a survival strategy in order to avoid being ostracised for coming across as "weird, odd", or being made fun of due to years of social exclusion. Autistic masking involves scrutinising every interaction and being hyper aware of every facial expression or gesture. Neurotypicals (generally) do not experience this. Masking comes at a huge cost due to the labour that goes into it.
A dark skinned boy with black hair is covering his face with his hands and blue t-shirt

自閉症患者為什麼要戴口罩？

  • 以適應社交場合。

  • 對過去欺凌的有條件的反應。

  • 以免被欺負。

  • 被神經典型者更多地接受。

  • 這是一種應對策略。

掩飾預示自殺傾向

戴面具的自閉症成年人有很高的焦慮和共同發生的心理健康問題[1]。 在自閉症成年人中，掩飾顯著預測自殺傾向[2]。自閉症患者覺得有必要假裝他們不是自閉症，尤其是傳統上被貼上“高功能”標籤的自閉症患者。這就是為什麼功能標籤具有誤導性和有害性的原因。被稱為高功能並不是一種恭維，因為它使人的困難無效並被駁回。 

  • Masking is a "response to the deficit narrative and accompanying stigma that has developed around autism". 

  • Masking shouldn't be associated with a "female autism phenotype"

  • Masking takes significant energy and is only sustainable for short periods.

來源


自閉症掩飾的概念分析：理解恥辱和選擇錯覺的敘述。 Amy Pearson 和 Kieran Rose.Autism in Adulthood.Mar 2021.52-60 。 http://doi.org/10.1089/aut.2020.0043

[1] Cage, E., & Troxell-Whitman, Z. (2019)。了解自閉症成人偽裝的原因、背景和成本。自閉症和發育障礙雜誌，49（5），1899-1911。 關聯

[2] Cassidy, S.、Bradley, L.、Shaw, R. 等。自閉症成人自殺的風險標誌物。分子自閉症 9, 42 (2018)。 關聯

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