Camouflaging-Burnout Circuit (insula

🧠 Overview

“Camouflaging-Burnout Circuit (insula–PCC)” is a state in which the brain has to continuously expend energy to “conceal or neutralise the true self” in order to blend into social environments that often do not accept differences in one’s behaviour or communication style. This is especially seen in individuals on the autism spectrum (ASD), ADHD, or those who are highly sensitive to social stimuli.
In the brains of these individuals, the main circuits working intensely are the insula, which is the centre for perceiving bodily signals (interoception) and detecting emotional threat, and the posterior cingulate cortex (PCC), which is the centre for “self-awareness” and “repetitive thinking about one’s own image in the eyes of others” within the Default Mode Network (DMN).

When a person is in a situation where they feel that “if I am my real self, I will be rejected or not accepted,” the insula triggers internal alarm signals that say “danger, change your behaviour,” pushing the body into a state of constant hyperarousal.
At the same time, the PCC starts working to create “self-scripts” or new, safer behavioural models, such as adjusting the tone of voice to sound cheerful, forcing eye contact, or mimicking the gestures of others in order to appear to fit in.

The insula–PCC circuit thus becomes a kind of “social mask generator” that has to keep spinning so that the person continues to be accepted.

However, when this process is repeated over a long period of time, the brain enters a state of neural fatigue — the insula continues to fire alarm signals even in situations that are not truly dangerous, and the PCC keeps spinning self-related thoughts that refuse to stop.
As a consequence, individuals begin to feel “mentally and emotionally drained” (emotional exhaustion), “disconnected from their own body” (body detachment), and “no longer know who they really are” (identity confusion).

Research on masking/autistic camouflaging has found that this chronic self-concealment is associated with abnormally elevated cortisol levels, heightened insula sensitivity to internal signals, and a DMN that cannot properly switch off during rest.

In the long term, this leads to Camouflaging Burnout — exhaustion that does not arise from workload itself, but from “the burden of having to be someone who is not oneself.”
People in this state often describe it as “feeling like I have slipped out of my own body,” “having to use all my energy just to make other people comfortable,” and “wanting to stop the world for a while so I don’t have to keep performing.”

Therefore, the Camouflaging-Burnout Circuit is not just a simple tiredness, but the sum total of the mismatch between brain, body, and self (neural–somatic–identity dissonance) that arises from using vast amounts of neural energy to survive in a world that does not understand those differences over a long period of time.

🔍 Core Symptoms

1. Cognitive fatigue after social situations

People in a state of Camouflaging Burnout often report that “the mental exhaustion after socialising” is unlike ordinary tiredness. It feels as if the brain is being squeezed to constantly scan the surroundings, interpret others’ facial expressions, tone of voice and body language, and control their own responses so that they remain “appropriate” at all times — like a CPU running too many processes until it overheats. Even just 30 minutes of social interaction can feel as draining as working for an entire day. This symptom is related to insula hyperactivity and continuous energy consumption within the salience network, to the point that the brain loses its ability to “reset” when the social situation ends.

2. Feeling that the “true self” and the “performed self” do not match

Self–mask incongruence is the core of Camouflaging Burnout. The person knows they are playing a role to gain acceptance from others, yet internally they do not feel like themselves. Over time, the brain begins to encode this performed self as part of the self-schema, leading to profound identity confusion where they can no longer distinguish which feelings are authentic and which thoughts exist merely because society expects them. This mismatch makes the PCC within the Default Mode Network (DMN) work in duplication, creating an endless loop of self-evaluation.

3. Blurred sense of self and feeling “out of body”

Many individuals describe feeling as though “themselves have disappeared from their body,” or feeling detached from their real emotions. Some experience viewing themselves from a third-person perspective (depersonalization). This arises when the insula sends distorted interoceptive signals and the PCC spins excessively in self-processing mode. To avoid emotional pain, the brain detaches itself from the ongoing experience.

4. Burnout with mixed depressive–anxious features

Beyond fatigue, people often show intense mood disturbances: waking up with absolutely no motivation, poor concentration, slower decision-making, a sense that the brain is sluggish, and a deeply rooted sense of worthlessness. Anxiety before meeting people is prominent, especially in contexts where they have to repeatedly perform a “normal” role. This creates a state of hypervigilance toward every single expression and behaviour they show.

5. Physical symptoms (Somatic / Interoceptive Signs)

Physical symptoms arise directly from heightened insula sensitivity — for example, acute headaches, chest tightness, shortness of breath, trembling hands, nausea, or chronic stomach pain without identifiable medical cause. Masking keeps the body in a state of chronic low-grade threat, where stress hormones like cortisol remain consistently high and the parasympathetic nervous system cannot be fully activated.

6. Crash / Shutdown / Meltdown reaction

After prolonged use of masking, the brain may enter “shutdown mode,” like a machine that has overheated and turns itself off. The person often becomes unable to work, talk, or even reply to messages, and needs to stay quiet for days. Some experience a “meltdown” — an explosive release of emotion such as crying, anger, or emotional breakdown that erupts suddenly after being suppressed for too long.

7. Social withdrawal

As burnout worsens, individuals begin to avoid all types of social engagement. Even activities they once enjoyed — meeting friends, going to the cinema, playing games with others — become psychologically burdensome. They feel that returning to “putting on the mask” again is impossible because their brain no longer has enough energy to maintain that level of self-control.

8. Over-thinking and replaying social scenes

After leaving any situation, the person replay the scene over and over in their mind, analysing: “Where did I mess up?” “Did they think I was weird?” This reflects over-activity of the PCC and DMN, and is closely linked with rumination and self-criticism, which are core drivers of depression.

9. Loss of pleasure in being alone (Anhedonia in Solitude)

Even when they get time away from people, they still do not feel relaxed, because the brain continues to operate in the same self-monitoring mode as during social interactions. Silence becomes burdensome, as the internal critical voice continues to speak non-stop.

10. Feeling nonexistent and losing faith in one’s own worth

When mental energy is depleted and there is no safe space to be themselves, individuals may feel that their existence is “unimportant” or “unnecessary.” This can escalate into despair (hopelessness), and for some, may be accompanied by thoughts of self-harm.

📋 Diagnostic Criteria

Note: This is a conceptual neuropsychological model, not an official DSM/ICD diagnostic standard. It is intended to support clinical-style understanding of Camouflaging Burnout.

A. History of chronic social Camouflaging / Masking

The individual persistently alters their behaviour in social situations in order to align with group norms, for example:

Forcing eye contact despite feeling uncomfortable
Mimicking other people’s tone of voice, gestures, or manners
Suppressing natural movements (stimming)
Pretending to smile or laugh in moments when society expects it
Relying heavily on pre-rehearsed conversational scripts

These behaviours are not temporary but function as long-standing social survival strategies that have become automatic neural patterns.

B. Burnout / Exhaustion clearly linked to periods of intense masking

There must be severe exhaustion (physical, emotional, and cognitive) directly associated with extended periods of socialising or performing a “normal” role. After such events, the person typically experiences a “crash,” during which they are temporarily unable to work or engage socially. This cannot be explained solely by sleep deprivation or physically heavy work.

C. Self–Mask Incongruence

The person feels a persistent gap between the “real self” and the “performed self,” such as feeling that life is constant acting, or being unsure who their real self actually is. This incongruence causes intense distress, leading to feelings of self-betrayal, hatred towards the image they must wear, and loss of confidence in their own worth.

D. Functional Impairment

The energy spent on masking leads to significant impairment in multiple life domains, for example:

Decreased academic/work performance, frequent absences
Reduced communication with others, emotional distance in relationships
Avoidance of activities they used to enjoy, or loss of motivation for everyday life
Physical health issues such as digestive problems, chronic muscle pain, or lowered immunity

E. Symptoms not better explained by another disorder alone

Although there may be comorbid conditions (e.g., depression, anxiety, thyroid dysfunction), Camouflaging Burnout has its own distinct pattern: exhaustion specifically bound to social masking, and a pronounced sense of loss of self.

F. Neurobiological correlates (in a conceptual sense)

Increased insula activation during social situations even when there is no real threat → indicating an internal threat detection bias
Continuous PCC / DMN activity even at rest → indicating self-referential processing that does not switch off
Reduced connectivity between the insula and prefrontal cortex → explaining fatigue in emotional regulation
Some fMRI studies show signs of allostatic overload in the autonomic nervous system

G. Emotional and behavioural indicators

Strong feelings of shame and the belief that “being myself is wrong”
Use of coping mechanisms such as dissociation, perfectionism, or avoidance
Loss of sense of belonging and feeling lonely even while surrounded by people

H. Additional conditions for neurodivergent groups

In individuals with ASD or ADHD, masking has particular forms, such as hiding sensory discomfort or forcing themselves to appear interested in things they are not truly interested in. Burnout in this group is often accompanied by sensory overload and difficulties with emotion regulation.

I. Duration and chronicity

Symptoms should persist for at least 3 months, or occur in repeated episodes several times per year, with each episode clearly associated with periods of intense social demands or pressure.

J. Distress Criterion

The person must experience clinically significant distress arising from the inability to be themselves, along with the perception that their emotional life has lost its balance at a deep level.

💡 Structural Summary

In terms of a brain model:

Insula = a scanner for bodily and emotional threat (body-based threat detection)
PCC/DMN = a system that generates narratives about “me”

When both operate together in an over-balanced way, the brain gets stuck in a mode of “constant vigilance + image management.”
→ This results in the Camouflaging Burnout Circuit, which forms the junction between neural symptoms, emotional states, and sense of self.

🧬 Subtypes or Specifiers

(Used to explore differing patterns, not to define separate diseases in a medical sense)

1. Autistic-Camouflaging Specifier

Found in people with ASD (formally diagnosed or strongly suspected)
Has a clear masking pattern such as copying social scripts, suppressing stimming, and forcing themselves into long stretches of small talk
Burnout usually comes with sensory overload, meltdown/shutdown, and a profound feeling of loss of self
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2. ADHD / Fast-Brain Masking Specifier

Has ADHD / executive dysfunction but “plays the role” of an organized, calm, highly productive person at all times
Uses enormous energy to control impulsivity, forgetfulness, and time-management difficulties, causing chronic strain in the insula–PCC circuit
May overlap with the High-Functioning / Masking Burnout Type that you have written about in other series

3. Social-Anxiety–Driven Camouflage Specifier

Masking is primarily driven by social anxiety / fear of negative evaluation
The PCC works overtime with self-referential negative thinking (“They must think I’m stupid/weird”), while the insula keeps firing bodily signals (racing heart, sweating, muscle tension) constantly
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4. Minority-Stress / Identity-Safety Specifier

People who have to “pretend to be normal” because they fear stigma, such as:

Neurodivergent individuals who are not yet open about it
LGBTQ+ individuals in unsafe contexts
Members of minority groups who must perform a “don’t stand out” persona

The colour of burnout in this group is heavily tinged with pain around identity, shame, and trauma.

5. High-Functioning Professional Specifier

Individuals whose outward image is “professional, capable, strong, socially adept”
Behind the scenes, they rely on intense masking + perfectionism + constant self-monitoring
Burnout appears as a sudden collapse after maintaining this façade for many years

Sub-specifiers by temporal pattern

Episodic Camouflaging Burnout: burnout arises in episodes corresponding to periods of heavy workload or major life transitions
Chronic Camouflaging Burnout: a constant state of exhaustion, feeling as though the mask has fused to the self and can no longer be removed

🧪 Brain & Neurobiology (insula–PCC Loop)

Camouflaging-Burnout Circuit does not stem from a weak will, but from a specific brain circuit that is pushed beyond its limits under chronic social pressure — especially the connections between the insula (the centre for bodily signals and threat) and the posterior cingulate cortex – PCC (the centre for self and repetitive self-related thinking). These are linked to three major brain networks:

Salience Network (SN) — detects stimuli that are “important” or “threatening”
Default Mode Network (DMN) — active when we think about ourselves or are in a reflective internal mode
Executive Control Network (ECN) — used for inhibition, evaluation, and behavioural planning

In people who repeatedly mask, these circuits develop cross-network hypercoupling, making it difficult for the brain to distinguish between “real threat” and “threat of being negatively judged.”

🧩 1. Insula: Interoceptive & Salience Hub

The insula is a brain structure buried deep within the Sylvian fissure, functioning as an “internal scanner” that detects bodily signals such as heart rate, breathing, sweating, muscle tension, and emotional responses.

In typical individuals, the insula alerts us when there is real danger, such as loud noise or confronting a stressful situation.
In those with a chronic camouflaging habit, the insula becomes over-trained to interpret “social differences” as threats — for example, “If I speak differently from others → danger.”
As a result, the body enters hyperarousal every time they are in a social setting, even when no real threat exists.

Over time, the insula develops hyperconnectivity with the amygdala and anterior cingulate cortex (ACC), making the threat-detection and emotional systems function in an “always-on mode,” leading to chronic fatigue as if the brain never gets a break from being on guard.

🧠 In fMRI, individuals with severe autistic masking show higher activation of the anterior insula compared to control groups, even in ordinary conversational situations.

🧭 2. Posterior Cingulate Cortex (PCC): The hub of self and personal narrative

The PCC is a key part of the Default Mode Network (DMN) — the system that operates when the brain is in self-referential mode, such as thinking about the past, future, or how others see us.

Under normal conditions, the DMN quiets down when we focus on external tasks.
Under masking, however, it remains continuously active because the brain keeps thinking, “Who should I be in their eyes?”

The PCC constructs “social scripts”, simulated roles that are deemed safe — for example, smiling at the right time or saying things that sound like they fit the group.

Biologically, the PCC connects with the hippocampus and medial prefrontal cortex (mPFC) to draw on memories of past social experiences in order to predict what to do in the future. This process is energetically expensive, and when repeated, leads to a self-rumination loop in which the brain continues to think about the self without end.

🔄 3. Insula–PCC Feedback Loop: Systemic Fatigue Mechanism

The connection between insula and PCC can be divided into four main stages that drive burnout:

Phase 1 — Threat Detection (Insula Activation)
Entering a social situation → the insula detects bodily discomfort such as rapid heartbeat, cold hands, or muscle tension and interprets it as social threat (“I might be judged”) → the stress system is switched on.

Phase 2 — Mask Construction (PCC/DMN Overdrive)
The PCC constructs behavioural scripts by drawing from past memories (“Last time I said this, people laughed… that means it was good”) to create “safe” patterns for social engagement — the brain shifts into full self-monitoring mode.

Phase 3 — Self–Body Mismatch (Prediction Error)
What the body feels ≠ what the brain orders it to display → an interoceptive prediction error emerges, which the insula detects with great clarity. Stress accumulates because “the brain knows it is deceiving itself.”

Phase 4 — Allostatic Load & Burnout
When this insula–PCC loop runs for too long, the neuroendocrine system (especially the HPA axis) secretes cortisol continuously, resulting in allostatic overload. The brain can no longer restore equilibrium → symptoms such as cognitive fog, fatigue, emotional flatness, and identity confusion appear.

🧩 4. Additional Neural Correlates

Amygdala: amplifies responses to social threat, intensifying masking
Anterior Cingulate Cortex (ACC): detects emotional conflict between “what is truly felt” and “what is expressed”
Prefrontal Cortex: controls behavioural inhibition, but its resources deplete over time under continuous masking
Hippocampus: stores traumatic memories of social rejection; later, merely encountering similar situations triggers insula alarms instantly

💥 5. Systemic Outcomes

When the insula–PCC circuit operates without rest:

The brain shifts into constant self-surveillance mode
The body remains in hypervigilance, as though continually escaping danger
The autonomic nervous system (ANS) loses balance → a tug-of-war between sympathetic and parasympathetic activity
Neural energy is burned up on “preventing rejection” instead of on creativity or rest

This is the origin of what is called Camouflaging Burnout — a state in which the brain is exhausted from having to “act like a normal person in a world that does not understand difference.”

⚠️ Causes & Risk Factors

Camouflaging Burnout does not arise from a single cause; it is the combined result of genetics, brain development, environment, and cumulative social experience. It can be broken down into layers as follows:

🧬 1. Neurodevelopmental Factors

Individuals with brain structures that differ from the statistical norm, such as ASD, ADHD, or other neurodivergent profiles, often begin learning “social survival strategies” in childhood.

They receive pressure to “act like everyone else.”
They are scolded when they show natural behaviours (e.g., avoiding eye contact, speaking too bluntly).
The brain encodes these experiences as a social threat template.

As they grow up, the insula becomes more sensitive to social stimuli than in the general population, and the PCC develops into a system of constant self-surveillance. Masking thus becomes an automatic behaviour that consumes tremendous energy.

🧠 2. Social Demands & Environmental Pressure

Societies that emphasise order, politeness, and “normality” increase pressure on the brain to remain in masking mode, especially in organisational cultures that reward “good with people” or “positive energy.”

The brain is forced to suppress atypical behaviours such as quietness, lack of eye contact, or direct speech.
Each act of suppression → the insula detects internal tension → signals the PCC to construct a new script.
This cycle repeats daily, gradually becoming neuro-fatigue.

🧩 3. Personality & Cognitive Style

People with tendencies toward perfectionism, high self-monitoring, or rejection sensitivity are more likely to burn out from masking than others, because their self-evaluation systems (PCC–mPFC) are especially active.

They do not merely conceal themselves “just to get by” but to do so perfectly.
They apply cognitive masking strategies, such as rehearsing conversations in their head and constantly monitoring others’ facial expressions.
This makes both the salience network and executive network work continuously and intensely.

🏠 4. Lack of Safe Spaces / Authentic Relationships

Those who lack safe places to be themselves cannot “give the insula–PCC circuit a break.”

In homes full of judgment, children learn that “being myself = being punished.”
In competitive workplaces, they must wear a professional mask 24/7.
In image-driven online worlds, the creation of an artificial self is further reinforced.

Without safe spaces, the brain interprets every context as a “field of social threat,” causing the salience network to remain active even during supposed rest.

😔 5. Deep Shame & Internalized Invalidity

One of the most powerful drivers of camouflaging burnout is “shame memory” — memories that the brain encodes from being laughed at, teased, or rejected in childhood.

The PCC retrieves these memories whenever the person enters a social situation.
The insula generates “unsafe” signals even without real threat.
This loop makes the individual feel that “being myself is a mistake.”

Biologically, shame is associated with activity in the anterior insula and subgenual ACC, which trigger the stress system in a way similar to genuine physical danger whenever the person thinks about themselves.

🩹 6. Co-occurring Mental Health Conditions

Chronic masking is associated with comorbid conditions such as:

Depression: from loss of sense of self and hope
Generalized Anxiety Disorder: from continuous self-monitoring and worry
OCD spectrum: from developing behavioural rituals to “control the image”
PTSD / C-PTSD: from bullying or social stigma

Brains of people with these conditions often show denser insula–PCC connectivity than usual, which explains why they feel “deeply exhausted both physically and mentally.”

💣 7. Cultural & Structural Factors

Cultural context also matters, for example:

East Asian collectivist cultures that prioritise harmony → masking is socially acceptable and even encouraged.
Western individualist cultures that emphasise confidence → neurodivergent people must use extra energy to appear “assertive.”
Lack of neurodiversity education in organisations → people must hide their differences instead of receiving accommodations.

🧩 8. Chronic Allostatic Load & Physiological Stress

Under chronic masking, the body remains in fight–flight–freeze mode; the sympathetic nervous system is repeatedly activated, disrupting the hypothalamic–pituitary–adrenal (HPA) axis.

Cortisol stays elevated → weakening the hippocampus and prefrontal cortex.
Sleep disturbances → the brain cannot reset attention and emotion-regulation systems.
Over time, this can lead to physical illnesses such as allergies, chronic fatigue syndrome (CFS), or immune dysregulation.

🌱 9. Generational & Epigenetic Influence

Some emerging studies suggest that social trauma (social invalidation) transmitted across generations may alter gene expression in brain regions such as the insula and ACC, particularly genes related to cortisol and serotonin receptors, making later generations more “sensitive to social threat perception” than usual.

🧭 10. Summary of Risk Pathway

Level	Main Risk Factors	Effect on the Brain	Behavioural Outcome
Genetic	Neurodivergent traits (ASD/ADHD)	Insula sensitivity, DMN hyperconnectivity	Masking from childhood
Social	Pressure to fit in	Insula overactivation	Social fatigue
Emotional	Shame, fear of rejection	PCC rumination loop	Burnout, identity loss
Cultural	Expectation of “normality”	DMN overstimulation	Chronic suppression of the authentic self

Mechanistic summary:

The continuous joint operation of the insula and PCC in a mode of “social threat monitoring + image control” is a key driver of Camouflaging Burnout. It is not merely psychological tiredness but a circuit-level neural fatigue, arising from the use of massive neural resources to “survive rejection,” until the nervous system loses balance completely.

🩺 Treatment & Management

These are general directions and do not replace seeing a psychiatrist or therapist in real life.

1. Psychoeducation: Naming one’s own experience

Explain that this exhaustion is not “laziness,” but rather the result of an overworked brain circuit due to masking.

Understand the roles of the insula–PCC:

Insula = detector of bodily and threat signals
PCC = the writer of “our personal story”

Knowing that “there is a name / a model that explains this” can greatly reduce self-blame and increase self-compassion.

2. Gradually reducing the load of camouflaging

Find spaces that are “safe enough” to try small acts of unmasking (online communities, neurodivergent-friendly groups, trusted close people).
Use the principle of Energy Accounting — choose in which contexts to mask (e.g., crucial work events) and allow yourself not to mask at full intensity in others.
Practise “micro-honesty,” for example:

“I’m a bit drained today, so if I’m quiet please don’t worry,”

instead of forcing yourself to appear energetic all the time.

3. Interoceptive & body-based work (caring for the Insula side)

Practise reconnecting with the body:

Body scan, mindful breathing, gentle stretching, yoga, somatic practices
Set self-check-in points throughout the day: “Is my heart beating fast? Are my shoulders tense? Am I frowning?”
Learn to read early signs of burnout such as mild headaches, early fatigue, or slipping focus — and allow yourself to rest before a major crash occurs.

4. Self-Narrative & Identity Work (caring for the PCC/DMN side)

Engage in therapies such as CBT, ACT, Compassion-Focused Therapy, or trauma-informed therapy to:

Challenge the belief that “my real self is disgusting/unacceptable.”
Build a new narrative that “being myself has value, and my kind of brain has strengths.”

Use journaling / narrative therapy to organise:

What kinds of masks have I worn?
Which masks does my true self want to thank and gently retire from my life?

5. Practical skills

Training in assertive communication & boundary setting:

e.g., choosing to say “Can I skip this event? I’m a bit drained” instead of forcing yourself to go and then crashing later.

Energy-efficient time and work management:

Scheduling tasks that require heavy masking so they are not back-to-back
Inserting “recovery blocks” throughout the day

6. Environmental & system-level supports

Request accommodations in workplaces/educational settings (where frameworks exist), such as:

Fewer unnecessary video meetings
More opportunities to communicate in writing
Quiet corners / sensory-friendly spaces

Strengthen a network of people who understand neurodiversity / mental health so that you do not feel compelled to perform a “normal” role all the time.

7. Professional Support & Safety

If there are symptoms of depression, anxiety, self-harm, or suicidal ideation → seek direct help from a psychiatrist or therapist.
An important point from research is that severe camouflaging is strongly associated with depression, anxiety, suicidality, and autistic burnout.
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Assessment by specialists in neurodevelopmental conditions who understand masking helps reduce missed or mistaken diagnoses.

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📝 Notes

“Camouflaging-Burnout Circuit (insula–PCC)” is a conceptual model that links subjective experience (feeling exhausted from wearing a mask) with specific brain circuits (insula–PCC–DMN–salience network).

Its aims are to:

Name this cluster of experiences
Connect with existing research on masking, autistic burnout, the insula, and the PCC
Open the way to developing assessment tools / psychoeducation / interventions for this specific group in the future

It should not be used as a substitute for real diagnosis, but can serve as an additional lens when explaining cases or writing articles in the NeuroNerdSociety series.

Example self-reflection questions for readers:

What kinds of masks do I use most often in my daily life?
After social events where I have to perform heavily, what signals does my body send (headache, stomach pain, brain fog, etc.)?
Who in my life makes me feel like I “don’t have to mask so much”? How do I feel when I’m with them?
If I could safely reduce masking by 10–20%, where would I like to start experimenting first?

📚 References

Bradley, L., Shaw, R., & Baron-Cohen, S. (2021). Autistic adults’ experiences of camouflaging and its impact on mental health. Autism, 25(5), 1492–1504.

Khudiakova, A., Hartman, C. A., & Begeer, S. (2024). Systematic review: Camouflaging in autism and its relationship to mental health and burnout. Journal of Autism and Developmental Disorders.

Livingston, L. A., & Happé, F. (2017). Conceptualising compensation in neurodevelopmental disorders: Reflections from autism spectrum disorder. Neuroscience & Biobehavioral Reviews, 80, 729–742.

Menon, V. (2010). Saliency, switching, attention and control: A network model of insular function. Brain Structure and Function, 214(5-6), 655–667.

Uddin, L. Q. (2015). Salience processing and insular cortical function and dysfunction. Nature Reviews Neuroscience, 16(1), 55–61.

Davey, C. G., Pujol, J., & Harrison, B. J. (2016). Mapping the self in the brain’s default mode network. NeuroImage, 132, 390–397.

Foster, B. L., & Parvizi, J. (2025). Functions of the posterior cingulate cortex and default mode network: Recent advances and clinical relevance. Trends in Cognitive Sciences.

Hull, L., Mandy, W., & Petrides, K. V. (2017). Behavioral and cognitive gender differences in autism: The role of camouflaging. Journal of Autism and Developmental Disorders, 47(8), 2519–2534.

Tierney, S., Burns, J., & Kilbey, E. (2016). Looking behind the mask: Social coping strategies of girls on the autistic spectrum. Research in Autism Spectrum Disorders, 23, 73–83.

Lai, M. C., Lombardo, M. V., & Baron-Cohen, S. (2014). Autism. The Lancet, 383(9920), 896–910.

Livingston, L. A., Shah, P., White, S. J., & Happé, F. (2020). Autistic social camouflaging: Conceptualisation, measurement, and links to mental health. Autism, 24(3), 643–654.

Williams, D. M., & Robinson, S. J. (2022). Autistic burnout: An insider’s perspective on the energy costs of social masking. Frontiers in Psychology, 13, 875921.

Wylie, K. P., Tregellas, J. R. (2010). The role of the insula in emotional awareness. Brain Structure and Function, 214(5-6), 579–593.

Farb, N. A. S., et al. (2012). Interoception, emotion, and the insula: A neurobiological perspective. Trends in Cognitive Sciences, 16(3), 123–131.

Quadt, L., Critchley, H. D., & Garfinkel, S. N. (2018). Interoception and emotion: New insights into the relationship between the body and the mind. Current Opinion in Behavioral Sciences, 19, 67–73.

Raichle, M. E. (2015). The brain’s default mode network. Annual Review of Neuroscience, 38, 433–447.

Parsons, S., & Runswick-Cole, K. (2023). The costs of social camouflaging: A qualitative review of autistic burnout and identity erosion. Autism in Adulthood, 5(2), 89–102.

Lombardo, M. V., Chakrabarti, B., & Baron-Cohen, S. (2011). Neural mechanisms of social cognition: An expanded model integrating the insula and cingulate cortex. Neuroscience & Biobehavioral Reviews, 35(9), 2046–2057.

Perry, A., Troje, N. F., & Bentin, S. (2010). Exploring motor and neural mechanisms of social camouflage. Social Cognitive and Affective Neuroscience, 5(1), 59–70.

Lai, M.-C., Hull, L., Mandy, W., Chakrabarti, B., & Baron-Cohen, S. (2020). Camouflaging and mental health in autism: A systematic review and meta-analysis. The Lancet Psychiatry, 7(9), 763–773.

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Camouflaging-Burnout Circuit (insula–PCC)