ADHD and Rejection Sensitivity: A qualitative study explores how the anticipation of rejection causes more psychological distress than the actual events, driving a “vicious circle” of emotional masking, bodily pain, and social withdrawal. (n=5)
https://doi.org/10.1371/journal.pone.0314669
16 Comments
n=5? Wow.
This new study tracked the psychological, behavioral, and physical impacts of rejection sensitive dysphoria in adults diagnosed with ADHD. Through systematic focus-group interviews, the research identified three primary themes that dictate how individuals cope with perceived criticism:
ANTICIPATION OVER REALITY: All participants agreed that the chronic expectation of rejection causes more dysphoria than an actual rejection itself. To avoid this intense anxiety, individuals engage in preemptive withdrawal, intentionally isolating themselves from friendships, family, university work, and career opportunities before any negative feedback can occur.
THE MASKING PARADOX: To hide their intense vulnerability from others, individuals utilize a “mask of toughness” to project a nonchalant attitude toward criticism. This creates a vicious circle because they appear completely unaffected externally, peers and employers assume critiques do not bother them, leading to an increase in real-world criticism and forcing the individual to withdraw even further.
SOMATIC DISTRESS: Perceived social rejection triggered acute physical pain rather than just mental sadness. Participants detailed unique and intense bodily sensations, including throat constriction, the feeling of a chair being kicked out from beneath them, a sudden drop in the heart, paralysis, and internal burning heat.
TL;DR: Rejection sensitivity is a highly disruptive aspect of emotional dysregulation in adult ADHD. Because individuals aggressively mask the severe mental and physical pain it causes, the symptom remains completely invisible to peers and largely unrecognized in standard clinical treatment models.
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RSD is not a vetted concept is clinical psychology.
N=5 / day for 1 person.
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Good to see an initial qualitative study into this topic. It’s unfortunate that people immediately jump to the n=5 without reading (or perhaps not understanding) the literal sixth word in the title.
Theyre starting to get it, this is at the core of adhd, its not the attention stuff.
Its severe disregulation
Nothing like finding people you like, actively avoiding them and then internally crashing out when they start drifting away:)
Interesting and relatable findings, but let’s raise that N, shall we?
“Kids, you tried your best and failed. The lesson is, never try.” — Homer Simpson
It me. And the sad part is, it’s based on nothing. Three formal invitations from galleries to show my work and I found a reason not to accept any of them. What if nothing sells? What if no one shows up? Opportunity after opportunity either ignored or rejected.
They might want to increase that sample size.
I’d say the vast majority of my social anxiety is anticipatory.
I’m Autistic and I know for a fact I don’t fit into most groups and am perceived as different.
Part of coping with not socializing the way most people do is that I create scripts in my head based on what’s most likely to happen or be discussed.
That script also involves being able to leave events easily or only stay for an hour if things go south. This is because it happens and I need to prepare for it.
I’m also drained afterwards, so I have to plan for that. Doing a Sunday thing with work on Monday? Hell no.
All in all, it’s often not worth it and I stick to my small friend group and predictable routines.
This is the worst torture ever. My suicide attempts were all relates to this
ironically i applied for legal help to sue the hospital over how my mam was treated at hospital before her death, was too late on limitations ground, expected it to get rejected got super depressed, borderline sewercidal and then they rejected and I have the same rebound effects so yep can vouch
Dang, I have always avoided going places and find it hard to talk with new people based on how I think they might perceive me, it’s even really difficult for me to talk with friends I have known for years if we have spent any significant time apart, like I can even think of things to say so I just avoid saying anything making it worse.