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CIFT: Information on Rejection Sensitivity

Rejection Sensitivity Rejection Sensitive Dysphoria (RSD) and Attention Deficit Hyperactivity Disorder (ADHD) #

You’re being provided this resource because you have a role in the life of someone with Attention Deficit Hyperactivity Disorder (ADHD) who experiences a high degree of sensitivity to rejection.

While rejection sensitivity is not currently a listed diagnostic trait of ADHD and Rejection Sensitivity Dysphoria (RSD) is not a formal diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders - 5 (DSM-V), the relationship between heightened sensitivity to and emotional distress from exposure to real or perceived rejection and ADHD has been well established.

Rejection sensitivity is used to describe when an individual experiences more emotional dysregulation and pain than typical in response to real or perceived rejection. Rejection Sensitive Dysphoria is used when individuals’ response to real or perceived rejection is so intense it feels extreme and nearly unbearable for the individual. It is believed that the vast majority of individuals with ADHD experience some degree of heightened sensitivity to rejection.

It is currently debated whether this response to rejection is a part of the neurological condition of ADHD itself, or if it develops as secondary response to the traumas of navigating the world as a neurodivergent individual. ADHDers are exposed to drastically more negative feedback and criticism than their neurotypical peers from childhood on, often due to their struggles with impulsivity, hyperactivity, inattentiveness – all of which can contribute to an increased likelihood of missing social cues or failing to meet social norms/expectations. Many ADHDers become extremely vigilant of social missteps and work hard to hide or mask their symptoms due to painful experiences with rejection.

Regardless of how the sensitivity to rejection is formed, ADHDers often do experience rejection as actually emotionally painful. Rejection in these cases can be actually occurring or can be perceived as occurring. Rejection can come from authority figures such as parents, teachers, coaches, or supervisors, or from peers, or even from within the ADHDer themselves when they have failed to meet their own standards or expectations. Feeling rejected can be triggered by feeling excluded, criticized, viewed negatively, or by failing/performing poorly.

How individuals respond to rejection sensitivity or RSD can vary widely based on the temperament of the individual as well as on gender and cultural differences. Some individuals may experience increased defensiveness and anger and respond with aggression, some may become extremely avoidant of conflict and any environments or activities that they perceive as having an increased risk of triggering rejection sensitivity or RSD. This avoidance can sometimes look like a lack of willingness to take risks or try new things. Some individuals become highly anxious, perfectionistic, and seek high levels of academic and career achievement. They may regularly engage in people-pleasing behaviors in an effort to minimize their exposure to rejection sensitivity and RSD triggers.

Many people use a mix of strategies to cope in different situations.

People wishing to play a supportive role in the life of someone with rejection sensitivity or RSD may benefit from keeping in mind that kindness with difficult feedback makes it easier for ADHDers to receive and process needed guidance.
Additionally, people with rejection sensitivity/RSD are very sensitive to positive feedback and can feel powerfully motivated by encouragement, feeling believed in, viewed positively, praise, and having their effort being acknowledged.

Because people with ADHD and rejection sensitivity/RSD may also struggle with anxiety and emotional dysregulation/flooding, when they do manage to seek help or request accommodations, it’s important to take their communication seriously and to respond to requests with understanding, explanations, and reassurances that they are still viewed positively/neutrally as appropriate.
When possible, flexibility in expectations and reasonable accommodation may be indicated.

Resources: #

Informational Resources
Below some additional ways for anyone to learn more:

Clinical References: #

Accredited and Peer-reviewed Resources
Below are peer reviewed studies for specialists (such as individuals in the mental health, medical, or teaching fields) to learn more: