A qualitative study led by researchers at Brighton and Sussex Medical School (BSMS) has shed new light on the lived experience of rejection sensitivity in people with ADHD, revealing its profound emotional, physical and social impact.
Rejection sensitivity dysphoria (RSD) – intense emotional distress triggered by perceived or real criticism or rejection – is increasingly recognised by people with ADHD, yet remains poorly understood in research and clinical practice. In this study, undergraduate researchers Beth Sutton and Anabelle-Rowney Smith worked alongside a team led by Dr Jessica Eccles and Dr Lisa Quad to explore the phenomenon through focus group discussions with ADHD students.
Listen to doctors Jessica Eccles and Lisa Quadt talk about the study in the above video.
Participants described rejection sensitivity as overwhelming and long-lasting, often involving intense anxiety, shame and physical sensations such as nausea, chest tightness or a sensation of burning or paralysis. Three key themes emerged from the analysis: withdrawal, masking and bodily sensations.
Many participants explained that fear of rejection led them to withdraw from friendships, family relationships, university work and career opportunities – sometimes avoiding submitting assignments or applying for jobs altogether. Others described “masking” their distress by appearing unfazed, which often resulted in emotional disconnection, loneliness and a sense of losing touch with their authentic selves.
Crucially, participants emphasised that rejection sensitivity was not simply an emotional response but a full-body experience, with strong physical sensations that mirrored stress or anxiety responses.
The study highlights the need for greater awareness of emotional dysregulation in ADHD and for more compassionate, informed responses from educators, employers and clinicians. Participants suggested that greater understanding, reassurance and acceptance could significantly reduce the intensity and impact of rejection sensitivity.
The researchers hope the findings will encourage deeper exploration of emotional traits in ADHD, support more inclusive mental health services, and help challenge stigma surrounding neurodivergent experiences.
Read the full paper >