What I have learned over the years as a clinical psychologist is that psychological research is nothing without clinical support. Scientific research must be grounded in theory, and theory does not exist in a vacuum—it develops from personal, real-life experience.
Here is the concept Rejection sensitive dysphoria (RSD) began – through personal stories online and in clinical practice. RSD is a concept popularized by psychiatrist William Dodson. Since the 1990s. Through his lectures, podcast interviews, and blog posts, Dodson describes RSD as hypersensitivity to perceived or real criticism from others, which he associates with RSD. ADHD. In one of his lecturesbased on his experience as a psychiatrist specializing in ADHD, he described RSD as one of the most disruptive and widespread manifestations of emotional disorder.
As the concept of RSD caught on like wildfire in the early 2000s, the online world agreed. Since then, the phenomenon of RSD has gained more and more interest and people are wondering:
- What exactly is RSD?
- How does it differ from a mood disorder or from social anxiety a mess?
- Is it an independent diagnosis or an obvious, unrecognized aspect of ADHD?
- Is this specific to ADHD or is it also present in autism?
- What are the specific symptoms of RSD that make it more general than rejection sensitivity?
The problem is that without enough research, people can only guess. When there is a thirst and demand for knowledge on a subject, the public begins to assume misinformation.
However, we don’t have to guess. There are already some existing empirical studies on RSD. Does this answer all our questions? no –away from it. But it’s a good start.
As someone who has published a book on the subject, I would like to review the available scientific research on RSD. Researchers, clinicians, and the general public can use this information as a baseline of what science has shown so far. These studies can (and should) serve as a springboard for further research on RSD.
Research on ADHD has already shown this 25-45% of youth with ADHD and 30-70% of adults with ADHD significantly struggles with regulating their emotions. Because Dodson conceptualized RSD as a form of emotional dysregulation in ADHD, RSD may be more common among neurodivergent individuals.
But now there is only five research studies that adequately answer some of the questions about RSD listed above. All of these studies have small samples (between 4 and 43 participants) and are all qualitative, meaning they include interview-style, open-ended questions about RSD. Again, not the quality bad. This is where the research is conducted need Let’s start as we explore a construction that has not been fully explored. But we’re still in the early stages of truly understanding RSD at an empirical level, and it’s important to recognize that.
In the articles of 2024, Dodson and colleagues provided detailed descriptions of 4 adults with ADHD who struggled with RSD: a 29-year-old man and 17-, 19-, and 42-year-old women. They define RSD as “episodic attacks of physical and emotional pain, intense shameand feeling excluded in the face of perceived or real rejection. All participants felt misunderstood and misdiagnosed by mental health professionals.
Sandland (2025) conducted a qualitative study of RSD in 7 neurodivergent adults (1 ADHD; 3). autistic; 2 ADHD and autistic; 1 with autism, ADHD and dyspraxia). Two participants were male, 4 were female, and 1 was female non-binary. Sandland describes RSD as a phenomenon influenced by both biological and environmental factors. In general, participants described their experiences with RSD as complex and involving emotional and physical distress that led to self-effacement or avoidance. Participants reported that RSD affected all areas of their lives, but they received little support for these difficulties. There was variability in participants’ definitions of RSD, suggesting confusion between individuals and even individuals. That is, some participants defined RSD differently throughout the study. Awareness of RSD came from their neurodivergent communities, who said they experienced support and acceptance.
Rowney-Smith et al. (2026) identified RSD as an understudied aspect of emotion regulation in ADHD. This study involved 5 undergraduates with ADHD who participated in focus group interviews. Researchers have identified three main themes in the study of RSD: (1) withdrawal, (2) maskingand (3) body sensations. Participants reported that RSD was associated with intense physical discomfort, which led them to respond with masking (shaping their behavior to be accepted by others). The mask led to retreat, lonelinessmental health difficulties (eg worry) and disruption of social activities (for example, at work).
Morley and Tyrrell (2023) published his research in magazine Attention Disruptions. Their study included 8 college students with ADHD, all diagnosed in adulthood, and most of these women reported struggling with RSD.
In the largest study on RSD, Ginapp and others. (2023) asked 43 adults aged 18-35 (84% female) about their experiences with ADHD in adulthood and “most participants reported that the diagnostic criteria did not accurately reflect their experiences with ADHD.” For example, 33 participants (approximately 77%) reported struggling with RSD, even though RSD (and emotional dysregulation, in general) was not listed as a primary symptom of ADHD. DSM-5– TR.
Given the growing interest in RSD and the role it plays for those who are neurodivergent, it is important to understand the current state of research and what remains to be learned. As you can see, we have a long way to go in RSD research. Beyond qualitative research, an important first step would be to develop a valid and reliable measure of RSD. It clarifies what RSD actually is, whether it differs from other constructs, and whether RSD can be consistently measured and defined in research studies.
