Associations Between ADHD Symptoms And Rejection Sensitivity In College Students

Rejection sensitivity (RS) is a tendency to anxiously anticipate, readily perceive, and overreact to social rejection.

People with ADHD often face frequent social challenges and negative feedback, which can lead to heightened RS. This sensitivity can exacerbate social difficulties, creating a cycle of anticipated rejection and social avoidance.

Some individuals with ADHD may experience an intense form of RS known as rejection sensitive dysphoria, characterized by extreme emotional pain and distress in response to perceived rejection.

Understanding this connection is crucial for developing effective interventions for individuals with ADHD in social settings.

Müller, V., Mellor, D., & Pikó, B. F. (2024). Associations Between ADHD Symptoms and Rejection Sensitivity in College Students: Exploring a Path Model With Indicators of Mental Well-Being. Learning Disabilities Research & Practice, 39(4), 223-236. https://doi.org/10.1177/09388982241271511

Key Points

• ADHD symptoms were positively associated with rejection sensitivity (RS) in college students.
• Well-being, creative/executive efficiency, self-regulation, and resilience partially mediated the relationship between ADHD symptoms and RS.
• Savoring capacity moderated the relationship between ADHD symptoms and RS.
• At low and average levels of savoring, the relationship between ADHD symptoms and RS was stronger. At high levels of savoring, the relationship was weaker and not significant.
• The model explained 50% of the variance in RS scores.
• Factors like well-being, creative/executive efficiency, self-regulation, resilience, and savoring capacity significantly affect the relationship between ADHD symptoms and rejection sensitivity in college students.
• This research has certain limitations such as reliance on self-report measures, cross-sectional design, and unequal gender distribution in the sample.
• The study highlights the importance of understanding and supporting college students with ADHD symptoms, particularly in developing interventions to enhance savoring capacity and overall mental well-being.

Rationale

The study aimed to examine the underlying mechanisms in the relationship between ADHD symptoms and rejection sensitivity (RS) among college students, with a focus on mental well-being.

Previous research has established links between ADHD symptoms and difficulties in social functioning, emotion regulation, and interpersonal relationships (Farmer et al., 2023; Wymbs et al., 2021).

However, the specific relationship between ADHD symptoms and RS, especially in the context of higher education, remained underexplored.

The researchers built upon the Maintainable Positive Mental Health Theory (MPMHT) proposed by Zábó et al. (2022), which conceptualizes mental health as a function of personal capabilities such as resilience and creative/executive competencies.

This framework recognizes the critical role of social acceptance, making it potentially valuable for understanding and supporting adults with ADHD symptoms, who often experience heightened sensitivity to rejection.

The study sought to confirm a direct link between college students’ ADHD symptomatology and RS, investigate whether positive psychological constructs mediate this relationship, and determine if savoring capacity moderates the relationship.

Savoring capacity refers to an individual’s ability to notice, appreciate, and enhance positive experiences.

By exploring these connections, the research aimed to provide insights that could inform interventions and support strategies for college students with ADHD symptoms.

Method

The study employed a cross-sectional design using an online survey.

Procedure

Participants completed an online Typeform survey distributed through Neptun, a unified platform used by all Hungarian universities, and through Facebook groups popular among Hungarian students.

The survey included demographic questions and several standardized measures.

Sample

The sample consisted of 304 Hungarian university students (237 female, 65 male, 2 undisclosed) aged 18-35 years (M = 24.38, SD = 4.39).

Participants were enrolled in various levels of higher education: 56.6% in bachelor’s programs, 21.7% in undivided one-tier master’s programs, 13.8% in doctoral studies, and 6.9% in master’s programs.

Most were full-time students (71.4%), with some part-time (26.3%) and distance learners (2.3%). Eleven participants (3.62%) reported a previous ADHD diagnosis.

Measures

1. Adult ADHD Self-Report Scale (ASRS-v1.1): 18 items measuring ADHD symptoms.
2. Mental Health Test: 18 items assessing well-being, savoring, creative/executive efficiency, self-regulation, and resilience.
3. Rejection Sensitivity Questionnaire (A-RSQ): 18 scenarios assessing anxiety and perceived likelihood of rejection in interpersonal situations.

Statistical measures

The researchers conducted descriptive and correlational analyses using IBM SPSS version 26.0.

They then performed multiple mediators with a moderator analysis using the PROCESS macro v4.1 for IBM SPSS, employing Model 5 with 5000 bootstrap samples.

Results

Hypothesis 1: There is a direct link between college students’ ADHD symptomatology and RS.

Result: Confirmed. ADHD scores were positively correlated with RS scores (r = .46, p < .01).

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Hypothesis 2: Positive psychological constructs (well-being, creative/executive efficiency, self-regulation, and resilience) mediate the relationship between ADHD symptomatology and RS.

Result: Partially confirmed. All four constructs partially mediated the relationship between ADHD symptoms and RS.

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Hypothesis 3: Savoring capacity moderates the relationship between ADHD symptomatology and RS.

Result: Confirmed. Savoring capacity significantly moderated the relationship between ADHD and RS (β = −.244, p < .001).

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Additional findings:

• 23.9% of participants scored in the low negative, 35.9% in the high negative, 22.7% in the low positive, and 12.2% in the high positive category for ADHD risk.
• ADHD scores were negatively correlated with well-being, creative/executive efficiency, self-regulation, resilience, and savoring capacity.
• The overall model explained 50% of the variance in RS scores.

Insight

This study provides valuable insights into the complex relationship between ADHD symptoms and rejection sensitivity in college students.

The findings suggest that individuals with higher levels of ADHD symptoms tend to experience greater sensitivity to rejection.

However, this relationship is not straightforward and is influenced by various factors related to mental well-being.

The partial mediation by well-being, creative/executive efficiency, self-regulation, and resilience indicates that these factors play a crucial role in explaining how ADHD symptoms lead to increased rejection sensitivity.

For example, individuals with ADHD symptoms may experience lower levels of well-being and reduced creative/executive efficiency, which in turn contribute to higher rejection sensitivity.

The moderating effect of savoring capacity is particularly intriguing. At low and average levels of savoring, the relationship between ADHD symptoms and rejection sensitivity was stronger.

However, at high levels of savoring, this relationship became weaker and non-significant.

This suggests that the ability to savor positive experiences may serve as a protective factor for individuals with ADHD symptoms, potentially buffering against the negative effects on rejection sensitivity.

These findings extend previous research by providing a more comprehensive understanding of the factors influencing the relationship between ADHD symptoms and rejection sensitivity in a college student population.

They highlight the importance of considering positive psychological constructs and savoring capacity when developing interventions for students with ADHD symptoms.

Future research could explore the efficacy of interventions targeting savoring capacity and other positive psychological constructs in reducing rejection sensitivity among college students with ADHD symptoms.

Longitudinal studies could also investigate how these relationships change over time and across different stages of academic life.

Strengths

The study had several methodological strengths, including:

1. Use of validated measures for assessing ADHD symptoms, rejection sensitivity, and mental well-being constructs.
2. Employment of a comprehensive theoretical framework (MPMHT) to guide the research.
3. Inclusion of both mediating and moderating variables in the analysis, providing a more nuanced understanding of the relationships.
4. Use of advanced statistical techniques (bootstrap analysis) to test indirect effects.
5. Consideration of multiple aspects of mental well-being, going beyond traditional deficit-focused approaches.

Limitations

This study also had several methodological limitations, including:

1. Cross-sectional design limits causal inferences.
2. Reliance on self-report measures may introduce bias.
3. Unequal gender distribution in the sample (78% female) limits generalizability.
4. Lack of information on participants’ academic majors may obscure potential field-specific differences.
5. The study was conducted in a single country (Hungary), which may limit cross-cultural generalizability.
6. The sample may have overrepresented individuals interested in ADHD and psychology due to recruitment methods.

These limitations impact the generalizability of the findings and the ability to draw causal conclusions.

The results should be interpreted with caution, particularly when applying them to diverse populations or making inferences about causality.

Implications

The results of this study have significant implications for supporting college students with ADHD symptoms:

1. Mental health services in universities should consider incorporating assessments of rejection sensitivity and positive psychological constructs when working with students with ADHD symptoms.
2. Interventions targeting savoring capacity may be particularly beneficial. Techniques such as mindfulness, gratitude practices, and positive imagery could be integrated into existing support programs for students with ADHD symptoms.
3. The partial mediation by well-being, creative/executive efficiency, self-regulation, and resilience suggests that holistic approaches addressing multiple aspects of mental well-being may be more effective than narrowly focused interventions.
4. Academic support services could incorporate strategies to enhance creative and executive efficiency, potentially mitigating the impact of ADHD symptoms on rejection sensitivity.
5. The findings underscore the importance of strengths-based approaches in supporting students with ADHD symptoms, focusing not just on symptom reduction but also on enhancing positive psychological resources.
6. Educators and counselors should be aware of the potential impact of ADHD symptoms on students’ social experiences and rejection sensitivity, and provide appropriate support and accommodations.
7. The study highlights the need for early intervention and ongoing support for college students with ADHD symptoms, as these issues can significantly impact their academic and social experiences.

Variables that may influence the results include cultural factors, academic discipline, severity of ADHD symptoms, and comorbid mental health conditions.

Future research should explore these potential moderating factors to refine our understanding of the relationships observed in this study.

References

Primary reference

Müller, V., Mellor, D., & Pikó, B. F. (2024). Associations Between ADHD Symptoms and Rejection Sensitivity in College Students: Exploring a Path Model With Indicators of Mental Well-Being. Learning Disabilities Research & Practice, 39(4), 223-236. https://doi.org/10.1177/09388982241271511

Other references

Farmer, G. M., Ohan, J. L., Finlay-Jones, A. L., & Bayliss, D. M. (2023). Well-being and distress in university students with ADHD traits: The mediating roles of self-compassion and emotion regulation difficulties. Mindfulness, 14(2), 448–459. https://doi.org/10.1007/s12671-022-02051-x

Wymbs, B. T., Canu, W. H., Sacchetti, G. M., & Ranson, L. M. (2021). Adult ADHD and romantic relationships: What we know and what we can do to help. Journal of Marital and Family Therapy, 47(3), 664–681. https://doi.org/10.1111/jmft.12475

Zábó, V., Oláh, A., & Vargha, A. (2022). A new complex mental health test in a positive psychological framework. Frontiers in Psychology, 13, 775622. https://doi.org/10.3389/fpsyg.2022.775622

Keep Learning

1. How might cultural differences impact the relationship between ADHD symptoms and rejection sensitivity in college students?
2. What specific interventions could be developed to enhance savoring capacity in students with ADHD symptoms?
3. How might the relationships observed in this study differ for students in various academic disciplines (e.g., STEM vs. humanities)?
4. In what ways could the findings of this study inform university policies and support services for students with ADHD symptoms?
5. How might the relationship between ADHD symptoms and rejection sensitivity change over the course of a student’s academic career?
6. What ethical considerations should be taken into account when implementing interventions based on these findings?
7. How might the concept of neurodiversity influence our interpretation and application of these research findings?