Rejection Sensitive Dysphoria and Social Behaviours in Autism and ADHD

Autism is a neurodivergent condition associated with a range of social impairments that often include poor social skills, social avoidance and fewer friendships and relationships. Leading explanations argue these behaviours stem from "an extreme case of diminished social motivation" (Chevallier et al. 2012). Yet, the evidence base for this view is inconsistent and mixed, with much recent literature arguing it is an incomplete explanation. For example, Jaswal and Akhtar (2019) argue this view misinterprets social motivation as residing within an individual, when it is more appropriately understood as arising from interactions between the individual and how others perceive and react to them. Likewise, first-hand autistic testimony often directly contradicts diminished social motivation accounts, describing a desire for friendships but difficulty making and keeping them, and struggles against this social stigma. Consequently, much recent literature argues we need to establish novel theoretical accounts of autistic behaviours that reflect the lived experience of these individuals.
Patterns observed in existing empirical literature suggest Rejection Sensitive Dysphoria (RSD) may be an overlooked factor that offers a more valuable account of autistic social behaviours than social motivation accounts. Arising primarily from repeated experiences of childhood rejection, RSD causes extreme and painful emotions in response to perceiving rejection from others, and constant vigilance for potential signs of rejection. People with RSD have difficulties making and keeping friends, become socially avoidant, and are more likely to develop mental health conditions, including anxiety and depression. However, whilst autistic populations possess both the risk factors and behavioural difficulties associated with RSD, only one published study has investigated the relation between RSD and autistic traits, finding a highly significant relationship but in the general population. To date, no research has explored RSD in clinical autistic samples, nor explored how RSD may explain patterns of social behaviour in autism.
This ESRC-funded PhD will explore RSD in clinical autistic samples. Through this research, we aim to understand (1) the strength of the relation between RSD and autistic traits, (2) how social and emotional difficulties and past social experiences contribute to RSD in autism, (3) how RSD impacts social behaviours in autism, and (4) how RSD impacts cognitive and emotional processing in autism. The research adopts a participatory, mixed-methods approach, collecting first-hand autistic testimony alongside questionnaires and novel experimental studies involving behavioural, cognitive and biological measures. To gain insight into the specificity of RSD to autism, we will compare our findings in autistic participants to both neurotypical and ADHD comparison groups.
This research transcends previous theories of autism, which cannot account for empirical inconsistencies in the literature investigating social behaviours in autism. In opposition to a distinct history of dehumanising and stigmatizing research in autism (see. Cowen, 2009; Botha, 2021), this research aims to establish a modern and destigmatising explanation of atypical behaviours in autism, faithful to first-hand accounts. Unlike diminished social motivation accounts of autism, RSD offers insight into the high rate of co-occurring mental health conditions in autism and considers how this may lead to different patterns of social behaviour in autism. Thus, the findings will not only contribute significantly to our theoretical understanding of autism but also offer novel clinical pathways to target common co-morbidities and behavioural difficulties in autism. Outcomes will be relevant to autistic individuals and parents, teachers, and practitioners who support them.