'Feeling constantly kicked down': A qualitative phenomenological study exploring rejection sensitivity in autistic adults.

Autistic individuals are at greater risk of social rejection than non-autistic peers. On social media, adults with autism report an extreme sensitivity to social rejection. This qualitative study explored lived experiences of heightened rejection sensitivity in this population. Purposive sampling through social media was used to recruit 19 autistic adults aged 21-71 (11 women, 8 men) who self-reported heightened rejection sensitivity. Face-to-face or online semi-structured interviews were held. Interpretative phenomenological analysis was utilized to analyse the data, and synthesized member checking was conducted to ensure data accuracy. Participants described their rejection sensitivity as profoundly overwhelming, exhausting emotions and thoughts when anticipating or perceiving rejection and criticism. These responses could be accompanied by physical tension, pain and reliving past rejections. Its intensity varied greatly depending on contextual factors (e.g. baseline mood and topic of rejection) and was frequently invalidated. Identified predisposing factors included inherent autistic traits and lifelong rejection experiences. Many strategies were employed to alleviate these challenges, including therapy, with varying success. The participants' lived experiences show that heightened rejection sensitivity can be a debilitating yet overlooked experience in autistic adults. Further quantitative research is needed to study its prevalence, predisposing factors, impact and potential interventions.Lay abstractUnderstanding rejection sensitivity in autistic adults: An interview study to gather insights from lived experiencesWhy was this study done?Autistic individuals are more likely to face rejection and criticism than non-autistic individuals. How stressful these events are can depend on their rejection sensitivity. People with higher rejection sensitivity are more anxious about being rejected, are quicker to think that they are being rejected and have stronger reactions when rejection happens. Some autistic adults on social media describe their rejection sensitivity as extreme. This study aimed to better understand how these adults with autism experience their rejection sensitivity and how it affects their daily lives.What did the researchers do?We interviewed 19 adults with autism, aged 21 to 71, who experience high rejection sensitivity. These interviews were done either face-to-face or online. After analysing the interviews, we shared the findings with participants to check if they matched their experiences.What did the researchers find?Participants described their rejection sensitivity as overwhelming and exhausting. When they felt rejected or criticized, or feared this would happen in the future, they experienced strong emotional and physical reactions, such as overthinking, tension and pain. They could also re-experience memories of past rejection or criticism during these moments. The intensity of these responses varied depending on the situation and was often dismissed by others, including healthcare professionals. Participants felt that their rejection sensitivity came from a combination of their autistic traits and lifelong experiences of being rejected. Some tried therapy or other ways to cope with their rejection sensitivity, with mixed success.What do the findings mean?This study shows that high rejection sensitivity can be a serious and often overlooked challenge for autistic adults. More research is needed to understand it better and support them with this experience.