Associations Between ADHD Symptoms and Rejection Sensitivity in College Students: Exploring a Path Model With Indicators of Mental Well-Being

“Second, we conducted multiple mediators with a moderator analysis (Model 5) using Preacher and Hayes (2008) PROCESS macro v4.”

“To help fi ll this gap in the literature, in this study we focused on the theory of positive psychology introduced by Seligman and Csikszentmihalyi (2000), which boosts research, enabling us to better understand the role of positive personality characteristics in fl ourishing at both individual and…”

“However, the mere elimination of negativity does not necessarily usher in positivity (Seligman et al., 2005).”

“Furthermore, positive emotions can act as a cushion against the impact of negative emotions (Fredrickson, 2001; Smith & Bryant, 2016).”

“Although the ASRS scale has been validated for screening purposes (Farcas et al., 2018; Kessler et al., 2005), it cannot replace clinical diagnoses.”

“Over this period, the concept of mental well-being has evolved from being solely de fi ned as an absence of ill-being, focusing exclusively on positive individual functioning without accounting for emotions (Rose et al., 2017), to encompassing a state of fl ourish-ing (Keyes, 2007).”

“The RS model (Downey & Feldman, 1996) suggests that extreme sensitivity to signals of rejection, leading to overreac-tions, stems from a natural learning process.”

“However, the high prevalence of emotional dysregulation alongside ADHD symptoms is independent of comorbidity (Shaw et al., 2014), underscoring the need for a deeper understanding of these connections, especially within the unique population of university students (Lovett et al., 2015).”

“While the original dichotomous scoring method (assigning 1 point for exceeding the threshold) has been updated, research suggests the 0 – 24 scale is more robust and better suited for studying ADHD prevalence and related factors compared to the 0 – 6 system (Kessler et al., 2007).”

“In addition to its direct association with well-being (eg, Bryant, 2003; Wood et al., 2003), savoring is further proposed as a moderator variable (Bryant & Veroff, 2007; Chadwick, 2012; Costa-Ramalho et al., 2015).”

“Since high RS and the subsequent emotional symptoms are prevalent among individuals with ADHD traits (Babinski et al., 2019; Jaisle et al., 2023), some view them as an intrinsic aspect of the disorder rather than merely an associated characteristic (Faraone et al., 2019).”

“The Rejection Sensitivity Questionnaire (A-RSQ; Berenson et al., 2009) assesses participants ’ cognitive-emotional disposition to anticipate rejection anx-iously.”

“In addition to its direct association with well-being (eg, Bryant, 2003; Wood et al., 2003), savoring is further proposed as a moderator variable (Bryant & Veroff, 2007; Chadwick, 2012; Costa-Ramalho et al., 2015).”

“Even high-functioning adults with ADHD symptomatology report experiencing heightened levels of judgment from others (Sedgwick et al., 2019).”

“…personal achievements, positive imagination, noticing pleasurable features in their environment, structured photography exercises, and re fl ecting on recent acts of kindness could nurture the capacity for savoring and serve as a fi rst-line intervention for this population (Parks & Schueller, 2014).”

“This aligns with the Dynamic Model of Affect (DMA), suggesting that individuals have a wider range of emotional experiences in the absence of stress, with positive and negative emotions operating more independently (Walter & Bruch, 2008).”

“Higher resilience correlates with a more rapid recovery from stressful situations, including potential social rejections (Verdolini et al., 2021).”

“In addition to its direct association with well-being (eg, Bryant, 2003; Wood et al., 2003), savoring is further proposed as a moderator variable (Bryant & Veroff, 2007; Chadwick, 2012; Costa-Ramalho et al., 2015).”

“Research has linked childhood ADHD symptoms and the often co-occurring oppositional behavior with negative attachment, implying that rejection by parents can, in some instances, be a persistent issue (Clarke et al., 2002; Gomez & Gomez, 2002).”

“Lastly, self-regulation, often compromised in ADHD (Christiansen et al., 2019), can lead to impulsivity and dif fi culties in managing emotional responses, further reducing its protective effect on sensitivity to rejection.”

“This positive outlook can alter the perception of social cues (Hecht, 2013), potentially mediating the perception of rejection.”

“Qualitative studies, for example, have revealed that adults with ADHD symptoms struggle with maintaining relationships (Kwon et al., 2018; Matheson et al., 2013) and moderating their behavior to conform to social norms (Schreuer & Dorot, 2017).”

“Given the rising number of students with disabilities on college campuses (DuPaul et al., 2021), there is an urgent need for a framework that promotes our understanding of health maintenance, helps social adjustment, and empowers them to thrive in this environment.”

“Over this period, the concept of mental well-being has evolved from being solely de fi ned as an absence of ill-being, focusing exclusively on positive individual functioning without accounting for emotions (Rose et al., 2017), to encompassing a state of fl ourish-ing (Keyes, 2007).”

“In recent years, there has been a growing interest in well-being research (Rusk & Waters, 2015).”

“Qualitative studies, for example, have revealed that adults with ADHD symptoms struggle with maintaining relationships (Kwon et al., 2018; Matheson et al., 2013) and moderating their behavior to conform to social norms (Schreuer & Dorot, 2017).”

“…functioning, co-occurring conditions like depression and anxiety (Anastropoulos et al., 2021; Solanto & Scheres, 2020), academic skills and coping mechanisms, stress management (Bettis et al., 2017; Van der Oord et al., 2020), and overall ADHD symptoms and life functioning (Eddy et al., 2021).”

“It is important to acknowledge that self-reported ADHD symptoms can overlap with other conditions, including substance use disorders (Bahji, 2024), autism spectrum disorder (Waldren et al., 2024), learning disabilities (Kellens et al., 2024), bipolar disorder (Barden et al., 2023), mood disorders…”

“Savoring can also contribute to perceived self-esteem and validation (Goodall, 2015).”

“While research suggests males are diagnosed with ADHD more frequently during childhood, this disparity appears to narrow by adult-hood, with diagnoses becoming more balanced (Babinski, 2024).”

“…fi rst-year university students represent a population with a signi fi cant prevalence of attention-de fi cit hyperactivity disorder (ADHD), with Mak et al. (2022) reporting that 15.9% of university students across nine countries screened positive for ADHD risk and Shaw and Selman (2023) noting…”

“Although adults with ADHD symptoms often encounter challenges in interpersonal relationships, social support can enhance functioning for this population (Ginapp et al., 2023).”

“The challenges that adults with ADHD symptoms encounter in social settings are well documented (Wymbs et al., 2021).”

“Notably, the well-established factors of positive psychology, such as competence, emotional stability, positive emotions, positive relationships, and resilience, signi fi cantly overlap with the characteristics needed for successful academic adjustment (Hassan et al., 2023).”

“Due to these unique stressors and vulnerabilities, university students are a population of particular interest to policy makers, mental health professionals, educators, and researchers (Emmerton et al., 2024).”

“While prior research has highlighted the moderating role of savoring capacity on health and life satisfaction (Smith & Bryant, 2016), the speci fi c relationship between ADHD symptoms and savoring capacity, especially concerning RS, has not been explored to the best of our knowledge.”

“Despite increasing awareness, a concerning number of individuals remain undiagnosed (Lovett et al., 2015), however.”

“While mindfulness-based and neurofeedback approaches are less common (eg, Harris et al., 2019), most programs emphasize organizational skills and time management (Hartung et al., 2022; LaCount et al., 2018).”

“Since high RS and the subsequent emotional symptoms are prevalent among individuals with ADHD traits (Babinski et al., 2019; Jaisle et al., 2023), some view them as an intrinsic aspect of the disorder rather than merely an associated characteristic (Faraone et al., 2019).”

“Further, parents are more inclined to demonstrate greater levels of criticism and lesser warmth towards children exhibiting ADHD traits (Psychogiou et al., 2007).”

“This issue is particularly concerning in Hungary, as national data suggests that ADHD prevalence among adults falls between 2% and 4% (Bitter et al., 2010).”

“BC = bias corrected; CI = con fi dence intervals; 5000 bootstrap samples. re fl ecting on them (Gentzler et al., 2016), which can help in the cognitive reframing of negative experiences.”

“These programs address such areas as executive functioning, co-occurring conditions like depression and anxiety (Anastropoulos et al., 2021; Solanto & Scheres, 2020), academic skills and coping mechanisms, stress management (Bettis et al., 2017; Van der Oord et al., 2020), and overall ADHD symptoms…”

“This inclination toward oversensitivity, in turn, can alter behavioral patterns in a way that can result in actual rejection (Meehan et al., 2018; Mor & Inbar, 2009; Ng & Johnson, 2013).”

“Symptoms of ADHD are generally perceived negatively (Beaton et al., 2022) and often provoke a hostile emotional state and intense interpersonal rejection (Paulson et al., 2005).”

“Additionally, they are prone to experience heightened psychological distress (Paulson et al., 2005).”

“This inclination toward oversensitivity, in turn, can alter behavioral patterns in a way that can result in actual rejection (Meehan et al., 2018; Mor & Inbar, 2009; Ng & Johnson, 2013).”

“Since high RS and the subsequent emotional symptoms are prevalent among individuals with ADHD traits (Babinski et al., 2019; Jaisle et al., 2023), some view them as an intrinsic aspect of the disorder rather than merely an associated characteristic (Faraone et al., 2019).”

“Individuals with higher levels of global well-being tend to view life and social interactions more positively (Lench & Bench, 2012).”

“Thus, growing research acknowledges emotional symptoms as intrinsic to ADHD, emphasizing their impact on well-being, educational outcomes, and mental health (Reimherr et al., 2020; Villemonteix et al., 2015).”

“Qualitative studies, for example, have revealed that adults with ADHD symptoms struggle with maintaining relationships (Kwon et al., 2018; Matheson et al., 2013) and moderating their behavior to conform to social norms (Schreuer & Dorot, 2017).”

“Thus, growing research acknowledges emotional symptoms as intrinsic to ADHD, emphasizing their impact on well-being, educational outcomes, and mental health (Reimherr et al., 2020; Villemonteix et al., 2015).”

“The Mediating Role of Mental Well-Being in the Link Between ADHD and RS Increased RS is associated with a lower quality of life, diminished social support, and reduced psychological well-being (Ng & Johnson, 2013).”

“For example, diversity factors such as ethnicity, gender, sexuality, culture, socio-economic status, and disability can signi fi cantly heighten stress and psychological dif fi culties during this period (Volstad et al., 2020).”

“Such sensitivity can be a product of early, extended, or intense experiences of rejection from caregivers or important individuals in a person ’ s life (Gardner et al., 2020).”

“In relation to RS, resilience acts as a mediator (Sart et al., 2016), enabling individuals to harness their mental resources to preserve their well-being in the face of stress and adversity.”

“…that self-reported ADHD symptoms can overlap with other conditions, including substance use disorders (Bahji, 2024), autism spectrum disorder (Waldren et al., 2024), learning disabilities (Kellens et al., 2024), bipolar disorder (Barden et al., 2023), mood disorders (particularly major…”

“Furthermore, it has been found to predict the progression and outcome of depression, exhibiting a positive association with a higher prevalence of depressive symptoms (Ayduk et al., 2000; De Rubeis et al., 2017).”

“In line with previous studies (eg, Hawi & Samaha, 2024; Garcia Pimenta et al., 2024), the current study assessed ADHD symptoms using the ASRS total scores, demonstrating good internal consistency (Cronbach ’ s α = .87).”

“Although positive coping programs demonstrably reduce negative emotions, evidence for mindfulness-based and relaxation-based programs improving positive emotional outcomes is mixed (Klibert et al., 2022).”

“Reduced scores in creative and executive ef fi ciency may lead to per-ceiving problems as threats, resulting in a tendency to avoid rather than proactively address challenges (Kraines & Wells, 2017).”

“…et al., 2018) and moderating the link between negative emotions and suicidal behaviors (Klibert et al., 2019) to in fl uencing the relationship between activity engagement and aspects of well-being, including life satisfaction, depression, loneliness, and sense of purpose (Smith et al., 2020).”

“…functioning, co-occurring conditions like depression and anxiety (Anastropoulos et al., 2021; Solanto & Scheres, 2020), academic skills and coping mechanisms, stress management (Bettis et al., 2017; Van der Oord et al., 2020), and overall ADHD symptoms and life functioning (Eddy et al., 2021).”

“While individuals with ADHD symptoms experience more stress and negative emotions during their university years than their peers without ADHD (Sahmurova et al., 2022), we anticipate that their capacity to savor may play a crucial role in experiences of rejection.”

“A systematic review by Álvarez-Godos et al. (2023) examining these interventions found the greatest improvements were in attention, executive functioning, anxiety, and organization.”

“Finally, global well-being encompasses not just psychological health but also spiritual and social dimensions (Zábó et al., 2022).”

“In line with previous studies (eg, Hawi & Samaha, 2024; Garcia Pimenta et al., 2024), the current study assessed ADHD symptoms using the ASRS total scores, demonstrating good internal consistency (Cronbach ’ s α = .87).”

“Savoring requires one to be present and attentive to the current moment, especially positive moments (Gregory et al., 2023).”

“Our fi ndings align with those of Farcas et al. (2018), who reported similar unweighted prevalence rates of ADHD risk (37.3”

“One of the hallmark symptoms of ADHD is dif fi culty with sustained attention (Segal, 2023).”

“Savoring, the ability and capacity to actively seek out, appreciate and hold onto positive experiences and pleasures (Bryant & Veroff, 2007; Bryan et al., 2022) is a prerequisite in the MPMHT framework (Zábó et al., 2022).”

“Previous studies have linked RS and reduced well-being (Efeoglu & Sen, 2022); however, the in fl uence of ADHD symptoms within this context has remained unexplored.”

“…is, empirical research suggests that savoring acts as a moderating factor in various situations, from buffering the impact of traumatic experiences (Sytine et al., 2018) and moderating the link between negative emotions and suicidal behaviors (Klibert et al., 2019) to in fl uencing the relationship…”

“…including substance use disorders (Bahji, 2024), autism spectrum disorder (Waldren et al., 2024), learning disabilities (Kellens et al., 2024), bipolar disorder (Barden et al., 2023), mood disorders (particularly major depressive disorder), and generalized anxiety disorder (Alarachi et al., 2024).”

“In addition to its direct association with well-being (eg, Bryant, 2003; Wood et al., 2003), savoring is further proposed as a moderator variable (Bryant & Veroff, 2007; Chadwick, 2012; Costa-Ramalho et al., 2015).”

“…from buffering the impact of traumatic experiences (Sytine et al., 2018) and moderating the link between negative emotions and suicidal behaviors (Klibert et al., 2019) to in fl uencing the relationship between activity engagement and aspects of well-being, including life satisfaction,…”

“First, well-being had the most substantial mediating effect, suggesting that ADHD symptoms might lead to reduced feelings of well-being (Fuller-Thomson et al., 2022).”

“The novel Behavioral Activation plus Savoring (BA + S) intervention (Kumar et al., 2024) represents this approach, supporting Klibert et al. ’ s (2022) work on savoring exercises as a preventive strategy against social stressors.”

“…that individuals with ADHD symptoms frequently face set-backs and challenges that can diminish their capacity to rebound from adverse situations (Freire et al., 2021), individuals may develop a heightened sensitivity to negative feedback, as they may lack the adaptive mechanisms to recover from…”

“…including substance use disorders (Bahji, 2024), autism spectrum disorder (Waldren et al., 2024), learning disabilities (Kellens et al., 2024), bipolar disorder (Barden et al., 2023), mood disorders (particularly major depressive disorder), and generalized anxiety disorder (Alarachi et al., 2024).”

“…with other conditions, including substance use disorders (Bahji, 2024), autism spectrum disorder (Waldren et al., 2024), learning disabilities (Kellens et al., 2024), bipolar disorder (Barden et al., 2023), mood disorders (particularly major depressive disorder), and generalized anxiety…”

“While mindfulness-based and neurofeedback approaches are less common (eg, Harris et al., 2019), most programs emphasize organizational skills and time management (Hartung et al., 2022; LaCount et al., 2018).”

“Similarly, ADHD is associated with increased experiences of rejection sensitivity (Müller et al. 2024), although not within diagnostic criteria for ADHD and not an experience limited to individuals with ADHD.”

“Rejection sensitivity is unendurable discomfort resulting from either perceived or actual rejection, criticism or teasing, which leads to excessive, counter-productive rumination (Downey & Feldman, 1996; Müller et al., 2024; Pearson et al., 2011).”

“One such example is the cognitive-behavioural co nstruct ‘rejection sensitivity,’ which is a phenomenon that is considered by some to be widespread but under-studied in the context of ADHD symptoms (Müller et al., 2024).”

“Attachment in ADHD : Some of the studies that address self-attacking in adults with ADHD equally mention that interpersonal difficulties are common reasons for self-referral to mental health services (Müller et al., 2024).”

“Neurodivergent people (especially those with ADHD and/or autism) can experience rejection sensitivity, which involves anxiously anticipating negative feedback and overre-acting to criticism [46].”