Characterizing Rejection Sensitivity in Autistic Adolescents and Implications for Depression and Anxiety Symptoms

Adolescence is a developmental period characterized by increased interest in peer relationships and social inclusion. Rejection sensitivity (RS) – the tendency to anticipate, perceive, and experience heightened emotional responses to rejection – is common in adolescence and linked to internalizing symptoms. However, RS is understudied in autistic adolescents despite their social communication differences, increased risk of peer rejection, and online lived experiences of heightened rejection sensitivity. It is also unknown how RS impacts different mental health symptoms and whether it might contribute to the heightened prevalence of anxiety and depression in autistic youth. In the present study, 106 autistic adolescents (14-17 years old) completed surveys of RS, internalizing symptoms, autistic traits, self-esteem, and peer victimization. Results showed that virtually all autistic adolescents experienced a degree of RS, with higher rates among females and those with higher autistic traits. Hierarchical regression models indicated that Anxious RS predicted social anxiety symptoms above and beyond traditional risk and protective factors, but neither Anxious nor Angry RS predicted depression or generalized anxiety. Findings have implications for risk stratification models and point to potential intervention targets; yet more research is needed to determine the directionality of relationships with rejection sensitivity.