Rejection sensitivity in severe alcohol use disorder: Increased anxious anticipation of rejection

Rejection sensitivity (RS) reflects the disposition to anxiously expect, readily perceive, and disproportionately react to rejection. It is linked to interpersonal problems and psychopathological symptoms, which are frequent in severe alcohol use disorder (SAUD) and are known to influence clinical outcomes. Consequently, RS has been put forward as a process of interest in this disorder. However, empirical studies investigating RS in SAUD are scarce and focused on its last two components, leaving the core process of anxious expectations of rejection unexplored. To fil this gap, 105 patients with SAUD and 73 age-and-gender-matched controls completed the validated Adult Rejection Sensitivity Scale. We computed anxious anticipation (AA), and rejection expectancy (RE) scores, corresponding to the affective and cognitive dimensions of anxious expectations of rejection, respectively. Participants also completed measures of interpersonal problems and psychopathological symptoms. We found that patients with SAUD had higher AA (affective dimension) but not RE (cognitive dimension) scores. Moreover, AA was associated with interpersonal problems as well as psychopathological symptoms in the SAUD sample. These findings meaningfully extend the RS and social cognition literatures in SAUD by showing that difficulties already arise at the anticipatory stage of socio-affective information processing. Moreover, they shed light on the affective component of anxious expectations of rejection as a novel, clinically relevant process in this disorder.