[Rejection sensitivity dysphoria: a critical reflection]

Rejection sensitivity dysphoria (RSD) is a term that has gained widespread recognition among people with ADHD and autism through social media. It refers to intense emotional responses to perceived rejection and criticism. American psychiatrist William Dodson introduced the concept based on clinical experience with clients with ADHD.

To inform healthcare professionals about the background and emergence of RSD, critically reflect on this development, and offer practical advice.

I describe the origins of RSD and combine insights from my doctoral research on this term with lived experience in a critical reflection.

Although RSD can offer meaningful validation and connectedness, its use in clinical practice entails four risks: 1. an increase in (self-)stigmatisation; 2. the framing as innate, causing social-environmental influences to remain underemphasised; 3. terminological fragmentation and confusion; and 4. limited empirical evidence.

The use of RSD in interprofessional communication is problematic. A better alternative is to use the established spectrum of rejection sensitivity. Narrative and neurodiversity-affirmative practice within a biopsychosocial or enactivist perspective may help tailor care to personal experiences, meaning-making, and needs. Structural changes, such as destigmatisation and inclusion, may further reduce experiences of RSD.