Rejection Sensitivity Test

What is a Rejection Sensitivity Test?

A Rejection Sensitivity Test is a valuable diagnostic tool used to identify heightened emotional responses to perceived or actual rejection. Rejection sensitivity, particularly in the form of rejection-sensitive dysphoria (RSD), is characterized by intense emotional reactions to criticism or rejection, whether real or anticipated. This condition is often associated with ADHD and other mental health conditions, manifesting as emotional dysregulation, negative self-talk, and extreme sadness.

Understanding the nuances of rejection sensitivity is essential, especially for mental health professionals. Patients experiencing RSD frequently report severe emotional pain, low self-esteem, and intense feelings of rejection that can impact their social interactions, romantic relationships, and overall well-being. These reactions may include intense bouts of negative emotions, making even commonplace interactions feel overwhelming. Such patients are often their own harshest critics, with symptoms potentially affecting their ability to maintain close friendships or handle perceived criticism from colleagues, partners, or peers.

Administering a Rejection Sensitivity Test using our template can provide valuable insights into the patient’s emotional regulation challenges since it is based on the Berenson et al.'s Rejection Sensitivity Questionnaire, Adult version (A-RSQ), developed in 2009. While the test itself is not an end-all-be-all rejection-sensitive dysphoria test that leads to a formal diagnosis, it can help you gauge the severity of the issue and guide further evaluation. The formal process of having rejection-sensitive dysphoria diagnosed requires a comprehensive assessment, especially when RSD symptoms coexist with other conditions like mood disorders or ADHD.

How to use our Rejection Sensitivity Test template

Even though our Rejection Sensitivity Test template is not a diagnostic tool, it still has a lot of value as a self-report or screening test. Here's how you can integrate it into your practice:

Step 1: Access the template

Access the Rejection Sensitivity Test template by clicking "Use template," which opens it in the Carepatron app. The app lets you customize it to add additional items, fields, or branding. You can also download a ready-to-use but non-customizable PDF by clicking "Download," which you can fill digitally or by hand. Ensure you have a copy ready for easy completion.

Step 2: Review the format

The test includes nine scenarios, each followed by two questions:

• Rejection concern: How anxious or concerned the respondent would feel in the described situation.
• Acceptance expectancy: How likely the respondent thinks the described positive outcome would occur.

Each question uses a scale from 1 to 6, where 1 represents low levels and 6 represents high levels.

Step 3: Administer the questionnaire

You can then administer the test via interview or give your client a printed sheet to fill out. Instruct them to imagine being in the situation described by each item and to reflect on their typical emotional response. Encourage them to answer both questions honestly, based on how they generally feel or react. There are no right or wrong answers after all! Also, ask them to reflect on their answers before submitting them.

Step 4: Calculate the score

Once all questions are completed, take a moment to calculate the score according to the scoring guidelines provided on the template (which we also included in a later section on this page). Based on that score, you can provide further insight into your client's emotional patterns and discuss areas that may require attention.

Scoring

To calculate a rejection sensitivity (RS) score for each situation, multiply the rejection concern score (response to question a) by the rejection expectancy score. The rejection expectancy score is determined by subtracting the acceptance expectancy (response to question b) from 7. Use the formula: Rejection Sensitivity = (Rejection Concern) × (7 - Acceptance Expectancy). For example, if a participant rates their rejection concern as 5 and their acceptance expectancy as 2, the rejection expectancy score would be 5 (7 - 2), and the RS score would be 5×5=255×5=25. Each RS score will range from 1 to 36.

The total rejection sensitivity score is calculated by finding the mean of the RS scores across all 9 situations. The total score will also range from 1 to 36. Then, use the ranges below:

Individual situation scores

• Low (1–12): Indicates low rejection sensitivity; the individual is likely confident and unconcerned about rejection in that situation.
• Moderate (13–24): Reflects some concern or hesitation but balanced expectations in the situation.
• High (25–36): Suggests significant sensitivity to rejection and lower expectations of acceptance.

Overall RS score

• Low (1–12): Reflects overall confidence and security in interpersonal relationships.
• Moderate (13–24): Suggests variable sensitivity, depending on the context or relationship.
• High (25–36): Highlights significant rejection sensitivity that may impact relationships and emotional well-being.

Scores can guide discussions about the individual’s interpersonal confidence and emotional responses. High scores may suggest the need for therapeutic strategies to address anxiety or insecurities in relationships, while moderate scores indicate areas for potential growth. Low scores typically reflect emotional resilience and confidence in social interactions.

Next steps after conducting the Rejection Sensitivity Test

After a rejection-sensitive dysphoria test, you probably already have some more insight into how your client handles rejection. As a mental health professional, you already have a good idea of what to do next—but for all the other readers who want more options, here's what you can do:

Initiate professional support

If you administered the test as a screening and your client's scores indicate high rejection sensitivity, then you can start supporting them in the current session (or in future ones). The test helps identify whether the client's experiences align with rejection-sensitive dysphoria or other mental health conditions. Therapy options such as cognitive-behavioral therapy can address emotional dysregulation and improve their ability to navigate interpersonal challenges.

Develop coping strategies

Use the results to help your client begin building effective coping mechanisms. Focus on managing intense emotional responses and reducing negative self-talk. Techniques such as mindfulness, journaling, and cognitive restructuring can help regulate overwhelming feelings and prevent emotional escalation. These strategies can improve how your client responds to perceived rejection and enhance overall resilience.

Address low self-esteem

Work on boosting your client's confidence by identifying and challenging the negative beliefs they have about themself. Guide them in understanding how intense feelings of rejection may stem from being their own harshest critic and help them develop a more compassionate self-view.

Focus on relationship skills

Teach your client how to manage rejection sensitivity in romantic relationships and other interpersonal interactions. Practicing open communication, setting healthy boundaries, and building trust can strengthen relationships and minimize misunderstandings, which can lead to overly sensitive reactions.

Monitor progress

Track your patient's emotional responses and relationships over time over multiple sessions. Let them know that you are there to support them, especially through intense bouts of sadness or severe emotional pain. Also, frequently revisit your treatment plan to make adjustments based on how well they are working—these are necessary to help your client achieve long-term emotional stability and avoid other associated mental health issues.

Reference

Berenson, K. R., Gyurak A., Ayduk, O., Downey G., Garner, M. J., Mogg, K. Bradley, B. P., & Pine, D. S. (2009). Rejection sensitivity and disruption of attention by social threat cues. Journal of Research in Personality, 43, 1064-1072. https://www.excelatlife.com/questionnaires/rejection_sensitivity_results.php