Associations between rejection sensitivity and mental health outcomes: A meta-analytic review

Abstract

Rejection sensitivity is a personality disposition characterized by oversensitivity to social rejection. Using a three-level meta-analytic model, 75 studies were reviewed that examined associations between rejection sensitivity and five mental health outcomes: depression, anxiety, loneliness, borderline personality disorder, and body dysmorphic disorder. The results showed significant and moderate associations between rejection sensitivity and depression (pooled r=0.332; p<0.001), anxiety (pooled r=0.407; p<0.001), loneliness (pooled r=0.386; p<0.001), borderline personality disorder (pooled r=0.413; p<0.001), and body dysmorphic disorder (pooled r=0.428; p<0.001). The associations between rejection sensitivity and depression, anxiety, and borderline personality disorder varied by type of sample, but the associations were similar for clinical and non-clinical (i.e., community) samples. The association between rejection sensitivity and anxiety was negatively moderated by percentage of females in samples. The association between rejection sensitivity and depression was negatively moderated by length of follow-up. The longitudinal associations between rejection sensitivity and depression, anxiety, and loneliness were stable over time. Implications of the findings for both risk assessment and prevention and intervention strategies in mental health practice are discussed.

The link between rejection sensitivity and borderline personality disorder: A systematic review and meta‐analysis

“…Whilst it is important to consider non‐clinical samples, given the subjectivity of thresholds for BPD (Zielinski & Veilleux, ), the finding that clinical BPD groups demonstrate significantly higher RS than control samples adds to the evidence base and provides a broader understanding of the experience of BPD across the spectrum. Furthermore, whilst RS is linked with other mental health problems (Gao et al ., ), these outcomes indicate that the rate of RS is still larger in BPD. However, further research is required as outcomes were not always consistent, possibly due to methodological limitations in recruiting samples without co‐morbidities.…”

“…Additionally, samples with BPD showed moderately greater RS when compared with samples of people with other mental health conditions. These findings are in line with previous reviews which suggest RS is linked with BPD (Gao et al ., ; Rosenbach & Renneberg, ). However, this current review extends upon the most recent (Gao et al ., ) with an additional 15 papers, including statistical comparisons between clinical and healthy control groups and grey literature.…”

“…These findings are in line with previous reviews which suggest RS is linked with BPD (Gao et al ., ; Rosenbach & Renneberg, ). However, this current review extends upon the most recent (Gao et al ., ) with an additional 15 papers, including statistical comparisons between clinical and healthy control groups and grey literature. Whilst it is important to consider non‐clinical samples, given the subjectivity of thresholds for BPD (Zielinski & Veilleux, ), the finding that clinical BPD groups demonstrate significantly higher RS than control samples adds to the evidence base and provides a broader understanding of the experience of BPD across the spectrum.…”

“…Since a seminal study showed RS was higher in participants with BPD compared to healthy controls (Staebler, Helbing, Rosenbach & Renneberg, ), several studies have attempted to explore the model of RS to explain the experience of BPD (Boldero et al ., ; Miano, Fertuck, Arntz, & Stanley, ; Zielinski & Veilleux, ). A recent meta‐analysis identified a moderate pooled correlation of BPD symptoms and RS as part of a larger review exploring the link between RS and psychopathology ( r = .413, p < .001; Gao et al ., ). The meta‐analysis incorporated 19 papers, including 31 effect sizes, and employed a three‐level meta‐analytic model to account for the inclusion of multiple statistics from same samples.…”

“…Rejection sensitivity has been linked with reduced self‐esteem (Watson & Nesdale, ) and may give rise to significant psychopathology (Gao, Assink, Cipriani, & Lin, ; Pietrzak et al ., ; Rosenbach & Renneberg, ). The RS model may be especially pertinent to BPD (Renneberg et al ., ) as several diagnostic factors subsumed within the DSM‐5 diagnostic criteria are similar to features of RS, including ‘fear of rejection’ and ‘anxious preoccupation with real or imagined abandonment’ (American Psychological Association, ).…”