Rejection Sensitive Dysphoria and Social Behaviours in Autism and ADHD

自闭症是一种神经分化疾病，与一系列社会障碍有关，这些障碍通常包括社交技能差、社交回避以及友谊和关系减少。主要的解释认为，这些行为源于“社会动机减弱的极端情况”(Chvallier等人)。2012年)。然而，这一观点的证据基础是不一致的，也是混杂的，许多最近的文献认为这是一个不完整的解释。例如，Jaswal和Akhtar(2019)认为，这种观点误解了社会动机存在于个人内部，而更恰当的理解是，社会动机产生于个人与其他人对他们的感知和反应之间的互动。同样，自闭症患者的第一手证词往往与减弱的社会动机描述直接矛盾，描述了对友谊的渴望，但难以建立和保持友谊，并努力与这种社会污名作斗争。因此，最近的文献认为，我们需要对自闭症行为建立新的理论解释，以反映这些人的生活经历。在现有的经验性文献中观察到的模式表明，拒绝敏感型焦虑症(RSD)可能是一个被忽视的因素，它提供了比社会动机描述更有价值的自闭症社会行为。RSD主要源于童年时期被拒绝的反复经历，当感觉到他人的拒绝时，RSD会引起极端和痛苦的情绪，并对潜在的拒绝迹象保持警惕。患有RSD的人在交朋友和保持朋友方面有困难，变得对社交避而远之，更有可能发展成包括焦虑和抑郁在内的心理健康状况。然而，虽然自闭症人群同时具有与RSD相关的风险因素和行为困难，但只有一项发表的研究调查了RSD与自闭症特征之间的关系，发现在普通人群中存在非常显著的关系。到目前为止，还没有研究在临床自闭症样本中探索RSD，也没有研究RSD如何解释自闭症的社会行为模式。这个由ESRC资助的博士将探索临床自闭症样本中的RSD。通过这项研究，我们旨在了解(1)RSD与自闭症特征之间的关系的强度，(2)社会和情绪困难以及过去的社会经历如何导致自闭症患者的RSD，(3)RSD如何影响自闭症患者的社会行为，以及(4)RSD如何影响自闭症患者的认知和情绪加工。这项研究采用了参与性的混合方法，收集了自闭症患者的第一手证词，并收集了调查问卷和涉及行为、认知和生物测量的新颖实验研究。为了深入了解RSD对自闭症的特异性，我们将在自闭症参与者中与神经典型组和ADHD对照组进行比较。这项研究超越了以前的自闭症理论，后者不能解释研究自闭症社会行为的文献中的经验性不一致。反对将自闭症研究非人化和污名化的独特历史(见。考恩，2009；博塔，2021)，这项研究旨在建立一个现代的和非典型的自闭症行为的解释，忠实于第一手的描述。与自闭症的社会动机减弱的描述不同，RSD提供了对自闭症中高比例共生的心理健康状况的洞察，并考虑了这可能如何导致自闭症中不同的社会行为模式。因此，这些发现不仅将有助于我们对自闭症的理论理解，而且还将为针对自闭症常见的共病和行为困难提供新的临床途径。结果将与自闭症患者和支持他们的父母、教师和从业者相关。

Autism is a neurodivergent condition associated with a range of social impairments that often include poor social skills, social avoidance and fewer friendships and relationships. Leading explanations argue these behaviours stem from "an extreme case of diminished social motivation" (Chevallier et al. 2012). Yet, the evidence base for this view is inconsistent and mixed, with much recent literature arguing it is an incomplete explanation. For example, Jaswal and Akhtar (2019) argue this view misinterprets social motivation as residing within an individual, when it is more appropriately understood as arising from interactions between the individual and how others perceive and react to them. Likewise, first-hand autistic testimony often directly contradicts diminished social motivation accounts, describing a desire for friendships but difficulty making and keeping them, and struggles against this social stigma. Consequently, much recent literature argues we need to establish novel theoretical accounts of autistic behaviours that reflect the lived experience of these individuals. Patterns observed in existing empirical literature suggest Rejection Sensitive Dysphoria (RSD) may be an overlooked factor that offers a more valuable account of autistic social behaviours than social motivation accounts. Arising primarily from repeated experiences of childhood rejection, RSD causes extreme and painful emotions in response to perceiving rejection from others, and constant vigilance for potential signs of rejection. People with RSD have difficulties making and keeping friends, become socially avoidant, and are more likely to develop mental health conditions, including anxiety and depression. However, whilst autistic populations possess both the risk factors and behavioural difficulties associated with RSD, only one published study has investigated the relation between RSD and autistic traits, finding a highly significant relationship but in the general population. To date, no research has explored RSD in clinical autistic samples, nor explored how RSD may explain patterns of social behaviour in autism. This ESRC-funded PhD will explore RSD in clinical autistic samples. Through this research, we aim to understand (1) the strength of the relation between RSD and autistic traits, (2) how social and emotional difficulties and past social experiences contribute to RSD in autism, (3) how RSD impacts social behaviours in autism, and (4) how RSD impacts cognitive and emotional processing in autism. The research adopts a participatory, mixed-methods approach, collecting first-hand autistic testimony alongside questionnaires and novel experimental studies involving behavioural, cognitive and biological measures. To gain insight into the specificity of RSD to autism, we will compare our findings in autistic participants to both neurotypical and ADHD comparison groups. This research transcends previous theories of autism, which cannot account for empirical inconsistencies in the literature investigating social behaviours in autism. In opposition to a distinct history of dehumanising and stigmatizing research in autism (see. Cowen, 2009; Botha, 2021), this research aims to establish a modern and destigmatising explanation of atypical behaviours in autism, faithful to first-hand accounts. Unlike diminished social motivation accounts of autism, RSD offers insight into the high rate of co-occurring mental health conditions in autism and considers how this may lead to different patterns of social behaviour in autism. Thus, the findings will not only contribute significantly to our theoretical understanding of autism but also offer novel clinical pathways to target common co-morbidities and behavioural difficulties in autism. Outcomes will be relevant to autistic individuals and parents, teachers, and practitioners who support them.