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Are there specific tests to identify RSD in ADHD patients? 

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Updated
ByMy Patient Advice
Author: Dr. Rebecca Fernandez, MBBS

Many people with ADHD report intense emotional pain when they feel criticised, rejected, or left out, an experience commonly described as Rejection Sensitive Dysphoria (RSD). While RSD is increasingly discussed in ADHD care, it is not a formally recognised diagnosis and there are currently no specific medical tests to identify it. 

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How clinicians explore RSD-like symptoms 

According to the NICE guideline NG87 (2025), emotional dysregulation, including sensitivity to rejection or criticism, is a recognised and impairing feature of ADHD. However, it is evaluated as part of the broader emotional and behavioural profile rather than through a distinct test. Clinicians typically assess RSD-like symptoms during an ADHD diagnostic assessment by discussing: 

  • Emotional reactions to feedback, failure, or criticism 
  • Intensity and duration of emotional distress 
  • Links between emotional triggers and attention or impulsivity 
  • Coexisting conditions such as anxiety or mood disorders 

What research says about emotional testing in ADHD 

Recent studies in Frontiers in Psychiatry and Frontiers in Neuroscience (2022–2025) show that RSD-like responses are linked to reduced regulation between the prefrontal cortex and amygdala, the brain regions that control emotion and stress response (Frontiers in Psychiatry, 2022). This means RSD is best understood as a neurobiological response pattern, not something measurable with a standalone screening tool. 

Guidance from NHS and NICE 

Both the NHS England ADHD Taskforce Report (2025) and NICE guidance emphasise assessing emotional regulation and self-esteem as part of ADHD care. NICE advises using structured clinical interviews and psychological questionnaires to explore how emotions affect daily functioning, relationships, and work performance. 

Getting help and support 

If emotional sensitivity or rejection-related distress is causing problems in daily life, discussing these experiences with an ADHD specialist or psychologist can help. Alongside NHS pathways, private services such as ADHD Certify provide assessments and follow-up reviews with qualified clinicians in the UK. 

Takeaway 

There are no formal diagnostic tests for RSD. Instead, clinicians identify rejection-related distress as part of the emotional dysregulation seen in ADHD. Understanding this overlap helps guide effective therapy and coping strategies, focusing on emotional awareness, self-regulation, and support. 

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Dr. Rebecca Fernandez, MBBS
Author

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy. 

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