The Cost of Rejection: Internalised Social Threat and its Impact on Self-Evaluation and Functioning

Fletcher, Kate and Sellwood, Bill and Di Basilio, Daniela (2025) The Cost of Rejection: Internalised Social Threat and its Impact on Self-Evaluation and Functioning. PhD thesis, Lancaster University.

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Abstract

This thesis explores the psychosocial impact of rejection and internalised social threat across the lifespan, examining how such experiences shape self-concept, self-worth, and functional outcomes. It addresses under-researched psychological mechanisms in populations where mental health outcomes are typically poor - specifically, children and adolescents experiencing rejection sensitivity, and adults with ADHD traits. It also considers the clinical implications of socially mediated identity disruption and the need for more identity-informed models of care. Section One presents a systematic review examining the relationship between Rejection Sensitivity (RS) and Self-Worth (SW) in children and adolescents. Nine quantitative studies were narratively synthesised. Across diverse methodologies, findings showed a consistent negative association between RS and SW, with higher RS linked to lower SW and poorer psychological outcomes. The review highlights how early relational dynamics and vigilance to rejection may shape self-perception and interpersonal functioning. Section Two reports an empirical study investigating relationships between ADHD traits, Fear of Negative Evaluation (FNE), Self-Concept Clarity (SCC), and functional impairment. A cross-sectional survey of 447 adults found that more pronounced ADHD traits were associated with greater FNE and functional impairment, and lower SCC. A sequential mediation model suggested that internalised social threat may disrupt self-concept and cumulatively contribute to poorer functional outcomes in adults with ADHD traits. Section Three offers a critical appraisal of the research process, integrating methodological and epistemological reflections with consideration of researcher positionality. It highlights how adopting identity-informed and socially responsive approaches can strengthen both the rigour and real-world relevance of psychological research and clinical care. Taken together, the thesis advocates for a shift away from ‘symptom’-focused or medicalised understandings of psychological distress. It highlights the need for clinicians and researchers to address internalised beliefs, relational harm, and social context - particularly experiences of interpersonal rejection - as central to psychological wellbeing, identity development, and life outcomes.