Could fear of rejection reduce cannabis-related problems in ADHD?

Theory suggests that social challenges, such as rejection sensitivity (i.e., a skewed perception and fear of rejection), may interact with attention-deficit/hyperactivity disorder (ADHD) symptoms to contribute to increased substance use among emerging adult college students. However, there are mixed findings regarding the association between rejection sensitivity and ADHD symptoms. The current study therefore examined the relations among ADHD symptoms, alcohol/cannabis use (and problems associated with use), and rejection sensitivity among college students. Participants (n = 4,150; mean age = 19.61 years) across seven U.S. universities were administered an online survey that included measures of rejection sensitivity, cannabis/alcohol use, problems related to use, and ADHD symptom severity. Significant positive bivariate correlations were found among ADHD symptoms, rejection sensitivity, and use-related problems. In regression analyses and contrary to our hypothesis, elevated rejection sensitivity attenuated the relation between ADHD symptom severity and both cannabis use and problems related to cannabis use. Overall, our findings indicate that rejection sensitivity and ADHD symptoms are positively related, and that rejection sensitivity may play a protective role in cannabis use and problems related to cannabis use for college students with high levels of ADHD symptom severity. Future studies should continue to examine how specific components of social functioning (such as rejection sensitivity) might affect ADHD related alcohol and cannabis use rather than social difficulties as a whole.