Fear of Rejection May Drive Disordered Eating Directly, Not Through Aggression, Study Finds

For psychologists, few questions are as deceptively simple as this one: when a person is exquisitely sensitive to rejection, where does the damage go? Does the anxiety of expecting to be spurned boil over into hostility and aggression, which then spills into unhealthy relationships with food? Or do aggression and disordered eating represent two separate branches growing from the same root? A new study published in Current Psychology by Tubanur Bayram Kuzgun of Cappadocia University offers a carefully constructed answer, and it challenges a tempting assumption that has quietly shaped how researchers think about interpersonal vulnerability and eating pathology.

Rejection sensitivity, a construct first formalized by Geraldine Downey and Scott Feldman in 1996, describes a disposition to anxiously expect, readily perceive, and intensely react to social rejection. People high in rejection sensitivity scan their social world for cues of impending dismissal, interpret ambiguous signals as threatening, and respond with disproportionate emotional force. Decades of research have linked this trait to a strikingly wide range of outcomes, from jealousy and conflict in intimate relationships to aggression, withdrawal, and, increasingly, disordered eating attitudes and behaviors. The breadth of that list is precisely what created the conceptual puzzle the new study set out to solve.

The puzzle can be stated in the language of clinical theory. Psychopathology is often organized along two broad axes: internalizing disorders, in which distress is turned inward, producing anxiety, depression, and conditions such as eating disorders; and externalizing disorders, in which distress is directed outward, producing aggression, impulsivity, and conduct problems. Rejection sensitivity has been implicated in both domains. That raises a structural question about the architecture of risk. Is the pathway sequential, with rejection sensitivity first producing aggression, which then somehow manifests as disordered eating? Or are aggression and disordered eating parallel outputs, two independent translations of the same underlying social threat system into different behavioral currencies?

To answer it, Kuzgun recruited 344 university students, roughly 61 percent of them female, with a mean age of about 20 years. Emerging adulthood is a strategically chosen window for this kind of work: it is a period of intense social reorganization, identity formation, and heightened concern with peer evaluation, and it is also a period in which disordered eating attitudes frequently emerge or intensify. Participants completed validated self-report instruments measuring rejection sensitivity, aggression, and eating attitudes, including Turkish adaptations of established scales such as the Buss-Perry Aggression Questionnaire and the Eating Attitudes Test short form. The study received ethical approval from Istanbul Arel University in March 2025, and informed consent was obtained from all participants.

The analytical engine of the study was structural equation modeling, a statistical framework that allows researchers to test whether a network of hypothesized relationships is consistent with the observed patterns of covariance among measured variables. Crucially, this approach makes it possible to evaluate mediation: whether the effect of one variable on another travels through a third variable, or whether a direct pathway remains once the indirect route is accounted for. In this case, the model tested whether aggression carried the influence of rejection sensitivity onto disordered eating attitudes, or whether rejection sensitivity reached disordered eating on its own.

The descriptive findings were consistent with a large body of prior work. Rejection sensitivity was positively associated with both aggression and disordered eating attitudes, meaning that students who anxiously expected rejection also reported more hostile tendencies and more problematic attitudes toward food and eating. Up to that point, the data told a familiar story. The decisive test came next, when the model separated the direct pathway from the indirect one.

The result was unambiguous in one direction and null in the other. Rejection sensitivity significantly predicted aggression, replicating its well-established role as an externalizing risk factor. But aggression, once its own relationship with rejection sensitivity was modeled, was not associated with disordered eating attitudes. The indirect effect, the hypothesized chain running from rejection sensitivity through aggression to disordered eating, was not statistically significant. Instead, rejection sensitivity retained a significant direct association with disordered eating attitudes. In other words, the link between expecting rejection and eating pathologically did not depend on hostility toward others; it operated along its own channel.

The theoretical implication is that aggression and disordered eating are best understood as parallel rather than sequential responses to rejection sensitivity. One response externalizes, converting anticipated social pain into anger and aggression toward others. The other internalizes, converting the same anticipated pain into disturbed attitudes toward eating, a domain of behavior that is, notably, directed at the self. This framing refines current models of interpersonal vulnerability by suggesting that a single social-cognitive trait can be transduced into qualitatively different forms of psychopathology, and that clinicians and researchers should not assume that treating one manifestation will automatically defuse the other.

The study also reinforces a growing movement to treat rejection sensitivity as a transdiagnostic vulnerability, a risk factor that cuts across diagnostic categories rather than belonging to any single disorder. Recent work cited in the article points in the same direction: longitudinal research has linked rejection sensitivity and related justice sensitivity to eating disorder pathology over five-year spans, systematic reviews have documented the role of social rejection sensitivity in anorexia nervosa, and experimental and longitudinal studies have connected appearance-based and interpersonal rejection sensitivity to loss-of-control eating in youth. Some researchers have argued that sensitivity to rejection may matter even more than actual experiences of peer stress for the development of eating pathology, a claim that fits neatly with the new finding that the pathway is direct rather than mediated by outward hostility.

As with any single study, important caveats apply. The design is cross-sectional, capturing associations at one point in time rather than tracking how risk unfolds across development, so causal direction cannot be established from these data alone. The sample consists of university students rather than clinical patients, and eating attitudes were measured by self-report, which may not fully capture diagnosed eating disorders. The data are also not publicly available, though the author notes they can be requested. Even so, the study’s central contribution stands: by statistically disentangling two candidate pathways, it provides evidence that the road from rejection sensitivity to disordered eating does not run through aggression. For a field increasingly interested in identifying shared mechanisms of vulnerability, that is a meaningful piece of the map, suggesting that the anxious anticipation of rejection may be a common root from which both outward anger and inward struggles with food can grow, each on its own branch.

Subject of Research: Rejection sensitivity as a transdiagnostic risk factor linking aggression and disordered eating attitudes in young adults

Article Title: Rejection sensitivity and disordered eating: evidence for distinct internalizing and externalizing pathways

Article References: Kuzgun, T. B. (2026). Rejection sensitivity and disordered eating: evidence for distinct internalizing and externalizing pathways. Current Psychology, 45(20), Article 1611. https://doi.org/10.1007/s12144-026-10171-z

Image Credits: AI Generated

DOI: 10.1007/s12144-026-10171-z

Keywords: rejection sensitivity, disordered eating, aggression, internalizing, externalizing, structural equation modeling, transdiagnostic, eating attitudes, emerging adulthood, psychology, social cognition, emotion regulation