Exploring Sensory Processing Sensitivity & Health: Comprehensive Study Notes

Article Information

  • Journal: Current Research in Behavioral Sciences, Vol. 8 (2025), Article 100165100165
  • Online publication date: 21 December 2024 (open access, CC BY 4.0)
  • Authors & Affiliations:
    • Christienne G. Damatac (corresponding author) – Donders Institute & Dept. of Cognitive Neuroscience, Radboud UMC, NL
    • Marleen J. ter Avest – same institutions as above
    • Tom F. Wilderjans – Methodology & Statistics, Leiden University
    • V. De Gucht – Health, Medical & Neuropsychology, Leiden University
    • Dion H.A. Woestenburg – Leiden University
    • Laurens Landeweerd – Institute for Science in Society, Radboud University
    • Tessel E. Galesloot – IQ Health, Radboud UMC
    • Linda Geerligs – Donders Institute, Dept. of AI, Radboud University
    • Judith R. Homberg – Donders Institute, Karakter Child & Adolescent Psychiatry Centre
    • Corina U. Greven – Donders Institute & Karakter (shared penultimate author)
  • Keywords: Sensory Processing Sensitivity (SPS), Environmental Sensitivity, Differential Susceptibility, Mental Health, Physical Health
  • Abbreviations:
    • SPS – Sensory Processing Sensitivity
    • HSPS – Highly Sensitive Person Scale
    • SPSQ / SPSQ-SF – 4343-item questionnaire / 2424-item short form
    • ADHD – Attention-Deficit Hyperactivity Disorder

Study Rationale & Aims

  • ~15-20%15\text{-}20\% of population are “highly sensitive” (Aron & Aron 19971997)
  • SPS: deeper information processing, heightened reactivity/awareness, ease of overstimulation
  • Differential Susceptibility Theory: some traits (e.g., SPS) amplify reactivity to both negative and positive environments (“for better and for worse”)
  • Research gaps:
    • Lack of large population studies linking SPS to both mental & somatic health while controlling neuroticism & environment
    • Limited data on SPS overlap with neurodevelopmental traits (ADHD, autism)
    • Few tests of positive environments; over-focus on negative, childhood adversity
  • Aims:
    1. Quantify associations between SPS and:
    • Stress-related traits (stress, anxiety, depression, burnout)
    • Well-being (life satisfaction)
    • Somatic health (physical complaints, OTC medication use)
    • Neurodevelopmental traits (ADHD, autistic traits) – include subscale overlap (Aim 1a1a)
    1. Test whether micro- / macro- level, positive / negative environments moderate SPS–health links
    2. Formally test SPS as a moderator within Differential Susceptibility framework (Aim 2a2a)

Sample & Power

  • Data source: Healthy Brain Study (population-based, NL)
  • Initial N=300N=300 (ages 30–3930\text{–}39; nfemale=139n_{female}=139; mean age μ=33.89 yr,  SD=2.84\mu=33.89\,\text{yr},\; SD=2.84)
  • After QC & exclusion of ≥3SD\ge 3 SD outliers → N=252N=252 ( 80%80\% power to detect d=0.35d=0.35 )

Measures

Sensitivity
  • SPSQ-SF (2424 items, α=0.88\alpha=0.88) – six subscales:
    1. Emotional & Physiological Reactivity
    2. Aesthetic Sensitivity
    3. Sensory Discomfort
    4. Social Affective Sensitivity
    5. Sensory Comfort
    6. Sensory Sensitivity to Subtle Stimuli
Health Outcomes
  • Stress: Perceived Stress Scale (α=0.87\alpha=0.87)
  • Depression: IDS-SR (log-transformed; α=0.80\alpha=0.80)
  • Anxiety: STAI-Trait (α=0.90\alpha=0.90)
  • Burnout: Utrecht Burnout Scale (α=0.74\alpha=0.74)
  • Well-being: Satisfaction With Life Scale (log; α=0.93\alpha=0.93)
  • Somatic:
    • Health Complaints (log; α=0.70\alpha=0.70)
    • OTC Medication Use (α=0.70\alpha=0.70)
  • Neurodevelopmental:
    • ADHD Screener (ASR, 66 items: Hyperactivity-Impulsivity &\& Inattention; α=0.68\alpha=0.68)
    • Autistic Trait Questionnaire (ATQ, 55 subscales; α=0.76\alpha=0.76)
Environment
  • Micro-level Positive: Daily Uplifts; Perceived Social Support (MSPSS)
  • Micro-level Negative: Daily Hassles
  • Macro-level Positive: Not available
  • Macro-level Negative: Childhood Trauma Questionnaire; List of Threatening Life Events
Covariates
  • Sex (male =0=0, female =1=1), Age, Big-5 Neuroticism (α=0.85\alpha=0.85), Big-5 Openness (α=0.87\alpha=0.87)

Data Processing

  • Continuous scores standardized (z-score) after outlier removal
  • Skewed outcomes log-transformed
  • Regression residuals checked for normality & homoscedasticity
  • Multiple-testing control: Benjamini–Hochberg FDR, α=0.05\alpha=0.05

Main Findings (Aim 1)

  • Significant positive associations with SPS (unadjusted):
    • Stress b=0.169,  pfdr=0.011b=0.169,\; pfdr=0.011
    • Depression b=0.184,  pfdr=0.011b=0.184,\; pfdr=0.011
    • Anxiety b=0.256,  pfdr=2.1×10−4b=0.256,\; pfdr=2.1\times10^{-4}
    • Burnout b=0.252,  pfdr=2.97×10−4b=0.252,\; pfdr=2.97\times10^{-4}
    • Health Complaints b=0.298,  pfdr=2.48×10−5b=0.298,\; pfdr=2.48\times10^{-5}
    • OTC Medication b=0.181,  pfdr=0.010b=0.181,\; pfdr=0.010
  • Non-significant: Life Satisfaction, ADHD total, Autism total
  • Adjusting for sex: pattern unchanged; adjusting for Neuroticism dampened effects (burnout, stress, health complaints remained). Full covariate model → only Burnout (b=0.22b=0.22) & Health Complaints (b=0.269b=0.269) retained significance.

Neurodevelopmental Overlap (Aim 1a)

  • No total-score correlations SPS ↔ ADHD/Autism.
  • Subscale correlations (selected):
    • Higher Emotional & Physiological Reactivity ↔ more Limited Social Skills, Rigidity, Childhood-Onset behaviors (ATQ).
    • Lower Social Affective Sensitivity & Sensory Comfort ↔ higher Limited Social Skills & Attention to Detail (ATQ).
    • Inattention (ADHD) modestly ↔ higher Aesthetic Sensitivity & Reactivity; ↔ lower Sensory Comfort.
    • Hyperactivity-Impulsivity showed no links.
  • Interpretation: Shared element = heightened emotional/physiological reactivity; distinctions via imagination, sensory comfort, empathy.

Environment × SPS Interactions (Aim 2)

  1. SPS × Daily Uplifts → Autistic Traits
    • Interaction b=0.119,  pfdr=0.042b=0.119,\; pfdr=0.042
    • In high-uplift contexts: higher SPS → more autistic traits; effect weak/absent at lower uplift levels.
  2. SPS × Life Events → Autistic Traits
    • b=−0.136,  pfdr=0.045b=-0.136,\; pfdr=0.045
    • Under many threatening events: higher SPS → more autistic traits; negligible under moderate events.
  3. SPS × Social Support → Life Satisfaction
    • b=0.148,  pfdr=0.020b=0.148,\; pfdr=0.020
    • Low support: higher SPS → lower life satisfaction; medium/high support: higher SPS → higher life satisfaction.
  • No significant interactions with Childhood Trauma, Daily Hassles.

Differential Susceptibility Tests (Aim 2a)

  • Criteria applied (significant interaction, simple slopes, regions-of-significance, proportion indices):
    • Supported for:
    1. Life Satisfaction moderated by SPS in response to Social Support (positive micro-env.)
    2. Autistic Traits moderated by SPS in response to Life Events (negative macro-env.)
    • Not supported for Daily Uplifts × Autistic Traits (did not meet all indices).

Discussion & Interpretation

  • SPS is a distinct, transdiagnostic trait linked to stress-related and somatic symptoms beyond neuroticism.
  • Differential susceptibility evidenced: high SPS amplifies benefits of support and costs of adversity.
  • Subscale analyses refine overlap/distinctions with ADHD & autism; SPS differs by absence of functional impairment and by sensory comfort/social empathy facets.
  • Clinical implication: tailoring environments (reduce overstimulation, enhance support) may boost well-being for highly sensitive adults.

Strengths

  • Population-based, well-characterised sample in milestone-rich age band
  • Rigorous QC, preregistration, multiple-testing correction
  • Broad battery covering positive/negative, micro/macro environments
  • Independent validation of new SPSQ-SF

Limitations

  • Age 30–3930\text{–}39 & higher education → limited generalisability
  • ADHD screener (6 items) brief; no positive macro-environment measure
  • Cross-sectional – cannot infer causality
  • Self-report only; childhood trauma skewed (floor effects)

Future Directions

  • Neurobiological studies to see if same circuits mediate sensitivity to positive vs. negative inputs
  • Lifespan & diverse samples to map age trends
  • Examine each SPS subscale separately in environmental models
  • Adopt neurodiversity-aligned instruments for autistic traits
  • Test SPS as stratification or mechanistic marker for personalised interventions

Ethical & Logistical Notes

  • Ethical approval: per institutional & Helsinki standards
  • Data access: via Healthy Brain Study application; preregistered on OSF
  • Funding: Reinier Post Foundation, Radboud University; NWO Aspasia grant 015.015.070015.015.070 to C.U. Greven; no funder influence declared
  • Code openly available: GitHub bit.ly/spshealthenvironment

Practical Take-Aways for Exam Prep

  • Remember definition of SPS and its four core characteristics.
  • Distinguish Diathesis-Stress (only negative) vs. Differential Susceptibility (negative and positive).
  • Know which health outcomes stayed significant after controlling neuroticism (Burnout, Health Complaints).
  • Be able to sketch interaction plots: SPS × Social Support, SPS × Life Events.
  • Recall sample characteristics, key instruments (SPSQ-SF subscales, environmental measures).
  • Understand why subscale analysis matters for differentiating SPS from ADHD/autism.
  • Ethical/open-science practices: preregistration, FDR, data/code access.