Clinical Director Asian American Senior Citizens Service Center, California
Background & Introduction: Sensory Processing Sensitivity (SPS) is a biologically based temperament trait characterized by heightened awareness and responsiveness to sensory and emotional stimuli. Although SPS has been linked to psychological outcomes such as anxiety and depression, its relationship with Substance Use Disorders (SUDs) remains largely unexplored. This study sought to clarify the sensory-emotional mechanisms underlying addiction vulnerability and functioning through three primary research questions: (1) Are individuals with a history of SUD more likely to exhibit high SPS than the general population? (2) How is the level of SPS related to SUD severity, functional impairment, and withdrawal experiences? and (3) Does drug of choice predict differences in SPS levels? Understanding these relationships could provide insights into how sensory-emotional traits contribute to substance use, recovery, and relapse risk. This research bridges personality science and addiction medicine, emphasizing the potential for personalized, sensory-informed treatment approaches.
Methods: A cross-sectional survey was conducted among adults (N = 65) who self-identified as meeting two or more DSM-5-TR diagnostic criteria for SUD. Participants were recruited through online recovery networks and completed the Highly Sensitive Person Scale (HSPS) to assess SPS and the SUD Functioning Survey, derived from DSM-5-TR criteria, to measure SUD severity, functional impairment, and withdrawal symptoms. The SUD Functioning Survey included domains such as concentration, emotional regulation, and sensory reactivity during withdrawal. Analyses were performed using R (v4.4.0). Statistical procedures included descriptive statistics, chi-square tests, Pearson correlations, ANOVA, and multiple regression analyses to explore associations between SPS dimensions—Ease of Excitation (EOE), Low Sensory Threshold (LST), and Aesthetic Sensitivity (AES)—and SUD-related outcomes. Demographic and substance-related variables were controlled in regression models. Statistical significance was set at p < .05.
Results: AES emerged as the strongest predictor of SUD outcomes. AES was significantly correlated with SUD diagnostic severity (r = .42, p < .01) and functional impairment (r = .38, p < .05). Regression analyses confirmed AES as an independent predictor of both SUD severity (β = .36, p = .01) and withdrawal symptomatology (β = .33, p = .03). EOE and LST demonstrated moderate correlations with SUD variables (r = .22–.29, p < .05) but did not remain significant in multivariate analyses. Sensory reactivity and concentration difficulty during withdrawal were positively associated with total SPS scores (r = .34, p < .01). ANOVA revealed no significant differences in SPS levels across primary substances used (F(3,61) = 1.85, p = .12). These findings suggest that higher sensory-emotional sensitivity—particularly aesthetic awareness—may represent a personality-linked vulnerability in SUD, influencing both severity and withdrawal functioning.
Conclusion & Discussion: This study provides novel evidence linking Sensory Processing Sensitivity to the severity and functional challenges associated with Substance Use Disorders. Elevated sensory-emotional sensitivity, particularly in aesthetic perception, was associated with greater impairment and withdrawal difficulties. These results suggest that while high SPS can be adaptive in supportive contexts, it may increase susceptibility to distress and maladaptive coping when managing substance use and recovery. Clinically, the findings support the integration of SPS-informed assessments into addiction treatment to better tailor interventions—such as sensory modulation strategies and individualized relapse prevention—to patients’ sensory and emotional profiles. Limitations include a self-selected, cross-sectional sample and reliance on self-report measures. Future longitudinal and clinical intervention studies are warranted. Overall, this research advances the biopsychosocial framework in addiction medicine by highlighting SPS as a potential factor in understanding and addressing variability in SUD presentation and treatment response.
References: Aron, E. N., & Aron, A. (1997). Highly Sensitive Person Scale. https://doi.org/10.1037/t00299-000 Aron, E. N., Aron, A., & Jagiellowicz, J. (2012). Sensory processing sensitivity: A review in the light of the evolution of biological responsivity. Personality and Social Psychology Review, 16(3), 262–282. Liss, M., Mailloux, J., & Erchull, M. J. (2008). The relationships between sensory processing sensitivity, alexithymia, autism, depression, and anxiety. Personality and Individual Differences, 45(3), 255–259. https://doi.org/10.1016/j.paid.2008.04.009 Mary-Krause, M., Herranz Bustamante, J. J., Collard, L., & Melchior, M. (2022). Is sensory processing sens itivity associated with psychoactive substance use? Emerging Trends in Drugs, Addictions, and Health, 2, 100038-. https://doi.org/10.1016/j.etdah.2022.100038 Meredith, P., Moyle, R., & Kerley, L. (2020). Substance use: Links with sensory sensitivity, attachment insecurity, and distress in young adults. Substance Use & Misuse, 55(11), 1817–1824. https://doi.org/10.1080/10826084.2020.1766502
Disclosure(s):
Luna Xiaoyan Lu, PsyD: No financial relationships to disclose
Learning Objectives:
Describe Sensory Processing Sensitivity and its subscales—Ease of Excitation, Low Sensory Threshold, Aesthetic Sensitivity—and their role in emotional and sensory regulation in individuals with Substance Use Disorders.
Analyze the relationships between SPS dimensions and SUD severity, functional impairment, and withdrawal symptoms, and interpret how these associations may inform personalized addiction treatment approaches.
Identify opportunities to apply sensory-informed and trauma-sensitive strategies in clinical practice to enhance engagement, improve outcomes, and promote equitable, patient-centered care for individuals with SUD.
