Meta-analysis: High sensitivity linked to depression, anxiety, and PTSD

Is it possible for a “fine mental organization” to increase vulnerability to mental disorders – and at the same time enhance the response to therapy? The first meta-analysis on this topic was published in Clinical Psychological Science: researchers collected dozens of studies on environmental sensitivity in adolescents and adults and showed stable, moderate positive links between sensitivity and common mental health problems – depression, anxiety disorders, PTSD, agoraphobia and avoidant personality disorder. At the same time, the authors emphasize the “dual nature” of sensitivity: such people suffer more from an unfavorable environment, but also respond better to positive influences and psychotherapy.

Background of the study

Mental health is formed at the intersection of heredity, life experience and the current environment - and people differ sharply in how strongly they react to external events. This stable individual difference is described by the concept of environmental sensitivity. This is not a diagnosis or a “weakness”, but a temperamental trait: for some, the “background” of the world is barely noticeable, while others experience both negative and positive things more acutely - from stress and criticism to support and therapy.

Historically, vulnerability has been explained by the diathesis-stress model: there is a “predisposition” that manifests itself under adverse circumstances. The modern framework of differential susceptibility and vantage sensitivity adds the second half of the picture: more sensitive people not only suffer more from an adverse environment, but also benefit more from a favorable one (warm family, support, psychotherapy). Hence the practical interest: if sensitivity is a “reaction amplifier”, taking it into account can help personalize prevention and treatment.

Data from individual studies have already hinted at links between sensitivity and depressive and anxiety symptoms, PTSD, avoidance, and social anxiety. But the literature has been mixed: different questionnaires have been used (e.g., “high sensitivity” scales in adults and children), samples have varied in age and clinical status, and effects have varied in magnitude and direction. Without a pooled analysis, it is difficult to know where there are stable associations and where we see noise in methods and samples.

Against this backdrop, meta-analysis, which systematically collects and integrates results from adolescents and adults and from common disorders, fills an important gap. It allows us to separate stable, reproducible relationships from random findings, to clarify the magnitude of the effect, and to ask practical questions: who to screen for increased sensitivity, which therapy formats (e.g., emotional regulation skills, CBT, mindfulness) are particularly well received by sensitive people, and how to build a supportive environment so that the amplifier works positively, not negatively.

What did they do?

• A systematic review and meta-analysis of studies examining the relationship between sensitivity and common mental disorders in adolescents and adults was conducted.
• We combined the results of dozens of samples around the world (news releases reported on the order of >30 studies and ~12 thousand participants), assessed the summary correlations, and checked the stability of the results.

Key findings

• Sensitivity is positively and moderately associated with:
  • depression and general anxiety;
  • PTSD;
  • agoraphobia and avoidant personality disorder;
  • in a number of samples - with social anxiety and OCD.
• The profile is consistent with the differential susceptibility model: more sensitive individuals experience both the negative and positive aspects of the environment more strongly, which explains both the greater risk of symptoms and the better response to therapy and supportive interventions.

What does it mean

Environmental sensitivity is a personality trait that reflects how powerfully you are affected by external stimuli and other people's emotions. It is not a diagnosis or a defect; the trait has a resource side (creativity, empathy, a rich emotional life), but in a harsh environment it can become a vulnerability.

• Practical conclusions for the clinic and everyday life:
  • For “highly sensitive” people, it makes sense to start using methods of emotional regulation, mindfulness, and CBT skills earlier and more actively.
  • When planning therapy, keep in mind that the response may be brighter - this is a chance to improve faster under suitable conditions.
  • In everyday life, hygiene of stimuli (sleep, screen load, “overheating” with social networks), boundaries and a supportive environment help.

Details and context

• The paper is the first meta-evaluation on the topic published in the peer-reviewed journal Clinical Psychological Science, published by SAGE. The authors call the associations “positive and moderate”; press materials highlight replication across disorders (including PTSD and agoraphobia).
• Popular paraphrases indicate the largest effects for depression and anxiety, and a total data size of over 30 studies/~12,000 people (estimates from news platforms and university press releases). The exact effect sizes depend on the methods and scales in the original studies.

Why is the find important?

• Stratification of assistance. Taking into account sensitivity helps to better adjust prevention and psychotherapy (including choosing intensity and format).
• Normalizing the trait. Understanding the "dual nature" removes the stigma: sensitivity is not a "weakness" but an amplifier of the influence of the environment.
• Research agenda: We need research on what interventions (types of CBT, emotion regulation training, digital tools) work best for highly sensitive people.

Restrictions

• The meta-analysis combines different sensitivity scales and heterogeneous clinical outcomes; residual heterogeneity is possible.
• Correlations are associations, not causation: outcomes can be influenced by environmental factors (stress, traumatic experiences).
• For individual diagnoses (e.g. avoidant personality disorder), the empirical base is still less extensive than for depression and anxiety.

Conclusion

High sensitivity is not a label, but an important parameter of individual vulnerability and strength. A new meta-analysis confirms: sensitivity is statistically associated with depression, anxiety, PTSD and a number of other disorders, but it is sensitive people who often benefit most from a positive environment and therapy. In diagnoses and in life, this is an argument for making the environment more friendly - and planning interventions that take into account your "amplifier" of reaction.

Source: The Relationship Between Environmental Sensitivity and Common Mental-Health Problems in Adolescents and Adults: A Systematic Review and Meta-Analysis. Clinical Psychological Science (SAGE), published online August 2025. https://doi.org/10.1177/21677026251348