Psychology
2012. Vol.3, No.1, 70-77
Published Online January 2012 in SciRes (http://www.SciRP.org/journal/psych) http://dx.doi.org/10.4236/psych.2012.31012
70
Sensory Processing Difficulties and Interpersonal Relationships
in Adults: An Exploratory Study
Nili Ben-Avi1, Moshe Almagor1, Batya Engel-Yeger2
1Department of Psychology, Haifa University, Haifa, Israel
2Occupational Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa,
Haifa, Israel
Received September 21st, 2011; revised November 4th, 2011; accepted December 8th, 2011
The purpose of this study was to investigate the association between sensory processing difficulties (SPD)
which refers to detection, modulation and response to sensory input and interpersonal relationships. 139
students participated in the study and completed two self report questionnaires: The Adolescent/Adult
Sensory Profile measuring sensory processing abilities as expressed in daily living and the Hebrew ver-
sion of the MMPI-2. The results demonstrated strong associations between different patterns of SPD and
a wide range of symptomathology, including anxiety, somatization, distress, and demoralization, difficu-
lties in social interactions, family, work and therapeutic relationships. The findings of this study indicate
that extreme sensory processing patterns are strongly related to distress and psychological difficulties.
Therefore, it is recommended that clinical therapists relate to sensory processing as part of their dynamic
conceptualization of patients’ difficulties. This also emphasizes the significance of interdisciplinary treat-
ment that takes sensory processing into consideration in order to create an intervention program that con-
siders the person’s specific sensory needs and their relationship with personality.
Keywords: Sensory Processing; MMPI-2; Interpersonal Relationships; Sensory Processing Difficulties;
Demoralization
Introduction
Individual’s personality interacts with the way one integrates
sensory and experienced events (Bender & Schilser in Chutroo,
2007). The association between individual’s sensory processing
capacities and various clinical features has been examined in
only few studies, focusing mainly on depression, anxiety and
emotional regulation (e.g., Kinnealey & Fuiek, 1999; Liss, Ti-
mmel, Baxley, & Killingsworth, 2005). The present study aims
to elaborate this association, particularly regarding interper-
sonal relationships in typically healthy individuals.
Sensory Processing
Sensory processing relates to the way one detects, regulates,
interprets and responds to sensory stimuli (Dunn, 2001). Senso-
ry processing includes physiological and behavioral compo-
nents: The physiological aspect of the process relates to stru-
ctural changes or the functioning of the nervous system (Kandel,
1991). The behavioral aspect relates to the individual’s capacity
to regulate reactions to stimuli adaptively to the environmental
requirements (Royeen & Lane, 1991). Typical sensory proce-
ssing enables adaptive and organized reactions to environmen-
tal demands, while atypical patterns of sensory processing may
negatively influence the functioning of the individual in every-
day life (Tal-Saban et al., 2002; Dunn, 2001). It is estimated
that 15% of the typical population experiences different levels of
atypical sensory processing patterns (Simeonsson et al., 2003).
Atypical sensory processing or SPD may be expressed by
hypersensitivity or hyposensitivity to sensory stimuli; this de-
pends on neurological threshold for sensory stimuli. A low neu-
rological threshold indicates that the individual requires low in-
tensity stimuli for the individual to react, while individuals with
a high neurological threshold need high intensity stimuli or take
longer to react to the same stimuli (Dunn, 2001). Wilbarger and
Wilbarger (1991) defined hypersensitivity as the tendency to
have a negative reaction to a sensory input that is commonly
considered harmless, as for example, hypersensitivity to odors
or noises in a room; tactile sensitivity to specific fabrics. On the
other hand, hyposensitivity is defined as a decreased sensitivity
to stimuli in the environment. A common consequence is inat-
tention to injuries, behavior such as excessive touching and
increased activity (Wilbarger & Wilbarger, 1991).
Cermak (1998) described hypersensitivity and hyposensitivity
as two extremes on the same continuum and not as separate
phenomena, as the contention was until then. Thus, hypersensi-
tivity in one sensory system may coexist with hyposensitivity in
another system (Royeen, 1989).
Dunn’s Model for Sensory Processing
Dunn’s (1997) model of sensory processing comprises two
axes of sensory processing: the neurological threshold of the
individual (high or low) and his/her behavioral response.
According to Dunn’s (1997) model, for each of the neurolo-
gical thresholds, the behavioral response strategy can be active
or passive. An active behavioral response is expressed by ac-
tions that aim to cope with the neurological threshold. A pas-
sive behavioral response is characterized by a lack of effort to
reduce or increase the stimulation, even if the stimulus does not
match the neurological threshold.

N. BEN-AVI ET AL.
The interactions between the threshold and behavioral re-
sponse axes form four orthogonal quadrants: 1) Sensation Avoi-
ding—which represents low neurological thresholds and an
active response strategy. This quadrant characterizes active
avoidance of sensory stimuli in order to reduce uncomfortable
experience; 2) Sensory Seekers-high neurological thresholds
and an active response strategy. Persons in the quadrant will try
to meet their neurological threshold actively seek high intensity
stimuli in order to actively increase the strength of the response;
3) Sensory Sensitivity-low neurological threshold and a passive
behavioral response. Individuals in this quadrant will not act
actively to stop or reduce the level of sensory threshold while
experiencing discomfort. 4) Low Registration-passive response
and high neurological threshold, these persons will respond to
sensory stimuli either slowly or not at all to. The Sensory pro-
cessing patterns are likely to have an impact on the individual’s
psychological functioning.
The Sensory Processing Patterns an d I nt e r p e rs o n a l
Relationshi ps among Adults Dunn’s Model
for Sensory Processing
Sensory Seeking Patter n: High Neurological Threshold and
Active Behavioral Response
This behavior can lead to social rejection due to the lack of
the physical boundaries and a dangerous behavior that is con-
sidered by others as irresponsible, impatient and lacking respect
for others.
According to Miller, Anzalone, Lane, Cermak, and Osten (2007),
people with a “sensory seeking” profile demonstrate activities
meant to increase sensory experience, such as an increased mo-
tor behavior, forming contact with objects and people (like bu-
mping into objects) and seeking strong stimuli such as spicy
food, strong noises and stimulating visual. In social context,
these behaviors represent over affection and an attempt to initi-
ate interpersonal contact in a non-informative way, seeking to
boost their sensory experiences so that the sensory input crosses
their reaction threshold This behavior may result in social re-
jection due to lack of physical boundaries and dangerous be-
havior that may be considered by others as irresponsible, impa-
tient and disrespectful.
MMPI-2 is one of the most commonly used personality tests
in mental health to assist in assessing psychopathology and pe-
rsonality structure and is composed of a large number of scales
providing a comprehensive description of the person. Correla-
tions between sensation seeking and several MMPI-2 scales ha-
ve already been reported. A positive correlation was found, for
both men and women, between sensation seeking and scale 9
(Ma), which is associated with impulsivity and hyperactivity
(McKinley & Hathaway, 1944; Zuckerman & Bone, 1972; Zuc-
kerman & Link, 1968). This correlation was explained by the
high activity level and the need for varied and intense stimuli
(Zuckerman & Link, 1968).
Other studies found an association between sensation seeking
and low scores on scale 0 (Si, Social extroversion-Introversion)
low scores measures behavior characteristic of extroversion
(Dunn, 2001; Eysenck, 1967; Sutker, Archer, & Allain, 1978;
Zuckerman & Bone, 1972; Zuckerman & Link, 1968).
Low Registry Pattern: High Neurological Threshold
and Passive Behavioral Response
Common characteristic of people with a “low registry” sen-
sory processing profile is the tendency to react easily or not to
react at all, to strong and even damaging stimuli. Children are
described as quiet, obedient, as having a low level of arousal
and as having trouble learning about their environment (Royeen
& Lane, 1991). Persons characterized by this pattern are typi-
cally lacking in reaction to sensory stimuli, which may be per-
ceived as indifference, sluggishness and lack of motivation or
interest in the world in general and in initiating relationships in
particular. Lack of response doesn’t stem from lack of motiva-
tion but rather from an absence of sensory reaction, leading to
inability to recognize possibilities for action. Common examples
include lack of reaction to falls, injuries or abnormal tempera-
ture (Miller, Anzalone, Lane, Cermak, & Osten, 2007) inability
to recognize and express emotions and lack of sense of humor
(Dunn, 1997).
Sensory Avoidance Pattern: Low Neurological Threshold
and Active Behavioral Response
Individuals who fit the “sensory avoidance” quadrant are cha-
racterized by an active attempt to avoid sensory stimuli due to
intense sensory reaction to every sensory stimulus. These reac-
tions produce tension, anxiety and nervousness, and problems
in initiating relationships. These individuals are likely to have
aggressive and negative reactions to intense, overwhelming and
invasive sensory stimuli (Miller, Anzalone, Lane, Cermak, &
Osten, 2007). The negative reactions can be expressed by se-
clusion, social withdrawal and avoidance of outdoor activities
such as traveling by automobile or plane.
Sensory Sensitivity Patte r n: Low Neurological Threshold
and Passive Behavioral Response
Individuals with the “sensory sensitivity” pattern experience
intense sensory reactions to every sensory stimulus, and there-
fore they also tend to be characterized by feelings of tension,
anxiety and nervousness, and problems in initiating relation-
ships. These individuals can have aggressive and negative reac-
tions to sensory stimuli that they experienced as intense, over-
whelming and invasive (Miller, Anzalone, Lane, Cermak, &
Osten, 2007).
Sensory Proce s si n g and Psychol o g i ca l C haracterist i c s
SPD are related to behavioral and adjustment problems of
children, particularly those associated with emotional regula-
tion, depression and anxiety. Sensory hypersensitivity has been
found to be related to lack of sleep, hyper-emotionality, exa-
ggerated defense mechanisms and incapacity to complete new
assignments (Royeen & Lane, 1991; Wilbarger & Wilbarger,
1991).Children (or their parents) are the main population that
appeals for treatment, therefore the measures for SPD was first
developed for children.
Even though research on sensory processing has been condu-
cted mostly on children, and we have reason to believe that Chil-
dren suffer from these difficulties more than adults, who learn
and adapted their life to live with the situation, there is some
evidence that adults with SPD also experience higher levels of
anxiety, depression and adjustment problems, (Kinnealey &
Fuiek, 1999). Liss, Timmel, Baxley, and Killingsworth’s (2005)
found significant connections between sensory hypersensitivity
and psychological distress, anxiety and depression. Considering
the fact that sensory processing profiles remain constant over
time, further research is necessary to determine the relationship
between sensory processing and psychological aspects among

N. BEN-AVI ET AL.
adults as well. The current research aims to contribute to the en-
deavor.
Goal of Cu rrent Study
The present study aims to explore and expand our knowledge
on the association between sensory sensitivity and social skills
among adults. Specifically, the purpose of this study is to ex-
plore the relationships between Dunn’s four sensory processing
patterns and the quality of interpersonal and social relationships
among typical adults. The study is unique in that it focuses on
this aspect among typical healthy adults; the study uses a com-
bination of measures which were not previously applied in this
population: the MMPI-2 and the Adolescent/Adult Sensory Pro-
file Questionnaire (AASP). The main hypothesis was that adult
participants with SPD will show different symptoms related to
interpersonal relationships compared to participants with typi-
cal sensory processing.
Method
Participants and Design
One-hundred thirty nine undergraduate students participated
in the study for credit and were recruited by computerized ex-
periment registration system of the department of Psychology at
University of Haifa. Credit points were offered to each student
willing to participate in the experiment. Thirteen participants
did not match the inclusion criteria and were omitted from the
statistical analysis (subjects with nervous system injuries, aller-
gies or taking medications which affect the central nervous
system). The MMPI-2 of three additional subjects was invalid
(according to the MMPI-2 criteria ); and were also omitted from
the statistical analysis. Thus, the statistical analysis was con-
ducted on 123 subjects: 36 men and 86 women. All subjects
spoke native Hebrew, all reported general overall good health,
did not report any kind of chronic disease and did not take
medications that affect the nervous system. The age of the sub-
jects ranged between 19 and 33 (M = 23.85, SD = 2.44), with a
significant gender difference: the men were significantly older
(M = 24.72, SD = 2.73) than the women (M = 23.48, SD =
2.05), [t(121) = 2.77, p < .01].
Measures
Background and Physical Condition Questionnaire
In this brief questionnaire, subjects were asked to report their
gender and age and answer several questions regarding their
health.
The Adolescent/Adult Sensory Profile Questionnaire (ASP) is
a self-report measure developed by Dunn and Brown (2002) as
a trait measure of sensory processing patterns and effects on
daily life behavior. The AASP consists of 60 items (on a 5-po-
int Likert scale) regarding how he or she generally responds to
different sensations. Fifteen items represent each of the four
quadrants, or sensory profile types. The sensory processing ca-
tegories are taste, smell, movement, sight, touch, hearing and
activity level (proprioception). These categories are distributed
throughout each of the 15 items included in each quadrant. The
current study found adequate reliabilities. Each of the four qua-
drants shows high Cronbach’s coefficient of internal consis-
tency.
The questionnaire was translated to Hebrew by Parush, En-
gel-Yeger and Ben-Sason (2006). The current study uses the
norms developed by Dunn and Brown (2002) in the United
States for the same age groups, since the norms in Israel have
not yet been developed.
In Dunn & Brown’s normative sample, an adequate freque-
ncy of responses matched the criteria for three of the four sen-
sory profiles: sensory sensitivity, sensory avoiding and low re-
gistry. Therefore, comparisons can be made between the per-
sonality characteristics of those respondents who had a normal
or a low rate and those who had a higher than average score on
each of these three sensory profiles (see Table 1).
The Minnesota Multiphasic Personality Inventory (MMPI-2)
The MMPI-2 (Butcher, Dahlstrom, Graham, Tellegan, & Kae-
mmer, 1989) provides extensive clinical, symptomatic, person-
ality and interpersonal evaluation of the individual’s mental
state. The version used here is the Hebrew translation (Almagor,
2005). The MMPI-2 has high reliability and validity (Almagor,
2005 ; Graham, 2005; Greene, 2010) .
Procedure
The research procedure was approved by the Haifa Univer-
sity ethics committee for experiments on humans (Approval nu-
mber 080/80). All subjects signed an informed consent that de-
scribed the study, procedures to ensure anonymity and confi-
dentiality, and provision of psychological help if requested. Su-
bjects were told they can quit the experiment at any point.
Students were told that the experiment deals with personality
structure and sensory experiences in everyday life, and that it
involves only filling questionnaires.
The questionnaires were administered in a balanced order:
Half completed the computerized MMPI-2 first, and then filled
out the sensory profile questionnaire. The other half completed
the experiment in the reverse order. In order to control for order
of administration, MANOVA procedures were employed were
conducted using Hotelling’s Trace criterion. No significant di-
fferences were found between the two groups. The administra-
tion was done in groups. Each group included 8 - 15 participants.
The entire experiment lasted for an hour and a half.
Results
In order to control for the gender effect, two MANOVA pro-
cedures were employed using Hotelling’s Trace criterion. No
significant differences were found between men and women in
the weighted variable of the sensory profile scores [F(4, 118) = .66,
n.s]. However, there were significant differences between men
and women for the weighted MMPI-2 scales variable [F(36, 86) =
4.45, p < .001].Therefore, gender was controlled during data a-
nalyses. There was no significant between gender and each one
of the sensory types for weighted MMPI-2 scale scores. In or-
der to control for the age effect, Pearson correlations between
the subjects’ age and the scores in the MMPI-2 scales and the
Table 1.
Frequency of respondents by intensity of sensory profile type (N = 123).
Intensity Sensory
sensitivity
Sensory
avoiding
Sensory
seeking
Low
registry
Low 5 6 18 9
Normal88 87 95 84
High 30 30 10 30
72

N. BEN-AVI ET AL.
sensory profile scales were computed. No significant correla-
tions were found; therefore it can be assumed that age was not
an intervening variable in this study.
Pearson correlation coefficients between scores on the four
sensory processing scales (representing the different sensory
processing patterns) and scores on all the MMPI-2 scales were
computed.
Due to the multiplicity of the correlations that were com-
puted for the 35 scales of the MMPI-2, a Bonferroni correction
was conducted to minimize Type I error due to the multiple co-
mparisons (0.05/35 = .0015). Consequently, Pearson correla-
tions where p < .0014 were considered significant. Table 2 de-
picts the computed Pearson correlations, indicating those found
to be significant.
Table 2.
Pearson correlations between sensory profile scale scores and scale scores
on the MMPI-2 (N = 123).
Scale
code Scale descr i ption Low registry Sensory seeking Sensory sensitivity Sensory avoidance
Clinical scales and sub-scales:
HS-1 Somatization .38* –.25 .47* .37*
D-2 Depression .32* –.29 .36* .22
WSD Distress –.21 .44* .45* .36*
HY-3 Hysteria .18 –.12 .15 .07
PD-4 Perversion .35* –.08 .37* .31*
PA-6 Suspicion .25 .02 .21 .15
PA2 Poignancy .31* –.04 .29* .60*
PT-7 Anxiety .46* –.16 .51* .43*
SC-8 Thinking Disorders .44* –.10 .44* .46*
DIS Distress .46* –.17 .47* .39*
BIM Bizarre mentation .24 .12 .24 .35*
MA-9 Hypomanic symptoms .12 .39* .00 .10
SI-0 Social introversion .41* –.51* .49* .44*
Si1 Shyness .37* –.44* .40* .35*
Si2 Social alienation .28 –.33* .24 .34*
Si3 Alienation–self and other .34* –.07 .45* .40*
Self-Report Scales
ANX Anxiety .39* –.14 .45* .40*
FRS Fears .20 –.19 .35* .17
OBS Obsessiveness .41* –.16 .47* .36*
DEP Depression .40* –.11 .40* .38*
HEA Health concerns .34* –.27 .41* .33*
ANG Anger .22 –.01
.41* .39*
CYN Cynicism .22 .04 .27 .36*
ASP Anti-social personality .20 .06 .20 .21
TPA Type A .18 –.02 .44* .40*
LSE Low self-esteem .45* –.20 .55* .47*
SOD Social discomfort .39* –.42* .36* .43*
FAM Family problems .29* –.14 .44* .40*
WRK Work problems .40* –.13 .52* .43*
TRT Problems in therapy .46* –.12 .49* .44*
Additional scales:
A Distress .46* –.13 .52* .44*
ES Ego strength –.44*.18 –.44* –.39*
MDS Marital problems .39* –.16 .43* .38*
MAC
R
Alcoholism –.02 .36* –.10 –.09
APS Alcoholism potential .27 .08 .34* .20
*p < .0014.
Pearson correlation coefficients between scores on the four
sensory processing scales (representing the different sensory pro-
cessing patterns) and scores on all the MMPI-2 scales were
computed. Due to the multiplicity of the correlations that were
computed for the 35 scales of the MMPI-2, a Bonferroni cor-
rection was conducted to minimize Type I error due to the mul-
tiple comparisons (0.05/35 = .0015). Consequently, Pearson
correlations where p < .0014 were considered significant. Ta-
ble 2 depicts the computed Pearson correlations, indicating tho-
se found to be significant.
Table 2 suggests that all the sensory processing types are
correlated with several clinical scales, although in different di-
rections. The likelihood of introversion and social discomfort is
higher as the tendency of the subject for sensory sensitivity,
sensory avoidance or low registry processing increases. How-
ever, the likelihood of these features is lower when the tenden-
cy for sensory seeking increases. The following analyses were
conducted for each type separately.
Sensory Sensitivit y Pr ofi l e: L ow Neurological
Threshold and Active Behavioral Response
A significant effect was found for the intensity of sensory
sensitivity on the weighted MMPI-2 scale scores [F(35, 85) = 1.87,
P < .01, η2 = .44]. Table 3 presents the results relevant to the
present study.
The findings depicted in Table 3 indicate that individuals
with an increased tendency for sensory sensitivity suffer from
higher levels of stress (A) , are more socially introverted (Si) ,
suffer more from a sense of alienation from themselves and
others (Si3), have lower self-esteem (LSE), and social discom-
fort due to problems at work (WRK) and in therapeutic rela-
tionships (TRT). They also suffer from a higher general level of
distress (DIS) and less ego strength (ES).
Sensory Avoidance Profile: Low Neurological
Threshold and Active Behavioral Response
A significant effect was found for the intensity of the ten-
dency for sensory sensitivity on the weighted MMPI-2 scale
scores [F(35, 85) = 1.61, P < .05, η2 = .40]. Table 4 presents the
results relevant to the present study.
Low Registry Profi le : Hig h Neurological T hreshol d
and Passive Behavioral Response
A significant effect was found for the intensity of the ten-
dency for low registry on the weighted dependent variable of
the MMPI-2 [F(35, 85) = 1.90, P < .01, η2 = .44]. Table 5 pre-
sents the results relevant to the present study.
The findings presented in Table 5 indicate that individuals
with an increased tendency for low registry suffer from higher
levels of stress (A), lower self-esteem (LSE), distress (WSD),
and difficulties at work (WRK).
Discussion
The aim of the current research was to explore the relation-
ships between Dunn’s model of sensory processing patterns and
the personality and symptomatic characteristics among normal
adults.
The findings indicate that in terms of psychological profiles,
there is a lot in common in the three patterns of sensory proc essing

N. BEN-AVI ET AL.
74
Table 3.
Partial results of the MANCOVA: Means and standard deviations of the scores on the MMPI-2 scales depending on the tendency for sensory sensitivity.
Scale code Scale description Participants with an increased tendency
for sensory sensitivity (N = 30)
Participants with a normal/decreased
tendency for sensory sensitivity (N = 93) F η2
M SD M SD
From the clinic a l scales:
DIS Distress 7.23 .70 4.53 .34 12.05*.09
Si-0 Social introversion 35.04 1.86 27.55 .91 13.08*.10
Si3 Alienation 7.38 .64 4.89 .31 12.09*.09
From the content scales:
LSE Low self-esteem 10.35 .71 4.92 .35 47.10*.28
WRK Problems at work 13.94 1.05 8.25 .51 23.72*.17
TRT Problems in therapy 7.46 .71 4.11 .34 18.25*.13
Additional scales:
A Level of distress 20.17 1.55 12.51 .75 19.80*.14
ES Ego strength 32.52 1.14 37.26 .56 13.86*.10
*p < .0014.
Table 4.
Partial results of the MANCOVA: Means and standard deviations of the scores on the MMPI-2 scales depending on the tendency for sensory avoidance.
Scale code Scale description Participants with an increased tendency
for sensory avoidance (N = 30)
Participants with a normal/decreased
tendency for sensory avoidance (N = 93) F η2
M SD M SD
From the clinica l s cales:
Si2 Social aleination 4.01 .42 2.42 .22 11.33*.09
From the content scales:
LSE Low self-esteem 8.57 .76 5.32 .39 14.50*.11
SOD Social discomfort 9.96 .92 6.49 .48 11.29*.09
Additional scales:
A Level of distress 18.82 1.54 12.85 .80 11.83*.09
ES Ego strength 32.73 1.13 37.14 .58 12.10*.09
MDS Marital distress 5.66 .51 3.82 .26 1.29* .08
*p < .0014.
Table 5.
Partial results of the MANCOVA: means and standard deviations of the scores on the MMPI-2 scales depending on the tendency for low registry.
Scale code Scale description Participants with an increased tendency
for low registry (N = 30)
Participants with a normal/decreased
tendency for low registry (N = 93) F η2
M SD M SD
From the clinic a l scales:
WSD Distress 10.75 1.10 6.67 .53 11.22*.09
From the content scales:
LSE Low self-esteem 8.69 .78 5.29 .38 15.27*.11
WRK Problems at work 12.90 1.07 8.45 .52 13.92*.11
Additional scales:
A Level of distress 18.92 1.61 12.83 .78 11.59*.09
*p < .0014.

N. BEN-AVI ET AL.
“sensory sensitivity”, “sensory avoidance” and “low registra-
tion”. The stronger the tendency of the subject for one or more
of this patterns, the higher is the likelihood they will report
more anxiety, somatization, distress characteristics, interperso-
nal difficulties, lack of ego strength, thought distortions and
poignancy.
The only variables that had significant correlations with all
sensory profiles were scales measuring aspects of Introversion;
Social Introversion (SI), Shyness (SI1, a subscale of SI), and
Social Discomfort (SOD). These three variables correlated po-
sitively with Sensory Sensitivity, Sensory Avoidance, and Low
Registration Sensory types, but negatively with Sensory Seek-
ing type.
The current study indicates that compared to individuals with
a normal neurological threshold, individuals with atypical sen-
sory pattern demonstrated lower self-esteem, more social dis-
comfort, more distress and less ego strength.
Furthermore, it was found that those with a low neurological
threshold and a passive behavioral response report more social
introversion, distress and problems at work. In contrast, parti-
cipants with a low neurological threshold and an active beha-
vioral response showed a higher score on the alienation from
self and other scale and more problems in the family.
The finding of the current study that individuals with sensory
sensitivity are characterized by a higher level of social introver-
sion, shyness, and social discomfort supports earlier studies
which found similar associations (Aron & Aron, 1997; Aron,
Aron, & Davies, 2005).
Sensory Sensitivit y Pr ofi l e: L ow Neurological
Threshold and Active Behavioral Response
Since high scorers on Sensory Sensitivity experience intense
sensory reactions to sensory stimuli, they are likely to control
their physical environment by accommodating it to their special
tendencies and needs. As opposed to the physical environment,
the social environment is more difficult, sometimes even im-
possible to control. This may explain their feelings of tension,
anxiety and nervousness, and their problems in initiating social
relationships.
Sensory Avoidance Profile: Low Neurological
Threshold and Active Behavioral Response
The findings of the current study suggest interpersonal diffi-
culties characterizing individuals with a Sensory Avoidance ty-
pe as opposed to those with a Sensory Sensitivity type. These
variables include social alienation, social isolation, interperso-
nal difficulties and family problems and crises.
High Neurological Threshold
The findings of the current study indicate that a high neuro-
logical threshold may be related to either a tendency for intro-
version or extroversion, depending on the response strategy (ac-
tive or passive). Previous studies found a relationship between
sensory hypersensitivity and social introversion and shyness
(Aron & Aron, 1997 ; Aron, Aron, & Davies, 2005). The current
study suggests that social introversion is strongly related to sen-
sory processing, when. high levels of sensory processing are re-
lated to high levels of introversion or extroversion. These find-
ings have a theoretical significance given the little research on
the subject of high neurological thresholds.
Low Registry Type: High Neurological Threshold
and Passive Behavioral Response
Individuals with low registry are characterized by a lack of
response to sensory stimuli, and they may appear as indifferent
and lacking interest in the world. There is very little empirical
research on this type of processing.
The tendency for social introversion that includes social wi-
thdrawal, shyness and lack of self esteem in social situations in-
creased as the tendency for low registry processing increased.
The findings of the current study suggest that individuals
with low registry processing demonstrate features that are simi-
lar to those of individuals with a low neurological threshold,
which include higher levels of distress, somatization, preoccu-
pation with the body, anxiety, negative self-esteem and proble-
ms at work. In addition, similarly to the correlations found re-
garding the low neurological threshold, as the low registry sen-
sory processing is more profound, somatization, distress, wea-
ker ego strength, social deviance, a tendency for poignancy, an-
xiety, thought disorders that stem from distress and social in-
troversion are more likely to occur.
These findings add a new aspect to the existing theoretical
knowledge and emphasize the significance of understanding the
psychological difficulties that characterize individuals with low
registry processing. In addition, the similarity between the fea-
tures of individuals with a high neurological threshold and a
passive response strategy and individuals with a low neurolo-
gical threshold and a passive response strategy might suggest a
mixed model of abnormal sensory processing. It seems that the
primary difficulty of some individuals with abnormal sensory
processing is regulating the sensory processing, so that they
oscillate between low and high neurological thresholds. This
results in lower social skills. A study that examined the rela-
tionship between sensory processing and disorders of the autis-
tic spectrum, found that 60% of the individuals with autis-
tic-spectrum disorders demonstrated higher scores on more than
one sensory processing type. The authors argued that disorders
on the autistic spectrum are related to abnormal sensory proc-
essing of both kinds (sensory hyposensitivity and sensory hy-
persensitivity), so that the sensory processing disruption stems
from regulation difficulties and oscillations between high and
low neurological thresholds (Crane, Goddard, & Pring, 2009).
Thus, individuals with a passive behavioral response seem to be
most susceptible to these regulation difficulties.
Sensory Seeki n g Pr o fi l e : High Neurolo gi cal
Threshold and Active Behavioral Response
High-scorers on Sensory Seeking are characterized by low
tendency for social introversion and extravagant characteristics.
Moreover, the stronger the tendency for sensory seeking, there
is less probability for depressive symptoms. These findings su-
ggest that people with sensory seeking profile may not experi-
ence stress, which is consistent with previous studies on this
processing type (Miller, Anzalone, Lane, Cermak, & Osten,
2007). Several studies found that there is a connection between
the intention and will to take part in high-risk sports activities
and the need for physiologic stimulation (Diehem & Armatas,
2004; Franques et al., 2003; Shoam, Rose, & Kahle, 1998).
Demoralization and Sensory Processing
One of the most important common factors in the MMPI-2 is

N. BEN-AVI ET AL.
“Demoralization” (Almagor & Koren, 2001; Tellegen et al.,
2003). Demoralization is experienced as a persistent inability to
cope, together with associated feelings of helplessness, hope-
lessness, meaninglessness, subjective incompetence and dimin-
ished self-esteem. It was found that this factor has a major con-
tribution on vast majority of the major psychological disorders
measured by the MMPI-2 (Almagor & Koren, 2001, Tellegen
et al., 2003). The work of Tellegen and associates (2003, 2008)
provide strong evidence for the prominence of demoralization
in understanding the nature of psychological disorders. In the
current study, it is clear that demoralization and introversion
plays a key factor in explaining the findings.
Recent studies have found significant correlations between
SPD and psychological difficulties among healthy adults. Engel-
Yeger & Dunn (2011a) demonstrated how anxiety (trait anxiety
and state anxiety) is related to extreme sensory processing pat-
tern. Another study by Engel-Yeger & Dunn (2011b) revealed
the connection between SPD and positive/negative Affect when
negative affect correlated with Sensory Sensitivity, Sensory
Avoiding and Low Registration and positive affect correlated
with sensory seeking. Theses finding are consistent with the re-
sult of the current study, suggesting the important role of sen-
sory processing in psychological and interpersonal difficulties.
Conclusion
Clinically, the current study contributes to the understanding
of how sensory processing in everyday life relates to psycho-
logical experiences and behavior.
Our findings do not support Dunn’s sensory processing mo-
del. The psychological and social difficulties were related to
three of the sensory processing types. These findings suggest
that a bipolar model of sensory processing with regard to psy-
chological and social difficulties may be a more precise one.
Limitations the Study
In order to examine the nature of the sensory processing, the
current study used a self report questionnaire that examines
behaviors after an encounter with sensory stimuli. Future stud-
ies on the sensory processing and clinical features subject that
will use physiological measures that evaluate directly, objec-
tively and measurably the reaction to sensory stimuli, will be
able to strengthen the validity of the findings in this study.
The current study examined the sensory processing patterns
in a distinct manner. As aforesaid, it may be that in certain con-
ditions, the sensory processing disturbance stems from regula-
tion difficulties and therefore it is expressed by oscillations
between a high neurological threshold and a low one. Future
studies in the field, that will be conducted on larger samples
and on more varied populations as far as age and clinical syn-
dromes are concerned, can investigate in a more focused man-
ner the possible oscillations in the sensory functioning.
The current study is a correlation study, and therefore it can-
not be indicative of causal relations between sensory processing
defects and clinical features. However, it is important to indi-
cate that sensory processing defects are neurological defects, so
it is likely that they form the ground for the development of the
personality, in an interaction with environmental factors, of
course. It can also be assumed that the relationship is not unidi-
rectional and that the developing clinical features contribute to
the development of the neurological defects. Future studies in
the field can examine the influence of sensory processing diffi-
culties on the development of the personality. In addition, more
studies are needed regarding the interaction between sensory
processing defects and environmental variables in the predic-
tion of psychological difficulties and clinical features. The
findings indicate that individuals with an increased tendency for
sensory avoidance suffer from higher levels of stress (A), suffer
more from a sense of alienation from themselves and others
(Si2), have lower self-esteem (LSE), and social discomfort
(SOD). They also suffer from a higher general level of distress
(A), family problems (MDS) and less ego strength (ES).
Acknowledgements
We wish to acknowledgement the help of Prof. Danny Koren
in commenting on an early draft of the study.
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