Neurodivergent Social Anxiety: Symptoms in Social Situations

Social interaction can require far more than talking.

We may need to follow several voices, interpret facial expressions, decide when to speak, filter background noise, remember what was said, monitor how we appear and respond quickly enough to keep the interaction moving.

For some neurodivergent people, this processing load is demanding even when the interaction feels emotionally safe.

Add fear of judgment, previous rejection, uncertainty, masking or difficulty regulating attention, and an ordinary conversation can begin to feel like a high-stakes performance.

This is sometimes described as neurodivergent social anxiety.

It is not a separate clinical diagnosis. It is a useful way of exploring how social anxiety can interact with autism, ADHD, AuDHD and other neurodivergent experiences.

In this article, we distinguish social anxiety from social overload, introversion and communication differences. We also explore why social situations may feel so demanding and which supports can reduce fear without forcing neurodivergent people to socialize in neurotypical ways.

The short answer

Neurodivergent social anxiety may involve a combination of:

😟 Fear of being judged or rejected
🧠 High real-time processing demands
🔊 Sensory overload
❓ Difficulty predicting what will happen
🎭 Monitoring and masking neurodivergent traits
🗣️ Worry about speaking too much, too little or at the wrong moment
🔄 Difficulty switching between listening and responding
💔 Memories of bullying, exclusion or misunderstanding
🌀 Post-conversation rumination
🪫 Significant recovery needs afterward

These factors can reinforce each other.

Social situations feel difficult, so anxiety increases. Anxiety consumes processing capacity, making the situation harder to navigate. Difficult interactions then appear to confirm the original fear.

What social anxiety means

Social anxiety involves marked fear or anxiety about situations in which a person may be observed, evaluated or judged.

Common fears include:

🗣️ Saying the wrong thing
😳 Appearing visibly anxious
🤐 Not knowing what to say
🗯️ Accidentally offending someone
👀 Being watched
💬 Receiving criticism
🚫 Being rejected
😂 Being laughed at
🧠 Going blank
🚪 Being unable to leave

Social anxiety disorder is more than occasional nervousness. The fear or avoidance is persistent, causes significant distress or substantially interferes with life.

Only an appropriately qualified professional can diagnose it.

“Neurodivergent social anxiety” is not a diagnosis

The term can describe the interaction between social anxiety and neurodivergent traits, needs or experiences.

It does not mean that:

❌ Every neurodivergent person has social anxiety
❌ Autism is a type of anxiety disorder
❌ Social difficulties automatically indicate autism
❌ ADHD causes fear of people
❌ Every preference for solitude needs treatment
❌ All social anxiety has the same underlying mechanism

A person can be autistic without social anxiety, socially anxious without being neurodivergent or experience both.

Social anxiety and social difficulty are different

A social situation can be difficult for reasons other than fear.

Someone may struggle because:

🔊 The environment is too noisy
🧠 Speech is moving too quickly
🗣️ Several people are talking at once
🔄 The conversation changes direction unpredictably
❓ Social expectations are unclear
🪫 Their processing capacity is already low
🎭 They are consciously managing their behavior
⏳ They need more time to respond
👥 The group’s communication style does not match theirs

These are real access demands.

Social anxiety is more specifically connected to fear of evaluation, embarrassment, rejection or social consequences.

In practice, both can occur together.

Fear load and processing load

A useful distinction is between fear load and processing load.

Fear load

Fear load includes:

😟 Worry about judgment
🚫 Fear of rejection
🗯️ Expecting criticism
😳 Fear that anxiety will become visible
🌀 Replaying previous mistakes
👀 Feeling watched
📉 Predicting social failure

Processing load

Processing load includes:

🧠 Interpreting language
🗣️ Planning a response
👀 Reading nonverbal cues
🔊 Filtering background noise
🔄 Switching between speakers
⏳ Keeping pace
📋 Holding information in working memory
🎭 Monitoring behavior

Reducing fear does not automatically eliminate processing load.

Similarly, making communication more accessible may reduce processing demands while some fear of judgment remains.

Effective support may need to address both.

Social anxiety in autism

Anxiety disorders are common among autistic adults, although prevalence estimates vary depending on the population and assessment method.

Autistic social anxiety may be influenced by several interacting factors.

Social communication requires active processing

Some autistic people describe consciously working out social information that others seem to process more automatically.

This may involve:

🧩 Interpreting implied meaning
😐 Deciding what a facial expression means
🗣️ Calculating when to speak
👀 Managing eye contact
💬 Choosing an acceptable level of detail
🔄 Adjusting to sudden topic changes
🧠 Remembering what has already been said
❓ Deciding whether a statement is literal

The effort required does not mean the person lacks interest in connection. They may care deeply about the interaction while finding its mechanics exhausting.

Social rules can be unpredictable

Social expectations are often contextual.

The same comment may be welcomed in one group and judged negatively in another. Directness may be valued at work but criticized in a friendship. Honesty may be requested until the answer is not socially comfortable.

This unpredictability can produce constant monitoring:

🔎 “Was that too direct?”
🧠 “Have we spoken for too long?”
⏳ “Is it our turn yet?”
😟 “Did their expression change?”
💬 “Were they being literal?”
🚪 “How do we end this conversation?”
🌀 “Should we have answered differently?”

When the rules remain unclear, anxiety can become an attempt to prevent hidden mistakes.

Sensory and social demands combine

A conversation in a quiet room may feel manageable. The same conversation in a restaurant may become nearly impossible.

The person may simultaneously process:

🍽️ Cutlery and dishes
🎵 Background music
🗣️ Nearby conversations
💡 Bright lighting
🧴 Food smells
👥 People moving
👕 Uncomfortable clothing
😟 Fear of missing what was said

What looks like social avoidance may partly be avoidance of the environment in which socializing is expected to happen.

Previous experiences teach caution

Many autistic people have histories of:

💔 Rejection
😂 Mockery
🚫 Exclusion
🗯️ Being called rude or difficult
😐 Having intentions misread
🎭 Being accepted only while masking
⚖️ Being punished for misunderstood behavior
🫥 Feeling tolerated rather than included

Anxiety can develop from repeated evidence that social mistakes carry consequences.

This does not mean every prediction of rejection is accurate in the present. It means the fear may have an understandable history.

The double-empathy perspective

Social difficulty is often framed as an autistic person failing to understand non-autistic people.

The double-empathy perspective suggests that misunderstanding can be mutual. People with different communication styles and experiences may find it harder to understand each other.

An autistic person may misread a non-autistic person.

A non-autistic person may also:

🗯️ Interpret directness as hostility
😐 Read a neutral face as disinterest
🤐 Assume reduced speech means refusal
👀 Treat limited eye contact as dishonesty
🧠 Mistake slow processing for poor understanding
👐 View stimming as inattention
📋 Expect unspoken rules to be obvious

Recognizing mutual mismatch can reduce shame without denying that social anxiety is genuinely painful.

The goal is not to decide that communication never needs work. It is to stop placing the entire burden on one neurotype.

Masking and social anxiety

Masking involves suppressing, modifying or hiding neurodivergent traits to meet social expectations.

It may include:

🎭 Rehearsing conversations
👀 Forcing eye contact
🤐 Suppressing stimming
😄 Constructing expected facial expressions
🗣️ Editing natural speech
📋 Preparing scripts
😂 Laughing at expected moments
🔎 Monitoring other people for cues
🧠 Reviewing every response before speaking

Masking can provide short-term protection. It may help someone avoid stigma, gain employment, build relationships or navigate an unsafe environment.

It can also intensify social anxiety.

When acceptance appears to depend on performance, the person may conclude:

💭 “People only like the version we construct.”
💭 “One mistake will reveal that we do not belong.”
💭 “We must monitor ourselves constantly.”
💭 “If we relax, something will go wrong.”
💭 “We cannot trust our natural response.”

Research generally associates greater camouflaging with poorer mental health, although the direction of causality is not always clear and not every autistic person experiences masking identically.

Social anxiety in ADHD

ADHD can also make social interaction more difficult or unpredictable.

Possible challenges include:

🗣️ Interrupting before another person finishes
⚡ Responding impulsively
🧠 Losing the thread of a conversation
🔄 Changing topics quickly
📖 Giving much more detail than intended
⏳ Struggling to estimate how long we have spoken
📱 Forgetting to reply
📅 Missing plans or arriving late
🤐 Going blank while trying to listen carefully
👀 Appearing distracted despite caring
🗯️ Reacting strongly before having time to process

Repeated correction or criticism can create anticipatory anxiety.

Someone may begin monitoring every word:

😟 “Are we talking too much?”
😟 “Did we interrupt again?”
😟 “Do they think we were not listening?”
😟 “Have we forgotten something important?”
😟 “Why have they not replied?”
😟 “Did our enthusiasm seem strange?”

The resulting self-monitoring consumes attention, which can make it even harder to participate naturally.

AuDHD and conflicting social needs

AuDHD refers to the co-occurrence of autism and ADHD.

The combination can create apparently contradictory social experiences:

👥 Wanting connection but becoming overloaded by interaction
⚡ Speaking enthusiastically and then worrying about oversharing
🎵 Wanting stimulation but struggling with noisy venues
🗓️ Craving predictable plans but resisting rigid schedules
🗣️ Wanting deep conversation but finding small talk exhausting
🔥 Feeling highly social during one period and unreachable afterward
💬 Caring about messages but repeatedly forgetting to answer
🚪 Wanting to attend while also desperately wanting to stay home

This inconsistency can itself create anxiety.

Other people may interpret changing capacity as unreliability, disinterest or rejection. The AuDHD person may then feel pressure to promise more consistency than their nervous system can sustainably provide.

Rejection sensitivity and RSD

Some people use the term rejection sensitive dysphoria, or RSD, for intense distress following actual, perceived or anticipated rejection.

Experiences may include:

💔 A small criticism feeling devastating
🌀 Replaying neutral comments
📱 Panicking when someone does not reply
🗯️ Becoming defensive before understanding the feedback
🚪 Withdrawing to avoid further rejection
🤝 People-pleasing
🏆 Perfectionism
🤐 Avoiding asking for help
😟 Assuming disappointment means abandonment
🔥 Feeling sudden shame or anger

RSD is not a formal diagnosis, and research has not established it as a distinct condition specific to ADHD.

Rejection sensitivity can be influenced by:

🧠 Emotional regulation differences
💔 Previous rejection
😂 Bullying
😟 Anxiety
🎭 Masking
🛡️ Trauma-related patterns
🫥 Low self-esteem
❓ Difficulty interpreting ambiguous communication

The label may describe a meaningful experience. It should not be treated as proof of one neurological mechanism.

Social anxiety before, during and after interaction

Social anxiety can extend far beyond the event itself.

Before

📅 Dreading the event for days
🧠 Rehearsing every possible conversation
👕 Worrying about appearance
🚗 Planning escape routes
📱 Considering cancellation repeatedly
😴 Losing sleep
🍽️ Feeling nauseated or unable to eat
❓ Seeking repeated reassurance

During

💓 Racing heart
🫁 Changes in breathing
🫨 Shaking
🌡️ Feeling hot or cold
🧠 Going blank
🗣️ Speaking very quickly or very little
👀 Monitoring every reaction
🎭 Masking more intensely
🚪 Searching for a way to leave
🔊 Becoming increasingly sensitive to sensory input

After

🌀 Replaying the conversation
🔎 Searching for mistakes
💔 Interpreting ambiguous moments negatively
📱 Checking for signs of rejection
🪫 Experiencing severe fatigue
🤐 Needing hours without interaction
😟 Feeling shame about ordinary behavior
📅 Avoiding the next opportunity

The recovery period may contain both anxiety and genuine cognitive or sensory exhaustion.

Post-event rumination

Social anxiety often continues through post-event processing.

The mind reviews:

🗣️ What was said
😐 The other person’s expression
⏳ A pause before they answered
😂 Whether a joke worked
📖 Whether too much was shared
🚪 How the interaction ended
📱 Why no message has arrived

This review can feel like problem-solving, but it often happens without enough information to reach a reliable conclusion.

Try separating three categories.

What we know

✅ “They ended the conversation at 4:00.”
✅ “We interrupted once.”
✅ “They said they would reply next week.”

What we are interpreting

🌀 “They left because we were annoying.”
🌀 “The interruption ruined everything.”
🌀 “They are delaying because they dislike us.”

What we can do

📱 Send one appropriate follow-up
🗣️ Repair a clear mistake
📝 Record anything genuinely useful
⏳ Allow uncertainty to remain
🛑 End the review when no new information is available

The goal is not to prove that everything went perfectly. It is to stop treating every uncertainty as evidence of rejection.

Social anxiety, introversion and social fatigue

These experiences can overlap but are not identical.

Introversion

An introverted person may prefer smaller amounts of interaction and need solitude afterward without experiencing strong fear of judgment.

Social fatigue

A person may enjoy socializing but become cognitively, emotionally or physically depleted.

Social overload

The combination of people, sound, movement and communication may exceed current processing capacity.

Social communication mismatch

The interaction may be difficult because participants use different expectations, levels of directness or ways of expressing interest.

Social anxiety

Fear of evaluation, embarrassment or rejection drives substantial distress or avoidance.

Depression or burnout

Low energy, reduced motivation and loss of capacity may make connection inaccessible even when fear is not the main barrier.

A person may experience several of these simultaneously. Identifying the mixture helps determine what support is likely to work.

Avoidance and safety behaviors

Avoidance can reduce anxiety immediately.

It might involve:

🚫 Declining invitations
📵 Not answering messages
🤐 Remaining silent
👥 Staying close to one familiar person
📋 Rehearsing every sentence
🎭 Masking continuously
🍷 Using alcohol to manage interaction
🚪 Leaving before anxiety can rise
🧠 Avoiding eye contact to prevent feeling observed
📱 Looking at a phone throughout the event

Some of these behaviors are genuine accessibility strategies. Others may maintain anxiety by preventing opportunities to discover what is manageable.

The distinction depends on function and context.

Headphones in a noisy venue may make participation possible. They are not automatically an unhealthy safety behavior.

Leaving an abusive group is protection, not pathological avoidance.

A useful question is:

“Does this strategy support participation on our terms, or is fear steadily making our world smaller?”

Realistic and exaggerated social fears

Not every fear of rejection is irrational.

Neurodivergent people may encounter:

⚖️ Discrimination
💼 Workplace penalties
😂 Mockery
🚫 Exclusion
🗯️ Misinterpretation
🎭 Pressure to hide disability
🤐 Punishment for direct communication
👀 Negative assumptions about movement or eye contact

Good support should not insist that these risks are imaginary.

At the same time, understandable fears can become generalized.

One rejecting person can begin to represent everyone. One awkward interaction can become proof that all future conversations will fail.

The goal is not forced optimism. It is more precise prediction:

🎯 Which situations are genuinely unsafe?
🤝 Which people have shown flexibility?
🏠 Which environments reduce processing demands?
🗣️ Which communication styles fit better?
📉 Which adjustments make participation sustainable?

What helps with neurodivergent social anxiety

Effective support should address fear, processing demands and environmental accessibility.

Reduce sensory load

Possible adjustments include:

🎧 Wearing hearing protection
🌘 Choosing softer lighting
🍽️ Meeting outside peak hours
👥 Choosing smaller groups
🚪 Sitting near an exit
🌳 Walking together instead of sitting face-to-face
📱 Using text or video rather than in-person contact
🏠 Meeting in a familiar location
⏳ Keeping the interaction shorter
👕 Wearing sensory-safe clothing

Reducing sensory load leaves more processing capacity available for the social interaction itself.

Make communication more predictable

Predictability can reduce both anxiety and cognitive load.

Try:

📅 Agreeing on the start and end time
📍 Confirming the location in advance
📝 Asking what the meeting will cover
📱 Using written follow-up
🗣️ Requesting direct communication
⏳ Taking time before answering
✅ Discussing one topic at a time
🚪 Planning how to end the interaction
🔄 Giving advance notice of changes
🤝 Bringing a trusted person when appropriate

Scripts can also help:

📱 “We need a moment to think about that.”
📱 “Could you say that more directly?”
📱 “We are interested, but our face may not show it.”
📱 “We need to leave at eight.”
📱 “We cannot process this properly in a noisy room.”
📱 “Let us reply in writing.”

A script is an accessibility tool, not a failure of authenticity.

Use gradual, chosen exposure

Avoidance can strengthen social anxiety when it repeatedly teaches the brain that anxiety can only be managed by escaping.

Gradual exposure can help a person learn that anxiety is tolerable and that feared outcomes do not always occur.

However, neurodivergent exposure needs careful goals.

Helpful exposure is:

✅ Chosen rather than forced
✅ Gradual rather than overwhelming
✅ Connected to something the person values
✅ Conducted in a reasonably accessible environment
✅ Focused on anxiety rather than suppressing harmless traits
✅ Followed by sufficient recovery
✅ Adapted when the task contains genuine barriers

It should not mean:

❌ Forcing eye contact
❌ Preventing stimming
❌ Remaining in sensory pain
❌ Practising neurotypical performance for its own sake
❌ Repeatedly entering unsafe groups
❌ Treating exhaustion as evidence of progress

The goal is increased freedom, not increased conformity.

Adapt cognitive behavioral therapy

Cognitive behavioral therapy is an established treatment for social anxiety in the general population.

Autism-specific evidence is smaller but suggests that adapted CBT may help some autistic adolescents and adults. Existing studies have limitations, including small effects, restricted samples and—in some cases—the absence of a control group.

Useful adaptations include:

📝 Written information
🗣️ Concrete language
📅 Predictable session structure
🧩 Autism-specific examples
🔊 Sensory adjustments
⏳ Additional processing time
🎭 Discussion of masking
⚖️ Recognition of realistic discrimination
🚪 Permission to pause or leave
🎯 Individual rather than normative social goals

Therapy should distinguish between an anxious prediction and a genuine communication mismatch.

Reduce masking pressure

The answer to social anxiety is not always becoming better at masking.

Consider where small reductions are safe:

👐 Allowing movement
👀 Using comfortable eye contact
🗣️ Speaking more directly
📱 Choosing written communication
🤐 Taking pauses
🎧 Using visible sensory tools
📖 Talking about genuine interests
🚪 Leaving before complete depletion
🪫 Being honest about recovery needs

Unmasking is not an all-or-nothing obligation. Masking can have protective functions, and disclosure is not safe in every environment.

The person should decide where, when and with whom greater authenticity is possible.

Prepare less, but prepare better

Preparation can reduce uncertainty. Excessive rehearsal can increase anxiety and make spontaneous changes harder.

Prioritize practical preparation:

📍 Where are we going?
⏰ When does it begin and end?
👥 Who will be present?
🚗 How will we leave?
🎧 Which sensory tools do we need?
🗣️ What are two possible opening questions?
📱 What will we say if we need a break?

Then stop preparing.

We do not need a script for every possible sentence.

Support attention and working memory

ADHD-related conversational difficulties may improve when less information must be held mentally.

Helpful strategies include:

📝 Writing down important points
📱 Following up by message
✅ Asking one question at a time
🔕 Reducing nearby notifications
🎧 Moving to a quieter space
🗣️ Telling trusted people that interruption is not intentional
⏳ Pausing before responding
🔄 Redirecting gently when the topic is lost
📅 Using reminders for replies and plans

When ADHD symptoms contribute substantially to social difficulties, appropriate ADHD assessment and treatment may also help.

Regulate before, during and after

Before:

🍽️ Eat and drink
😴 Protect sleep where possible
📅 Reduce demands earlier in the day
🎧 Pack sensory tools
🚪 Make an exit plan
⏳ Include travel time

During:

🪑 Choose a manageable position
🎧 Reduce noise
🚶 Take movement breaks
🥤 Check basic needs
🗣️ Ask for clarification
🤐 Allow pauses
🚪 Leave before reaching complete overload

After:

📵 Reduce messages
🤐 Allow time without speech
🍽️ Choose simple food
🛋️ Rest
👐 Use familiar regulation
🛑 Postpone the social performance review
📅 Keep the next demand manageable

Use our Neurodivergent Reset Plan when social, sensory and cognitive load have already become too intense.

Choose better-fitting forms of connection

Social progress does not have to mean attending larger groups or becoming more spontaneous.

Connection may work better through:

📱 Text-based conversation
🎮 Shared activities
🚶 Walking together
📚 Interest-based groups
👥 One-to-one contact
🗓️ Planned interaction
🏠 Familiar environments
🤝 Neurodivergent peer spaces
🎨 Parallel activity
⏳ Shorter but more frequent contact

The aim is meaningful connection, not performing the most socially demanding format.

Helping someone with social anxiety

Supportive responses include:

🤝 “We can make the plan more predictable.”
🗣️ “You do not need to answer immediately.”
🚪 “Leaving early is an option.”
📱 “We can communicate in writing.”
🎧 “Use whatever sensory support helps.”
⏳ “You can take a break without explaining.”
💬 “Would you like reassurance, problem-solving or space?”
🛡️ “We will not force you into an overwhelming situation.”

Less helpful responses include:

❌ “Just be yourself”
❌ “Nobody is looking at you”
❌ “You need to get out of your comfort zone”
❌ “Stop overthinking”
❌ “Everyone feels awkward”
❌ “You seemed fine”

The person may have appeared fine because they were devoting enormous effort to appearing fine.

When professional support may help

Consider professional support when social anxiety:

📉 Is making life increasingly restricted
💼 Interferes with work or education
🤝 Prevents wanted relationships
📱 Makes essential communication inaccessible
🍷 Leads to reliance on alcohol or substances
🌀 Produces hours of rumination after interactions
🎭 Requires exhausting levels of masking
😴 Seriously affects sleep
💔 Contributes to depression or hopelessness
🚨 Creates thoughts of self-harm or suicide

Useful support may include:

🧠 Adapted CBT
🎯 Gradual, collaborative exposure
🫀 Regulation and interoception work
💬 Trauma-informed therapy where relevant
🧩 ADHD treatment when ADHD is contributing
🤝 Peer support
🏠 Environmental accommodations
💊 Medication for a diagnosed anxiety disorder when clinically appropriate

Treatment should help the person build a life with more choice—not simply increase their ability to tolerate inaccessible situations.

Reflection

😟 Is your social distress driven mainly by fear, processing load, sensory overload—or a combination?
🎭 In which situations does masking protect you, and where does it create unnecessary exhaustion?
🤝 Which people, environments or communication formats make connection feel easier?

The takeaway

Neurodivergent social anxiety is not one official condition.

It describes the way fear of judgment can interact with:

🧠 Social processing demands
🔊 Sensory overload
🎭 Masking
⚡ ADHD impulsivity and attention differences
❓ Uncertainty
💔 Rejection and bullying
🗣️ Communication mismatch
🪫 Social exhaustion

Not every difficult social experience is an anxiety symptom. Sometimes the environment is overwhelming, the communication is inaccessible or the interaction simply demands more energy than is currently available.

Helpful support may involve adapted therapy and gradual exposure. It may also involve:

🎧 Sensory adjustments
📱 Written communication
⏳ More processing time
🚪 Exit plans
👥 Smaller groups
🎭 Reduced masking
🤝 Better-fitting relationships
📉 Realistic social demands
🛋️ Sufficient recovery

The goal is not to eliminate every uncomfortable feeling or turn every neurodivergent person into an effortless social performer.

The goal is greater freedom: more ability to enter wanted relationships, communicate needs, tolerate manageable uncertainty and leave situations that are genuinely harmful or inaccessible.

Read Next

Explore further support through the Anxiety Learning Hub.

Use the Neurodivergent Reset Plan when social and sensory demands become overwhelming.

Learn how body signals affect anxiety in Interoception and Neurodivergence.

Build portable support with the Sensory Toolkit for Adults.

References

Spain, D., Sin, J., Linder, K. B., McMahon, J., & Happé, F. (2018). Social anxiety in autism spectrum disorder: A systematic review. Research in Autism Spectrum Disorders, 52, 51–68.

Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2019). Anxiety and depression in adults with autism spectrum disorder: A systematic review and meta-analysis. Psychological Medicine, 49(4), 559–572.

Bemmer, E. R., Boulton, K. A., Thomas, E. E., et al. (2021). Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder. Molecular Autism, 12, Article 11.

Hull, L., Levy, L., Lai, M. C., et al. (2021). Is social camouflaging associated with anxiety and depression in autistic adults?. Molecular Autism, 12, Article 13.

Summerill, J., & Summers, S. J. (2025). The consequences of social camouflaging in autistic adults: A systematic review. Research in Autism Spectrum Disorders.

Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry, 171(3), 276–293.

National Institute for Health and Care Excellence. Social anxiety disorder: Recognition, assessment and treatment.