Anxious-depressive attack (ADA) is a recently proposed symptom cluster consisting of sudden intense feelings of distressing emotions with no direct psychological cause. It is characterized by intrusive rumination of mainly regretful memories accompanied by a violent emotional storm, resulting in countermeasures including acting out behaviors. ADA seems to manifest in various anxiety and affective disorders as well as some personality disorders, but may have been overlooked. A previous study showed that patients with ADA were more socially anxious and more depressive than those without ADA, regardless of their diagnoses. Social anxiety disorder (SAD) is one of such disorders with a high prevalence of ADA (44.4%). According to clinical reports, patients with SAD appear hypersensitive to rejection or criticism. The present study examined the relationships among ADA, social anxiety, depression and rejection sensitivity (RS) in patients diagnosed with SAD using structural equation modeling (SEM). Findings showed that RS directly significantly affects ADA, as well as indirectly via depression and social anxiety. Depression had a direct, positive effect on ADA, whereas social anxiety had an indirect effect on ADA via depression. The present study suggests that RS may contribute to the development of ADA in patients with SAD.