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Mitchell BJ, Coifman KG, Olatunji BO. Is disgust more resistant to extinction than fear? A meta-analytic review of laboratory paradigms. Behav Res Ther 2024; 174:104479. [PMID: 38301293 DOI: 10.1016/j.brat.2024.104479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 02/03/2024]
Abstract
Disgust can be acquired via evaluative conditioning; a process by which a neutral stimulus (conditioned stimulus; CS) comes to be evaluated as disgusting due to its pairing with an inherently disgusting stimulus (unconditioned stimulus; US). Research has shown that conditioned disgust responses are resistant to extinction which may have implications for disorders (i.e., contamination-based obsessive-compulsive disorder, specific phobias, and post-traumatic stress disorder) in which heightened disgust has been implicated. Importantly, extinction is the primary mechanism by which exposure therapies are thought to achieve symptom reduction for these disorders. Exposure therapies were originally modeled on fear extinction, whereas disgust extinction was largely overlooked until recently. Accordingly, differences in the degree to which learned disgust and fear can be attenuated via extinction learning remains unclear. The present investigation was a meta-analysis directly comparing the degree of extinction of conditioned disgust (n = 14) and conditioned fear (n = 14) in laboratory paradigms. Extinction was operationalized as the standardized mean difference (SMD) in evaluative ratings between the CS+ (the CS paired with the US) and CS- (the unpaired CS) after extinction training. Results of a subgroup analysis indicated that disgust (SMD = 0.52) was significantly more resistant to extinction than fear (SMD = 0.37). Additionally, a series of meta-regression analyses indicated that extinction was not influenced by important study characteristics (e.g., sex, age, number of conditioning and extinction trials). The findings suggest that extinction-based approaches may be less effective at attenuating learned disgust and research is needed to better optimize treatments for disgust-related disorders.
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Affiliation(s)
- Benjamin J Mitchell
- Department of Psychological Science, Kent State University, l, Kent, OH, United States.
| | - Karin G Coifman
- Department of Psychological Science, Kent State University, l, Kent, OH, United States
| | - Bunmi O Olatunji
- Psychological Sciences, Vanderbilt University, Nashville, TN, United States
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2
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D'Mello RJ, Kumar A. Experience of Disgust and Symptom Severity in Contamination Subtype of Obsessive-Compulsive Disorder: Role of Experiential Avoidance. Indian J Psychol Med 2022; 44:580-585. [PMID: 36339694 PMCID: PMC9615452 DOI: 10.1177/02537176221116267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The emotion of disgust has been linked with the underlying nature of the contamination subtype of obsessive-compulsive disorder (C-OCD). Prior studies show that disgust contributes to the development of C-OCD by reinforcing avoidance strategies. Therefore, experiential avoidance (EA) may influence the effect between disgust sensitivity (DS) and C-OCD symptom severity. This study aimed to investigate the mediational role of EA between DS and C-OCD severity. METHODS A cross-sectional design was adopted with 45 patients of OCD and 45 healthy controls. Both the groups were assessed on the Obsessive-Compulsive Inventory, the Disgust Scale (Revised), and Acceptance and Action Questionnaire-II. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) checklist and symptom severity scale were additionally administered to the patients with OCD. Independent t-tests, Pearson's product-moment correlation, regression analysis, and mediation analysis were used. RESULTS DS and EA were positively associated with contamination-washing symptoms and symptom severity. Regression analysis indicated that DS and EA were highly associated with contamination/washing severity scores among both the patients with C-OCD and the healthy controls. CONCLUSION The study implicates that disgust is a central emotion underlying the presentation of obsessions and compulsions, which are of contamination concerns. Further, EA has a role in the maintenance of OCD through avoidance learning; however, it may not be interacting with DS to cause OCD.
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Affiliation(s)
- Raina Jane D'Mello
- Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ajay Kumar
- Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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3
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Anxious Personality Traits: Perspectives from Basic Emotions and Neurotransmitters. Brain Sci 2022; 12:brainsci12091141. [PMID: 36138877 PMCID: PMC9496710 DOI: 10.3390/brainsci12091141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022] Open
Abstract
Objective: Recently, many emotional diseases, such as anxiety and depression, have prevailed, and it is expected that emotional disease will be the leading cause of social and economic burden in 2030. These emotional diseases may be due to certain personality traits, which could be the reasons for the development of mental illness. Personality theories have been constantly developed over the past hundreds of years, and different dimensions of personality traits corresponding to different physiological bases and emotional feelings have been proposed. However, personality may be the least studied area in psychology. Methods: In this paper, we will give a short review on the development of personality theories as well as dimensional emotional theory. Then, we will compare the similarities between the emotional dimension and personality dimension. Furthermore, we will also investigate the neural mechanisms of personality and emotions, focusing on neuromodulators for anxiety-related personality traits, in order to provide a clear relationship between different neurotransmitters and anxiety-related personality traits. Results: The results of our study suggest that the emotional dimension and personality dimension may be somewhat related, for example, the extrovert/introvert dimension of personality might be related to the hedonic dimension, which includes happiness/sadness, and the neurotic dimensions might be related to emotional arousal. In addition, our study found that personality traits are also related to basic emotions, for instance, people who are too self-centered are prone to feeling a mood of disgust or depression, while anger and fear correspond to unstable personality traits. The analysis suggested that the neural substrates of both personality and emotions might be described as follows: extroverted–joy–dopamine (DA); introverted–disgust–5-hydroxytryptamine (5-HT); unstable (neuroticism)–anger/fear–noradrenaline (NE); stable–calmness. Conclusions: The results of this study suggest that there is a correlation between personality traits and emotions, and both depend on monoamine neurotransmitters (dopamine, norepinephrine and serotonin). In addition, personality disorders can be interfered via the regulation of emotions and neurotransmitters. This paper opens up a whole new perspective for future research on personality traits and emotional diseases and has great clinical value and practical significance.
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Peters J, Visser RM, Kindt M. More than just fear: Development and psychometric evaluation of the Spider Distress Scale to assess spider fear and spider-related disgust. J Anxiety Disord 2022; 90:102602. [PMID: 35841782 DOI: 10.1016/j.janxdis.2022.102602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 05/20/2022] [Accepted: 07/02/2022] [Indexed: 11/19/2022]
Abstract
Spider fear is an excellent model to experimentally study processes in the maintenance and treatment of long-lasting fears. A valid, reliable, and practical tool to assess spider-related distress dimensionally, and to differentiate between spider-related fear and disgust in a time-sensitive manner, may help to better understand individual differences in these two emotions and to tailor treatments accordingly. We developed a concise self-report questionnaire, the Spider Distress Scale (SDS), that combines the strengths of established spider fear questionnaires and addresses their shortcomings. We explored (study 1 and 2) and confirmed (study 3) a two-factor structure of the SDS in samples from the general population (n = 370; n = 360; n = 423), recruited online via Prolific Academic from the United Kingdom, the Netherlands, and the United States. The fear and disgust factors of the SDS are highly internally consistent and the SDS has excellent test-retest reliability. We found good convergent and discriminant validity, based on self-report measures and spider behavioural approach tasks, and the SDS successfully differentiated between individuals with and without spider fear (study 4, n = 75). Our series of studies suggests that fear and disgust are functionally related, but that disgust towards spiders can be differentially assessed when focussing on unique elements of disgust-related information.
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Affiliation(s)
- Jacqueline Peters
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
| | - Renee M Visser
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Merel Kindt
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Stevens ES, Behar E, Siev J. The roles of disgust sensitivity and anxiety sensitivity in attentional bias in dental anxiety. J Anxiety Disord 2021; 83:102450. [PMID: 34340171 DOI: 10.1016/j.janxdis.2021.102450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 05/04/2021] [Accepted: 07/06/2021] [Indexed: 12/15/2022]
Abstract
Individuals with dental anxiety show biased attentional processing of threat- and dental-related information. Disgust sensitivity and anxiety sensitivity are both associated with dental fears and attentional biases. Whereas disgust sensitivity is generally associated with attentional avoidance (Armstrong et al., 2014), anxiety sensitivity may be associated with attentional engagement (Keogh et al., 2001a). Elucidating the role of these constructs in dental anxiety-relevant attentional biases could inform theoretical models and/or intervention recommendations. Participants (N = 51) with high dental anxiety completed a Posner paradigm to assess attentional biases to dental versus neutral stimuli. We examined whether disgust sensitivity and anxiety sensitivity moderated degree of attentional bias. Results indicated that both disgust sensitivity (mutilation subscale) and anxiety sensitivity (physical concerns subscale) statistically moderated degree of attentional bias at trend level, and in opposite directions. Simple effects analyses further indicated that disgust sensitivity regarding mutilation was associated with less attentional bias toward dental relative to neutral stimuli, potentially indicating attentional avoidance, and remained so when adjusting for anxiety sensitivity. In contrast, simple effects analysis indicated that anxiety sensitivity regarding physical concerns was not associated with magnitude of attentional bias. If replicated, findings highlight the potential role of disgust in dental anxiety.
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Affiliation(s)
- Elizabeth S Stevens
- University of Illinois at Chicago, Department of Psychology, United States; VA Puget Sound Health Care System, Seattle Division, United States.
| | - Evelyn Behar
- Hunter College - City University of New York, Department of Psychology, United States
| | - Jedidiah Siev
- Swarthmore College, Department of Psychology, United States
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Mayor E, Meyer A, Miani A, Lieb R. An exploration of the nomological network of trypophobia. PLoS One 2021; 16:e0257409. [PMID: 34520484 PMCID: PMC8439462 DOI: 10.1371/journal.pone.0257409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/01/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Trypophobia is characterised by an aversion to or even revulsion for patterns of holes or visual stimuli featuring such patterns. Past research has shown that trypophobic stimuli trigger emotional and physiological reactions, but relatively little is known about the antecedents, prodromes, or simply covariates of trypophobia. AIM The goals of this study were (a) to draw the contours of the nomological network of trypophobia by assessing the associations of symptoms of trypophobia with several constructs that were deemed relevant from past research on anxiety disorders and specific phobias, (b) to compare such associations with those found for symptoms of spider phobia and blood and injection phobia (alternative dependent variables), and (c) to investigate the main effect of gender on symptoms of trypophobia and replicate the association of gender with symptoms of spider phobia and blood and injection phobia (higher scores for women). METHODS Participants (N = 1,134, 53% men) in this cross-sectional study completed an online questionnaire assessing the constructs of interest. RESULTS Most assessed constructs typically associated with anxiety disorders (neuroticism, conscientiousness, anxiety sensitivity, trait anxiety, disgust sensitivity, and disgust propensity) were also associated with trypophobia in the predicted direction. All of these constructs were also associated with spider phobia and blood and injection phobia. Behavioral inhibition was negatively associated with trypophobia and spider phobia-contrary to what was expected, but positively with blood and injection phobia. We found no gender difference in trypophobia, whereas women scored higher on spider phobia and blood and injection phobia. DISCUSSION Although some differences were observed, the nomological network of trypophobia was largely similar to that of spider phobia and blood and injection phobia. Further studies are needed to clarify similarities and dissimilarities between trypophobia and specific phobia.
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Affiliation(s)
- Eric Mayor
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Andrea Meyer
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Alessandro Miani
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Roselind Lieb
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
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Knowles KA, Olatunji BO. Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory. Clin Psychol Rev 2020; 82:101928. [PMID: 33091745 DOI: 10.1016/j.cpr.2020.101928] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/07/2020] [Accepted: 10/07/2020] [Indexed: 12/31/2022]
Abstract
The State-Trait Anxiety Inventory - Trait version (STAI-T) was developed to measure an individual's tendency to experience anxiety, but it may lack discriminant evidence of validity based on strong observed relationships with measures of depression. The present series of meta-analyses compares STAI-T scores among individuals with depressive disorders, anxiety disorders, and nonclinical comparison groups, as well as correlations with measures of anxiety and depressive symptom severity, in order to further examine discriminant and convergent validity. A total of 388 published studies (N = 31,021) were included in the analyses. Individuals with an anxiety disorder and those with a depressive disorder displayed significantly elevated scores on the STAI-T compared to nonclinical comparison groups. Furthermore, anxiety and depressive symptom severity were similarly strongly correlated with the STAI-T (mean r = .59 - .61). However, individuals with a depressive disorder had significantly higher STAI-T scores than individuals with an anxiety disorder (Hedges's g = 0.27). Given these findings, along with previous factor analyses that have observed a depression factor on the STAI-T, describing the scale as a measure of 'trait anxiety' may be a misnomer. It is proposed that the STAI-T be considered a non-specific measure of negative affectivity rather than trait anxiety per se.
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The longitudinal structure of disgust proneness: Testing a latent trait-state model in relation to obsessive-compulsive symptoms. Behav Res Ther 2020; 135:103749. [PMID: 33032019 DOI: 10.1016/j.brat.2020.103749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 09/15/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022]
Abstract
Although disgust proneness (DP) is increasingly recognized as a personality characteristic that confers risk for psychiatric conditions such as obsessive-compulsive disorder (OCD), the extent to which it reflects a time-varying (TV) or state-like factor versus a time-invariant (TI) or trait-like personality characteristic is unclear. In a 6-wave, 5-month longitudinal study, community participants (n = 982) recruited through ResearchMatch completed the Disgust Propensity and Sensitivity Scale Revised (van Overveld, de Jong, Peters, Cavanagh, & Davey, 2006), a measure of three variants of DP including Somatic Disgust Sensitivity, Ruminative Disgust Sensitivity, and Disgust Propensity. A latent variable (trait-state-occasion) model was applied to all of the DP dimensions. The results showed that although estimates of TI factor variance and TV factor variance were both significant for Somatic Disgust, Ruminative Disgust, and Disgust Propensity, the proportion of TI factor variance (range from .68 to .82) for the DP dimensions was substantially and significantly greater than the amount of TV factor variance (range from .18 to .32). Furthermore, while TV factor stability was statistically significant for the DP dimensions, the size of the coefficients were only moderate in magnitude. Subsequent analysis then examined the extent to which TV or TI components of DP were associated with latent OCD symptoms at each of the six time points. The results showed that estimates of the regression weight for the TI DP factor were significant and larger than those for the TV factor which were often nonsignificant. These findings suggest that DP is largely TI, and it is this TI component that is most strongly associated with OCD symptoms.
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10
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Olatunji BO, Kim J, Cox RC, Ebesutani C. Prospective associations between disgust proneness and OCD symptoms: Specificity to excessive washing compulsions. J Anxiety Disord 2019; 65:34-40. [PMID: 31158647 DOI: 10.1016/j.janxdis.2019.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/12/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022]
Abstract
Although considerable evidence has linked disgust proneness (DP) to obsessive-compulsive disorder (OCD), few studies have examined the extent to which DP predicts OCD symptoms over time. Further, it remains unclear if DP is a risk factor for the contamination subtype of OCD specifically or if it is prospectively associated with other OCD symptom subtypes. The present study sought to address these gaps in the literature with a large sample of unselected community participants (n = 497) that completed measures of DP and OCD symptoms monthly over a 6-month period. Latent growth analysis revealed that initial levels of DP were associated with higher initial level of total OCD symptoms when controlling for depression, but not the slope of change in total OCD symptoms over time. Initial levels of total OCD symptoms were also associated with higher initial levels of DP when controlling depression, but not the slope of change in DP over time. Examination of symptom specificity revealed that initial levels of DP were associated with initial levels of washing, neutralizing, obsessing, ordering, and hoarding symptoms. However, initial levels of DP were associated only with the slope of change in the washing subtype when controlling for depression such that high initial levels of DP were associated with steeper increases in washing symptoms of OCD over the 6-month period. These findings suggest that although DP may have concurrent associations with symptoms of OCD more broadly, prospective associations are specific to the contamination/washing subtype of OCD. The implications of these findings for the etiology and treatment of contamination-based OCD are discussed.
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Affiliation(s)
| | - Jingu Kim
- Konkuk University, Republic of Korea
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Knowles KA, Jessup SC, Olatunji BO. Disgust in Anxiety and Obsessive-Compulsive Disorders: Recent Findings and Future Directions. Curr Psychiatry Rep 2018; 20:68. [PMID: 30094516 PMCID: PMC6422162 DOI: 10.1007/s11920-018-0936-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW In the past 20 years, the role of disgust in anxiety disorders and obsessive-compulsive disorder (OCD) has been investigated with increasing precision. In this review, we examine recent evidence implicating disgust in anxiety and OCD, highlighting recent measurement and methodological improvements. Specific emphasis is placed on understanding the mechanisms that may account for the role of disgust in OCD and related disorders. RECENT FINDINGS Recent developments include clarification of the role of distinct disgust-relevant vulnerabilities in the etiology of anxiety and OCD, an improved understanding of the neurobiology of disgust processing in OCD, and an increased focus on disgust-related mechanisms that contribute to psychopathology, such as disgust-based learning and emotion regulation. Disgust proneness is increasingly linked with symptoms of anxiety and OCD. However, further examination of the mechanisms that account for the roles of distinct disgust-relevant vulnerabilities is needed, and studies that directly examine disgust during the course of treatment are limited. Increasingly, the field has moved toward experimental investigation of specific disgust-relevant mechanisms that influence the etiology and treatment of OCD and related anxiety disorders.
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Predicting Contamination Aversion Using Implicit and Explicit Measures of Disgust and Threat Overestimation. BEHAVIOUR CHANGE 2018. [DOI: 10.1017/bec.2018.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Explicit measures of disgust and threat overestimation have consistently been found to be involved in contamination aversion. However, evidence of the involvement of these factors at the implicit level is mixed, and the role of both responses has not been looked at concurrently. This study aimed to compare the ability of implicit and explicit measures of disgust and threat overestimation to predict contamination aversion and whether this depends on the type of contaminant. Sixty-five participants completed explicit and implicit measures of disgust and threat overestimation, as well as several measures of contamination aversion, including obsessive-compulsive tendencies, and contamination fear and avoidance of contaminants directly associated with disease (direct contaminants) and harmful substances (harm contaminants). It was found that both explicit disgust and explicit threat overestimation predicted contamination-fear obsessive-compulsive tendencies. Explicit disgust predicted contamination fear and avoidance of direct contaminants, whereas explicit threat overestimation predicted contamination fear and avoidance of harm contaminants. The involvement of implicit processes was weak, with some suggestion of difficulty disengaging predicting avoidance of contaminants. Implications for understanding dysfunctional contamination aversion are discussed.
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Olatunji BO, Armstrong T, Elwood L. Is Disgust Proneness Associated With Anxiety and Related Disorders? A Qualitative Review and Meta-Analysis of Group Comparison and Correlational Studies. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2017. [DOI: 10.1177/1745691616688879] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Research suggests that disgust may be linked to the etiology of some anxiety-related disorders. The present investigation reviews this literature and employs separate meta-analyses of clinical group comparison and correlational studies to examine the association between disgust proneness and anxiety-related disorder symptoms. Meta-analysis of 43 group comparison studies revealed those high in anxiety disorder symptoms reported significantly more disgust proneness than those low in anxiety symptoms. Although this effect was not moderated by clinical versus analogue studies or type of disorder, larger group differences were observed for those high in anxiety symptoms associated with contagion concerns compared to those high in anxiety symptoms not associated with contagion concerns. Similarly, meta-analysis of correlational data across 83 samples revealed moderate associations between disgust proneness and anxiety-related disorder symptoms. Moderator analysis revealed that the association between disgust proneness and anxiety-related disorder symptoms was especially robust for anxiety symptoms associated with contagion concerns. After controlling for measures of negative affect, disgust proneness continued to be moderately correlated with anxiety-related disorder symptoms. However, negative affect was no longer significantly associated with symptoms of anxiety-related disorders when controlling for disgust proneness. The implications of these findings are discussed in the context of a novel transdiagnostic model.
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Olatunji BO, Ebesutani C, Kim J, Riemann BC, Jacobi DM. Disgust proneness predicts obsessive-compulsive disorder symptom severity in a clinical sample of youth: Distinctions from negative affect. J Affect Disord 2017; 213:118-125. [PMID: 28222359 DOI: 10.1016/j.jad.2017.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/09/2017] [Accepted: 02/13/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although studies have linked disgust proneness to the etiology and maintenance of obsessive-compulsive disorder (OCD) in adults, there remains a paucity of research examining the specificity of this association among youth. METHOD The present study employed structural equation modeling to examine the association between disgust proneness, negative affect, and OCD symptom severity in a clinical sample of youth admitted to a residential treatment facility (N =471). RESULTS Results indicate that disgust proneness and negative affect latent factors independently predicted an OCD symptom severity latent factor. However, when both variables were modeled as predictors simultaneously, latent disgust proneness remained significantly associated with OCD symptom severity, whereas the association between latent negative affect and OCD symptom severity became nonsignificant. Tests of mediation converged in support of disgust proneness as a significant intervening variable between negative affect and OCD symptom severity. Subsequent analysis showed that the path from disgust proneness to OCD symptom severity in the structural model was significantly stronger among those without a primary diagnosis of OCD compared to those with a primary diagnosis of OCD. LIMITATIONS Given the cross-sectional design, the causal inferences that can be made are limited. The present study is also limited by the exclusive reliance on self-report measures. CONCLUSIONS Disgust proneness may play a uniquely important role in OCD among youth.
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Affiliation(s)
| | | | - Jingu Kim
- Konkuk University, Republic of Korea
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Melli G, Chiorri C, Stopani E, Bulli F, Carraresi C. Development and validation of a new Italian short measure of disgust propensity: The Disgust Propensity Questionnaire (DPQ). Clin Psychol Psychother 2017; 24:1189-1204. [DOI: 10.1002/cpp.2073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 12/26/2016] [Accepted: 12/29/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Gabriele Melli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); Florence Italy
- University of Pisa; Pisa Italy
| | | | - Eleonora Stopani
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); Florence Italy
| | - Francesco Bulli
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); Florence Italy
| | - Claudia Carraresi
- Institute for Behavioral and Cognitive Psychology and Psychotherapy of Florence (IPSICO); Florence Italy
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Olatunji BO, Ebesutani C, Kim EH. Does the measure matter? On the association between disgust proneness and OCD symptoms. J Anxiety Disord 2016; 44:63-72. [PMID: 27776255 DOI: 10.1016/j.janxdis.2016.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/16/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
Abstract
Although some studies suggest that the association between disgust proneness (DP) and obsessive-compulsive symptoms (OCS) is specific to the contamination subtype, others suggest that DP is associated with OCS more broadly. To examine if the discrepant findings may partially reflect differences in self-report measures used, this investigation employed structural equation modeling to examine the association between DP and OCS in three samples that completed different combinations of measures of DP, OCS, and anxiety/negative affect. In Study 1 (n=626), the path from DP to contamination-based OCS was significantly stronger than the path from DP to non-contamination OCS when controlling for anxiety sensitivity. In Study 2 (n=403), the results showed that the path from DP to contamination-based OCS did not significantly differ from the path from DP to non-contamination OCS when controlling for negative affect. Lastly, Study 3 (n=296) showed that the path from DP to contamination-based OCS was significantly weaker than the path from DP to non-contamination OCS. These findings highlight that the self-report measures employed is an important moderator when making inferences about the association between DP and contamination-based OCS and non-contamination OCS.
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Affiliation(s)
| | | | - Eun Ha Kim
- VA Tennessee Valley Healthcare System, United States
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17
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Olatunji B, Sarawgi S, Viar-Paxton M. An Initial Test of Reconsolidation in Disgust-Related Learning and Extinction. J Cogn Psychother 2016; 30:190-202. [PMID: 32755924 DOI: 10.1891/0889-8391.30.3.190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examines whether the spacing of a single unreinforced retrieval trial relative to extinction learning allows for "rewriting" the original disgust association, thereby preventing the return of disgust using a paradigm that employs disgust-relevant unconditioned stimuli (US). During conditioning, disgusting US were paired with a color square that served as the conditioned stimuli (CS). Participants (n = 54) then returned to the lab 24 hours later and received a "reactivation" intervention which consisted of one unpaired presentation of the CS+. Participants were then randomized to receive extinction trials either 10 min (Group A) or 6 hours (Group B) after reactivation. A third control group (Group C) did not receive the reactivation manipulation before extinction. Participants returned 24 hours later for additional extinction trials and at a 1-month follow-up for disgust reinstatement. Although the paradigm resulted in participants evaluating the CS+ as significantly more unpleasant after being associated with a disgust-relevant US, extinction learning within the reconsolidation window did not influence self-reported reduction or return of disgust. However, there was some evidence suggesting that those who received reactivation (Groups A and B), regardless of timing, evaluated the CS+ as less unpleasant after extinction relative to acquisition, whereas this pattern was not observed among those who did not receive reactivation (Group C). The implications of these findings for anxiety-related disorders in which disgust has been implicated will be discussed.
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Richman SB, DeWall CN, Pond RS, Lambert NM, Fincham FD. Disgusted by Vengeance: Disgust Sensitivity Predicts Lower Vengeance. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2014. [DOI: 10.1521/jscp.2014.33.9.831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Olatunji BO. Selective effects of excessive engagement in health-related behaviours on disgust propensity. Cogn Emot 2014; 29:882-99. [DOI: 10.1080/02699931.2014.951314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Change in disgust reactions following cognitive-behavioral therapy for childhood anxiety disorders. Int J Clin Health Psychol 2014; 15:1-7. [PMID: 30487816 PMCID: PMC6224794 DOI: 10.1016/j.ijchp.2014.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/16/2014] [Indexed: 11/20/2022] Open
Abstract
Disgust, in addition to fear, is a prominent emotional state associated with avoidance of distressing stimuli. While most of the research in disgust has been conducted in relation to Obsessive-Compulsive Disorder (OCD), recent data has also implicated disgust in the etiology of anxiety disorders in general. Studies have shown that decreases in disgust are key to symptom reduction in individuals with OCD. However, there has been little empirical work exploring whether these interventions are efficacious for childhood anxiety disorders that present with prominent disgust components. This study examined how disgust propensity in children with anxiety disorders responds to cognitive-behavioral therapy (CBT) with an emphasis on exposure. Forty-one children, ages 7 to 17, with anxiety disorders were evaluated for disgust propensity and were treated with intensive, weekly, CBT. It was found that disgust levels decreased following treatment across all anxiety disorder diagnoses, where children with primary OCD exhibited significantly greater reductions. Clinical implications and suggestions for further research of the treatment of disgust in relation to childhood anxiety disorders are discussed.
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Olatunji BO, Ebesutani C, Haidt J, Sawchuk CN. Specificity of disgust domains in the prediction of contamination anxiety and avoidance: a multimodal examination. Behav Ther 2014; 45:469-81. [PMID: 24912460 DOI: 10.1016/j.beth.2014.02.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 02/07/2014] [Accepted: 02/07/2014] [Indexed: 11/13/2022]
Abstract
Although core, animal-reminder, and contamination disgust are viewed as distinct "types" of disgust vulnerabilities, the extent to which individual differences in the three disgust domains uniquely predict contamination-related anxiety and avoidance remains unclear. Three studies were conducted to fill this important gap in the literature. Study 1 was conducted to first determine if the three types of disgust could be replicated in a larger and more heterogeneous sample. Confirmatory factor analysis revealed that a bifactor model consisting of a "general disgust" dimension and the three distinct disgust dimensions yielded a better fit than a one-factor model. Structural equation modeling in Study 2 showed that while latent core, animal-reminder, and contamination disgust factors each uniquely predicted a latent "contamination anxiety" factor above and beyond general disgust, only animal-reminder uniquely predicted a latent "non-contamination anxiety" factor above and beyond general disgust. However, Study 3 found that only contamination disgust uniquely predicted behavioral avoidance in a public restroom where contamination concerns are salient. These findings suggest that although the three disgust domains are associated with contamination anxiety and avoidance, individual differences in contamination disgust sensitivity appear to be most uniquely predictive of contamination-related distress. The implications of these findings for the development and maintenance of anxiety-related disorders marked by excessive contamination concerns are discussed.
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22
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Fan Q, Olatunji BO. Individual differences in disgust sensitivity and health-related avoidance: Examination of specific associations. PERSONALITY AND INDIVIDUAL DIFFERENCES 2013. [DOI: 10.1016/j.paid.2013.04.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nicholson E, McCourt A, Barnes-Holmes D. The Implicit Relational Assessment Procedure (IRAP) as a measure of obsessive beliefs in relation to disgust. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2013. [DOI: 10.1016/j.jcbs.2013.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Adams TG, Cisler JM, Brady RE, Lohr JM, Olatunji BO. Preliminary Psychometric Evidence for Distinct Affective and Cognitive Mechanisms Mediating Contamination Aversion. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2013. [DOI: 10.1007/s10862-013-9343-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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25
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Nicholson E, Barnes-Holmes D. Developing an implicit measure of disgust propensity and disgust sensitivity: examining the role of implicit disgust propensity and sensitivity in obsessive-compulsive tendencies. J Behav Ther Exp Psychiatry 2012; 43:922-30. [PMID: 22387628 DOI: 10.1016/j.jbtep.2012.02.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 01/27/2012] [Accepted: 02/08/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES There is increasing evidence that disgust responding occurs at both a primary and secondary level in the form of disgust propensity and disgust sensitivity. The unique contributions of anxiety and disgust need to be established if disgust is to be implicated in the etiology of anxiety disorders such as obsessive-compulsive disorder (OCD). The primary objective of the current study was to develop two separate implicit measures of disgust propensity and sensitivity and to explicate the role of implicit disgust propensity and sensitivity in avoidance behavior and OC tendencies. METHODS The current study (N = 33 undergraduate students) utilized a measure of implicit cognition, the Implicit Relational Assessment Procedure (IRAP), to independently analyze disgust propensity and disgust sensitivity. In addition, a series of behavioral approach tasks (BAT) and questionnaires measuring general disgust, obsessive-compulsive (OC) tendencies and general psychopathology were implemented to validate the implicit measures. RESULTS Disgust sensitivity predicted avoidance behavior on the BATs independent of disgust propensity and anxiety, while disgust propensity did not. Both disgust propensity and sensitivity predicted self-reported OC tendencies and individually predicted obsessing and washing concerns, respectively. LIMITATIONS Our findings are based on a non-clinical student sample and further research is required for generalization to OCD. CONCLUSIONS The implicit measures appeared to be measuring two separate constructs and had differential relationships with behavior and OC tendencies. Overall, the results support current theories relating to pathological disgust and OCD.
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Affiliation(s)
- Emma Nicholson
- Department of Psychology, National University of Ireland, Maynooth, Co. Kildare, Ireland.
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26
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Davey GCL. Disgust: the disease-avoidance emotion and its dysfunctions. Philos Trans R Soc Lond B Biol Sci 2012; 366:3453-65. [PMID: 22042921 DOI: 10.1098/rstb.2011.0039] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This review analyses the accumulating evidence from psychological, psychophysiological, neurobiological and cognitive studies suggesting that the disease-avoidance emotion of disgust is a predominant emotion experienced in a number of psychopathologies. Current evidence suggests that disgust is significantly related to small animal phobias (particularly spider phobia), blood-injection-injury phobia and obsessive-compulsive disorder contamination fears, and these are all disorders that have primary disgust elicitors as a significant component of their psychopathology. Disgust propensity and sensitivity are also significantly associated with measures of a number of other psychopathologies, including eating disorders, sexual dysfunctions, hypochondriasis, height phobia, claustrophobia, separation anxiety, agoraphobia and symptoms of schizophrenia--even though many of these psychopathologies do not share the disease-avoidance functionality that characterizes disgust. There is accumulating evidence that disgust does represent an important vulnerability factor for many of these psychopathologies, but when disgust-relevant psychopathologies do meet the criteria required for clinical diagnosis, they are characterized by significant levels of both disgust and fear/anxiety. Finally, it has been argued that disgust may also facilitate anxiety and distress across a broad range of psychopathologies through its involvement in more complex human emotions such as shame and guilt, and through its effect as a negative affect emotion generating threat-interpretation biases.
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Affiliation(s)
- Graham C L Davey
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK.
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27
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Taberner J, Fullana MA, Caseras X, Pertusa A, Bados A, van den Bree M, Torrubia R. Familial Predictors of Obsessive-Compulsive Symptom Dimensions (Contamination/Cleaning and Symmetry/Ordering) in a Nonclinical Sample. J Clin Psychol 2012; 68:1266-75. [DOI: 10.1002/jclp.21861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | - Alberto Pertusa
- Division of Psychological Medicine; King's College London; Institute of Psychiatry; London; UK
| | - Arturo Bados
- Department of Personality; Assessment and Psychological Treatment; University of Barcelona; Spain
| | | | - Rafael Torrubia
- Department of Psychiatry; Autonomous University of Barcelona; Barcelona; Spain
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An Evaluation of Obsessive Beliefs as Predictors of Performance on In Vivo Assessments of Obsessive–Compulsive Symptoms. COGNITIVE THERAPY AND RESEARCH 2012. [DOI: 10.1007/s10608-012-9457-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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29
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Kim EH, Ebesutani C, Young J, Olatunji BO. Factor Structure of the Disgust Scale–Revised in an Adolescent Sample. Assessment 2012; 20:620-31. [PMID: 22290443 DOI: 10.1177/1073191111434200] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although recent research with the Disgust Scale–Revised (DS-R) has contributed to current knowledge regarding the structure of disgust, this line of research has exclusively employed adult samples. The current study extended existing research by examining the factor structure of the DS-R in an adolescent sample ( N = 637). Exploratory factor analysis revealed three factors: Contagion, Mortality, and Contact Disgust. Subsequent to removing three items due to inadequate factor loadings, confirmatory factor analysis provided support for the 3-factor model across gender, grade level, and racial subgroups. Tests of item–intercept invariance also revealed no differences in item means across grade level. However, three and four items were associated with differences across race and gender, respectively. Latent factor means were also found to be invariant across racial groups and grade level, but not across gender. Implications of the DS-R factor structure in this adolescent sample and its domains are discussed.
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Affiliation(s)
- Eun Ha Kim
- University of Mississippi, University, MS, USA
| | - Chad Ebesutani
- Department of Psychology, Duksung University, Seoul, South Korea
| | - John Young
- University of Mississippi, University, MS, USA
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30
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Armstrong T, Tomarken AJ, Olatunji BO. The moderating effects of contamination sensitivity on state affect and information processing: Examination of disgust specificity. Cogn Emot 2012; 26:136-43. [DOI: 10.1080/02699931.2011.561296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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Olatunji BO, Ebesutani C, David B, Fan Q, McGrath PB. Disgust proneness and obsessive-compulsive symptoms in a clinical sample: structural differentiation from negative affect. J Anxiety Disord 2011; 25:932-8. [PMID: 21696916 DOI: 10.1016/j.janxdis.2011.05.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 03/31/2011] [Accepted: 05/26/2011] [Indexed: 10/18/2022]
Abstract
Although a growing body of research has revealed robust associations between disgust and obsessive-compulsive disorder (OCD) symptoms, there remains a paucity of research examining the specificity of this association in clinical samples. The present study employed structural equation modeling to differentiate disgust from negative affect in the prediction of OCD symptoms in a clinical sample (n=153). Results indicate that disgust and negative affect latent factors were independently related to OCD symptoms. However, when both variables were simultaneously modeled as predictors, latent disgust remained significantly associated with OCD symptoms, whereas the association between latent negative affect and OCD symptoms became nonsignificant. Multiple statistical tests of mediation converged in support of disgust as a significant intervening variable between negative affect and OCD symptoms. The implications of these findings for further delineating the role of individual differences in disgust proneness in the development of OCD are discussed.
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Affiliation(s)
- Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, 111 21st Avenue South, Nashville, TN 37203, USA.
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32
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Specificity of disgust vulnerability in the distinction and treatment of OCD. J Psychiatr Res 2011; 45:1236-42. [PMID: 21353249 PMCID: PMC3118257 DOI: 10.1016/j.jpsychires.2011.01.018] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 01/27/2011] [Accepted: 01/28/2011] [Indexed: 11/20/2022]
Abstract
A growing body of research has implicated disgust as a potential risk factor for the development and maintenance of obsessive-compulsive disorder (OCD). The first aim of the present study was to determine whether related, yet distinct, disgust vulnerabilities are endorsed more strongly by individuals with OCD than by those with another anxiety disorder. The second aim was to examine the unique contributions of changes in disgust to symptom improvement observed with exposure-based treatment for OCD. In study 1, individuals with OCD, generalized anxiety disorder (GAD), and nonclinical controls (NCCs) completed a measure of disgust propensity and disgust sensitivity. Compared to NCCs and individuals with GAD, those with OCD more strongly endorsed disgust propensity. However, individuals with OCD did not significantly differ from individuals with GAD in disgust sensitivity, although both groups reported significantly higher disgust sensitivity levels compared to NCCs. Study 2 comprised mediation analyses of symptom improvement among individuals with OCD and revealed that decreases in disgust propensity over time mediated improvement in OCD symptoms, even after controlling for improvements in negative affect. The implications of these findings for conceptualizing the role of disgust in the nature and treatment of OCD are discussed.
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33
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Cisler JM, Adams TG, Brady RE, Bridges AJ, Lohr JM, Olatunji BO. Unique affective and cognitive processes in contamination appraisals: Implications for contamination fear. J Anxiety Disord 2011; 25:28-35. [PMID: 20691567 PMCID: PMC3066658 DOI: 10.1016/j.janxdis.2010.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 07/07/2010] [Accepted: 07/09/2010] [Indexed: 11/26/2022]
Abstract
A large body of evidence suggests an important role of disgust in contamination fear (CF). A separate line of research implicates various cognitive mechanisms in contamination fear, including obsessive beliefs, memory biases, and delayed attentional disengagement from threat. This study is an initial attempt to integrate these two lines of research and examines whether disgust and delayed attention disengagement from threat explain unique or overlapping processes within CF. Non-clinical undergraduate students (N = 108) completed a spatial cueing task, which provided measures of delayed disengagement from frightening and disgusting cues, and a self-report measure of disgust propensity (DP). Participants also completed a chain of contagion task, in which they provided contamination appraisals of an object as a function of degrees of removal from an initial contaminant. Results demonstrated that DP predicted greater initial contamination appraisals, but a sharper decline in estimations across further degrees of removal from the contaminant. Delayed disengagement from disgust cues uniquely predicted sustained elevations in contamination estimations across further degrees of removal from the contaminant. These results suggest that DP and delayed disengagement from disgust cues explain unique and complimentary processes in contamination appraisals, which suggests the utility of incorporating the disparate affective and cognitive lines of research on CF.
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Affiliation(s)
- Josh M. Cisler
- University of Arkansas
,University of Arkansas for Medical Sciences, Brain Imaging Research Center
,To whom correspondence should be directed: 216 Memorial Hall, Department of Psychology, University of Arkansas, Fayetteville, AR, 72701;
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34
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Olatunji BO, Moretz MW, Wolitzky-Taylor KB, McKay D, McGrath PB, Ciesielski BG. Disgust vulnerability and symptoms of contamination-based OCD: descriptive tests of incremental specificity. Behav Ther 2010; 41:475-90. [PMID: 21035612 DOI: 10.1016/j.beth.2009.11.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 11/13/2009] [Accepted: 11/14/2009] [Indexed: 10/19/2022]
Abstract
The present investigation examines the incremental association between disgust propensity and sensitivity and contamination-based obsessive-compulsive disorder (OCD) symptoms. Structural equation modeling in Study 1 indicated that general disgust was related to contamination fear even when controlling for negative affect in a nonclinical sample. Evidence was also found for a model in which the effect of negative affect on contamination fear is mediated by general disgust. Study 1 also showed that both disgust sensitivity and disgust propensity uniquely predicted contamination fear when controlling for negative affect. Growth curve analyses in Study 2 indicated that higher baseline contamination fear is associated with less reduction in contamination fear over a 6-week period as disgust sensitivity increases even when controlling for negative affect. Lastly, disgust propensity was associated with concurrent levels of excessive washing symptoms among patients with OCD in Study 3 when controlling for depression. Implications of these findings from nonclinical, analogue, and clinical samples for future research on the specificity of disgust-related vulnerabilities in the etiology of contamination concerns in OCD are discussed.
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Affiliation(s)
- Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, 111 21st Avenue South, Nashville, TN 37203, USA.
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35
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Disgust Propensity as a Predictor of Intrusive Cognitions Following a Distressing Film. COGNITIVE THERAPY AND RESEARCH 2010; 36:190-198. [PMID: 22661795 PMCID: PMC3348448 DOI: 10.1007/s10608-010-9331-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although extant research examining predictors of development of Posttraumatic Stress Disorder (PTSD) have focused primarily on fear and anxiety, recent research suggests that a range of different emotional reactions may occur in response to traumatic events. For example, specific aspects of traumatic exposure frequently include either experiencing or witnessing events that may elicit disgust, including injury, death, or sexual assault (e.g., Dalgleish and Power in Behav Res Ther Spec Issue Festschrift Spec Issue John Teasdale 42(9):1069–1088, 2004); McNally in J Anxiety Disord 16(5):561–566, 2002). However, no published research has specifically examined the role of disgust propensity in the development and maintenance of PTSD. Thus, the aim of the present study was to evaluate the relationship between disgust propensity and intrusive symptoms. To this end, 30 undergraduates without symptoms of PTSD were recruited to participate in a distressing film paradigm (for a review of this paradigm see Holmes and Bourne in Acta Psychol 127(3):553–566, 2008). Anxiety, depression, and trait disgust scores were entered hierarchically into a regression equation to predict the number of intrusions during a post-film thought monitoring period. Results indicated that disgust propensity predicted intrusions independent of anxiety and depression. Although still preliminary, results suggest that disgust propensity may be one factor that predicts frequency of intrusive memories after witnessing injury or bodily harm.
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36
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Changes in disgust correspond with changes in symptoms of contamination-based OCD: a prospective examination of specificity. J Anxiety Disord 2010; 24:313-7. [PMID: 20097515 DOI: 10.1016/j.janxdis.2010.01.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 12/29/2009] [Accepted: 01/05/2010] [Indexed: 11/22/2022]
Abstract
Although several studies have implicated disgust in contamination-based obsessive-compulsive disorder (OCD), there remains a paucity of research examining this relationship prospectively. To address this gap in the literature, undergraduate students (n=177) participated in a 12-week prospective study for which they completed measures of contamination-based OCD symptoms, disgust, and negative affect. Change in disgust levels over the 12-week period predicted change in symptoms of contamination-based OCD, even when controlling for age, gender, and change in negative affect. However, this association was driven by change in the perceived negative impact of experiencing disgust (disgust sensitivity) rather than change in the intensity that disgust is generally experienced (disgust propensity). Subsequent analyses also revealed that change in disgust sensitivity fully mediated the association between change in disgust propensity and change in symptoms of contamination-based OCD. The implications of these findings for further delineating the causal role of disgust-related vulnerabilities in contamination-based OCD are discussed.
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37
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Olatunji BO, Cisler J, McKay D, Phillips ML. Is disgust associated with psychopathology? Emerging research in the anxiety disorders. Psychiatry Res 2010; 175:1-10. [PMID: 19969378 DOI: 10.1016/j.psychres.2009.04.007] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 03/25/2009] [Accepted: 04/15/2009] [Indexed: 10/20/2022]
Abstract
Recent evidence indicates that the propensity towards experiencing disgust may contribute to the development and maintenance of some anxiety disorders. This article summarizes the empirical evidence with emphasis on illuminating potential mediators, moderators, and mechanisms of the disgust-anxiety disorder association that may inform the development of an integrative conceptual model. Early research using neuroimaging methods suggest that disgust processing is associated with activation of the insula. This research has the potential to facilitate progress in developing an empirically informed psychobiological theory on the causal role of disgust in the anxiety disorders.
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Affiliation(s)
- Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA.
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38
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Incremental specificity of disgust sensitivity in the prediction of obsessive-compulsive disorder symptoms: Cross-sectional and prospective approaches. J Behav Ther Exp Psychiatry 2009; 40:533-43. [PMID: 19683221 DOI: 10.1016/j.jbtep.2009.07.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Revised: 05/15/2009] [Accepted: 07/24/2009] [Indexed: 11/21/2022]
Abstract
The present study examines the association between disgust sensitivity (DS) and obsessive-compulsive disorder (OCD) symptoms in two non-clinical samples. Findings from Study 1 (n=270) revealed a significant association between DS and OCD symptoms even after controlling for negative affect and anxiety sensitivity. Subsequent analysis also revealed a specific association between DS and the washing subtype of OCD symptoms when controlling for other OCD symptom dimensions. DS did not significantly predict residual change in total symptoms of OCD over a 12-week period (n=300) when controlling for risk factors for anxiety disorder symptoms in general (e.g., negative affect, anxiety sensitivity) and OCD specifically (e.g., obsessive beliefs) in Study 2. However, exploratory analyses suggest that DS may be predictive of residual change in some OCD symptom subtypes but not others. Implications of these findings for future research on the role of disgust in OCD are discussed.
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39
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Davey GCL, Chapman L. Disgust and eating disorder symptomatology in a non-clinical population: the role of trait anxiety and anxiety sensitivity. Clin Psychol Psychother 2009; 16:268-75. [PMID: 19639650 DOI: 10.1002/cpp.623] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The present paper reports the results of a study investigating the relationship between a domains-independent measure of disgust (the Disgust Propensity and Sensitivity Scale-Revised) and measures of eating disorder symptomatology in a non-clinical population. Significant correlations between disgust sensitivity and disgust propensity and selected eating disorder symptomatology measures suggested that disgust is significantly correlated with measures of eating disorder symptomatology and is appraised more negatively. However, both measures of disgust propensity and sensitivity failed to predict any significant residual variance in scores on eating symptomatology measures when either trait anxiety or anxiety sensitivity was controlled for. This suggests that while the experience of disgust may be heightened in individuals with eating disorders, it may be linked to other relevant emotions such as anxiety and anxiety sensitivity rather than being an independent risk factor for symptoms.
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40
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Fear and disgust processing during repeated exposure to threat-relevant stimuli in spider phobia. Behav Res Ther 2009; 47:671-9. [DOI: 10.1016/j.brat.2009.04.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 01/27/2009] [Accepted: 04/30/2009] [Indexed: 11/20/2022]
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41
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Ouimet AJ, Gawronski B, Dozois DJ. Cognitive vulnerability to anxiety: A review and an integrative model. Clin Psychol Rev 2009; 29:459-70. [DOI: 10.1016/j.cpr.2009.05.004] [Citation(s) in RCA: 170] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Revised: 05/05/2009] [Accepted: 05/30/2009] [Indexed: 12/16/2022]
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Cisler JM, Brady RE, Olatunji BO, Lohr JM. Disgust and Obsessive Beliefs in Contamination-related OCD. COGNITIVE THERAPY AND RESEARCH 2009; 34:439-448. [PMID: 20877585 DOI: 10.1007/s10608-009-9253-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A large body of evidence suggests that disgust is an important affective process underlying contamination fear. An independent line of research demonstrates that obsessive beliefs, particularly overestimations of threat, are also an important cognitive process underlying contamination fear. The present study attempts to integrate these two lines of research by testing whether obsessive beliefs potentiate the influence of disgust propensity on contamination fear. The interaction between disgust propensity and obsessive beliefs was tested in two large non-clinical samples (N = 252 in Study 1; N = 308 in Study 2) using two different self-report measures of contamination fear. Regression analyses supported the hypotheses in both samples. The interaction remained significant when controlling for negative affect. The results are hypothesized to suggest that contamination fear results, at least partly, from obsessive beliefs about the contamination-based appraisals that accompany heightened disgust responding. These results complement previous affective-driven explanations of the role of disgust in contamination fear by suggesting cognitive factors that similarly potentiate disgust's role in contamination fear.
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Disgust Sensitivity and Psychopathological Symptoms: Distinctions from Harm Avoidance. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2008. [DOI: 10.1007/s10862-008-9096-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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