Disgust, fear, and the anxiety disorders: a critical review

Conceptual-level disgust conditioning in contamination-based obsessive-compulsive disorder

Pavlovian fear conditioning and extinction represent learning mechanisms underlying exposure-based interventions. While increasing evidence indicates a pivotal role of disgust in the development of contamination-based obsessive-compulsive disorder (C-OCD), dysregulations in conditioned disgust acquisition and maintenance, in particular driven by higher-order conceptual processes, have not been examined. Here, we address this gap by exposing individuals with high (HCC, n = 41) or low (LCC, n = 41) contamination concern to a conceptual-level disgust conditioning and extinction paradigm. Conditioned stimuli (CS+) were images from one conceptual category partially reinforced by unconditioned disgust-eliciting stimuli (US), while images from another category served as non-reinforced conditioned stimuli (CS-). Skin conductance responses (SCRs), US expectancy and CS valence ratings served as primary outcomes to quantify conditioned disgust responses. Relative to LCC, HCC individuals exhibited increased US expectancy and CS+ disgust experience, but comparable SCR levels following disgust acquisition. Despite a decrease in conditioned responses from the acquisition phase to the extinction phase, both groups did not fully extinguish the learned disgust. Importantly, the extinction resilience of acquired disgust was more pronounced in HCC individuals. Together, our findings suggest that individuals with high self-reported contamination concern exhibit increased disgust acquisition and resistance to extinction. The findings provide preliminary evidence on how dysregulated disgust learning mechanism across semantically related concepts may contribute to C-OCD.

Association between Disgust Sensitivity during Pregnancy and Endogenous Steroids: A Longitudinal Study

The emotion of disgust protects individuals against pathogens, and it has been found to be elevated during pregnancy. Physiological mechanisms discussed in relation to these changes include immune markers and progesterone levels. This study aimed to assess the association between steroids and disgust sensitivity in pregnancy. Using a prospective longitudinal design, we analyzed blood serum steroid concentrations and measured disgust sensitivity via text-based questionnaires in a sample of 179 pregnant women during their first and third trimesters. We found positive correlations between disgust sensitivity and the levels of C19 steroids (including testosterone) and its precursors in the Δ5 pathway (androstenediol, DHEA, and their sulfates) and the Δ4 pathway (androstenedione). Additionally, positive correlations were observed with 5α/β-reduced C19 steroid metabolites in both trimesters. In the first trimester, disgust sensitivity was positively associated with 17-hydroxypregnanolone and with some estrogens. In the third trimester, positive associations were observed with cortisol and immunoprotective Δ5 C19 7α/β-hydroxy-steroids. Our findings show that disgust sensitivity is positively correlated with immunomodulatory steroids, and in the third trimester, with steroids which may be related to potential maternal-anxiety-related symptoms. This study highlights the complex relationship between hormonal changes and disgust sensitivity during pregnancy.

Is disgust more resistant to extinction than fear? A meta-analytic review of laboratory paradigms

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.

Examining reciprocal relations between disgust proneness and OCD symptoms: A four-wave longitudinal study

BACKGROUND AND OBJECTIVES

Although disgust proneness has been implicated in the development of obsessive-compulsive disorder (OCD), available studies have largely employed cross-sectional designs and the prospective and potentially reciprocal association between disgust proneness and OCD symptoms remains unclear. The present study employs cross lagged panel analysis to examine the prospective and reciprocal association between disgust proneness and OCD symptoms.

METHOD

A community sample of adults (N = 307) completed symptom measures of disgust proneness and OCD symptoms at four time points with 1 month intervals.

RESULTS

The results showed that the cross-lagged paths from disgust proneness to OCD symptoms were significant (average β = 0.07, p's < 0.001) when controlling for depression. However, the paths from total OCD symptoms to disgust proneness were not significant. In contrast, the cross-lagged paths from disgust proneness to washing OCD symptoms were not significant. However, the paths from washing OCD symptoms to disgust proneness were significant (average β = 0.05, p's < 0.01) when controlling for depression.

LIMITATIONS

The study is limited is limited by exclusive reliance on self-report in a nonclinical sample.

CONCLUSIONS

The findings offer preliminary evidence suggesting that disgust proneness may be a cause and consequence of OCD depending on the nature of the symptoms. Thus, the longitudinal relation between disgust proneness and OCD may be transactional where one influences the effect of the other.

Validation of the open biological negative image set for a Portuguese population: Comparing Japanese and Portuguese samples and an exploration of low-order visual properties of the stimuli

Recently, Shirai and Watanabe Royal Society Open Science, 9(1), 211128 (2022) developed OBNIS (Open Biological Negative Image Set), a comprehensive database containing images (primarily animals but also fruits, mushrooms, and vegetables) that visually elicit disgust, fear, or neither. OBNIS was initially validated for a Japanese population. In this article, we validated the color version of OBNIS for a Portuguese population. In study 1, the methodology of the original article was used. This allowed direct comparisons between the Portuguese and Japanese populations. Aside from a few emotional classification mismatches between disgust, fear, or neither-related images, we found that arousal and valence relate distinctively in both populations. In contrast to the Japanese sample, the Portuguese reported increased arousal for more positive valenced stimuli, suggesting that OBNIS images elicit positive emotions in the Portuguese population. These results showed important cross-cultural differences regarding OBNIS. In study 2, a methodological change was introduced: instead of the three classification options used originally (fear, disgust, or neither), six basic emotions were used (fear, disgust, sadness, surprise, anger, happiness), and a "neither" option, to confirm whether some of the originally "neither-related" images are associated with positive emotions (happiness). Additionally, the low-order visual properties of images (luminosity, contrast, chromatic complexity, and spatial frequency distribution) were explored due to their important role in emotion-related research. A fourth image group associated with happiness was found in the Portuguese sample. Moreover, image groups present differences regarding the low-order visual characteristics, which are correlated with arousal and valence ratings, highlighting the importance of controlling such characteristics in emotion-related research.

Human emotional evaluation of ancestral and modern threats: fear, disgust, and anger

Introduction

Animal and human ancestors developed complex physiological and behavioral response systems to cope with two types of threats: immediate physical harm from predators or conspecifics, triggering fear, and the risk of infections from parasites and pathogens leading to the evolution of the behavioral immune system with disgust as the key emotion. Integration of the evolutionary concepts of the fear module and behavioral immune systems has been infrequent, despite the significant survival advantages of disgust in various contexts. Studies comparing attention to ancestral and modern threats accompanied by fear have yielded ambiguous results and what qualifies as salient modern disgusting stimuli remains unclear. We do not know whether disgust or the behavioral immune system, as inherent aspects of human psychology, have adapted to safeguard us from pandemic risks or poisoning by modern toxic substances.

Methods

To test these effects, we have developed a survey comprised of 60 short vignettes describing threats evoking fear and disgust belonging to one of the three main categories of threats: (1) ancestral (phylogenetic), (2) modern (ontogenetic), and (3) pandemics of airborne disease. Each vignette was evaluated on a 7-point Likert scale based on fear, disgust, and anger. In total, 660 respondents completed the survey. The data were analysed using a factor analysis and general linear model with the respondent as a random factor.

Results

The results show that the strongest fear is triggered by modern threats (electricity, car accidents), while the highest disgust is evoked by ancient threats (body waste products, worms, etc.). Interestingly, disgust does not respond to modern threat stimuli such as toxic substances or radioactivity as these evoke mainly fear and anger. Finally, a distinct response pattern was found for pandemic threats, in which both fear (e.g., of disease and death) and disgust (e.g., of used face masks) are employed.

Discussion

Our study offers valuable insights into the emotional responses to ancestral and modern threats and their adaptation to pandemic challenges. Ancestral threats are not always more powerful stimuli than adequate threats of the modern type, but they function specifically. Thus, snakes and heights as fear-inducing ancestral threats form separate factors in a multivariate analysis, whereas all ancestral disgust stimuli group together. The threat of a pandemic forms a specific category and people process it emotionally and cognitively. These insights contribute to our understanding of human psychology and behavior in an ever-changing world.

Conscious knowledge of CS-UCS contingency information affects extinction retrieval of conditioned disgust responses: Findings from an online de novo disgust conditioning task

Objective

The present study aimed to establish and develop an online de novo conditioning paradigm for the measurement of conditioned disgust responses. We further explored the effects of explicit instructions about the CS-UCS contingency on extinction learning and retrieval of conditioned disgust responses.

Method

The study included a sample of 115 healthy participants. Geometric figures served as conditioned stimuli (CS) and disgust-evoking pictures as unconditioned stimuli (UCS). During disgust conditioning, the CS+ was paired with the UCS (66% reinforcement) and the CS- remained unpaired; during extinction and retrieval, no UCS was presented. Half of the participants (n = 54) received instructions prior to the disgust extinction stating that the UCS will not be presented anymore. 1-2 days or 7-8 days later participants performed a retrieval test. CS-UCS contingency, disgust and valence ratings were used as dependent measures.

Results

Successful acquisition of conditioned disgust response was observed on the level of CS-UCS contingency, disgust and valence ratings. While some decline in valence and disgust ratings during the extinction stage was observed, contingency instructions did not significantly affect extinction performance. Retrieval one week later revealed that contingency instructions increased the discrimination of the CSs.

Conclusions

Extinction of conditioned disgust responses is not affected by explicit knowledge of the CS-UCS contingencies. However, contingency instructions prior to extinction seem to have a detrimental effect on long-term extinction retrieval.

Attenuating experimentally acquired disgust: Comparing counterconditioning, exposure and unconditioned stimulus revaluation

BACKGROUND AND OBJECTIVES

Disgust is implicated in the aetiology and maintenance of various psychopathologies such as anxiety disorders and obsessive-compulsive disorders. Despite its prominent role in psychopathology, little is known about how to effectively attenuate disgust. The study examined strategies to modify an experimentally acquired disgust response in a sample of undergraduate students.

METHODS

A conditioning paradigm was used where participants (N = 175) first underwent acquisition of disgust via repeated presentations of a neutral picture (functioning as conditioned stimulus + [CS+]) paired with a disgusting picture (functioning as unconditioned stimulus [US]). Participants were then randomly assigned to either an exposure (repeated presentation of CS-only trials), counterconditioning (pairing CS+ with pleasant pictures), US revaluation (pairing disgusting US with pleasant pictures) or a control (filler task) condition. We hypothesised that counterconditioning would attenuate evaluative learned disgust to the greatest extent, relative to exposure and US revaluation. Participants' evaluations of the pictures were attained with a disgust-pleasantness visual analogue scale.

RESULTS

Exposure, counterconditioning and US revaluation reduced disgusting US expectancies. However, experimental and control conditions did not differ in terms of attenuating disgust towards CS+.

LIMITATIONS

Measures of psychopathology and implicit evaluations of disgust were not collected. Modest power might have limited significance of the results.

CONCLUSIONS

No statistical support for the effectiveness of disgust attenuation following exposure nor counterconditioning were found. Findings for US revaluation are inconclusive. Implications for future research are discussed.

Fear of clowns: An investigation into the aetiology of coulrophobia

Introduction

Fear of clowns or coulrophobia is a little understood phenomenon despite studies indicating that it has a high prevalence in the general population. There have been no previous investigations into the aetiology of this fear, although several plausible hypotheses from the wider literature can be generated; the fear stems from media portrayals of scary clowns, from the unusual physical appearance or the unpredictable behaviour displayed, or it derives from an unpleasant personal experience.

Methods

The current study reviews the literature in this area and also pilots a new questionnaire (Origin of Fear of Clowns Questionnaire; OFCQ) to explore the causes of the fear of clowns in a sample of 528 participants who reported such a fear.

Results

Our findings suggest that uncertainty of harmful intent, media influences and unpredictability of behaviour play an important role in the origins of coulrophobia. There are also multiple features of clown appearance which produce a negative experiential state and a sense of a direct threat.

Discussion

We conclude that the origins of clown fear are multi-factorial and primarily relate to aspects of their facial appearance, their behaviour, and how they have been portrayed in the media. Surprisingly, fear derived from personal experience was not one of our main findings. Further research is focused on looking at associations between the level of fear and each aetiological category.

Pavlovian Disgust Conditioning and Generalization: Specificity and Associations With Individual Differences

Although studies have identified differences between fear and disgust conditioning, much less is known about the generalization of conditioned disgust. This is an important gap in the literature given that overgeneralization of conditioned disgust to neutral stimuli may have clinical implications. To address this knowledge gap, female participants (n = 80) completed a Pavlovian conditioning procedure in which one neutral food item (conditioned stimulus; CS+) was followed by disgusting videos of individuals vomiting (unconditioned stimulus; US) and another neutral food item (CS-) was not reinforced with the disgusting video. Following this acquisition phase, there was an extinction phase in which both CSs were presented unreinforced. Importantly, participants also evaluated generalization stimuli (GS+, GS-) that resembled, but were distinct from, the CS after each conditioning phase. As predicted, the CS+ was rated as significantly more disgusting and fear inducing than the CS- after acquisition and this pattern persisted after extinction. However, disgust ratings of the CS+ after acquisition were significantly larger than fear ratings. Participants also rated the GS+ as significantly more disgusting, but not fear inducing, than the GS- after acquisition. However, this effect was not observed after extinction. Disgust proneness did predict a greater increase in disgust and fear ratings of the CS+ relative to the CS- after acquisition and extinction. In contrast, trait anxiety predicted only higher fear ratings to the CS+ relative to the CS- after acquisition and extinction. Disgust proneness nor trait anxiety predicted the greater increase in disgust to the GS+ relative to the GS- after acquisition. These findings suggest that while conditioned disgust can generalize, individual difference variables that predict generalization remain unclear. The implications of these findings for disorders of disgust are discussed.

The role of self-reported fear and disgust in the activation of behavioral harm avoidance related to medical settings

INTRODUCTION

Although adaptive defense mechanisms are useful in helping us avoid getting injured, they are also triggered by medical interventions and procedures, when avoidance is harmful. A body of previous results showed that both fear and disgust play a pivotal role in medical avoidance. However, the underlying mechanisms are not fully understood. Thus, the aim of the current study was to examine the effects of experience, perceived control, and pain on medical avoidance with disgust and fear as mediating factors from an evolutionary perspective.

METHODS

We assessed participants' knowledge of and experience with medical procedures, former negative medical experiences, and health-related information; their life history strategy variation; pain-related fear and anxiety of medical procedures; perceived control over emotional reactions and extreme threats; disgust sensitivity; blood-injury-injection phobia and medical treatment avoidance.

RESULTS

We found that more knowledge, experience, and a slower life strategy were linked to a greater level of perceived control and attenuated emotional reactions. Further, better ability to control affective and stress reactions to negative experiences was linked to reduced disgust and fear of pain, and thus might mitigate the level of perceived threat, and diminish fear and disgust reactions.

DISCUSSION

More knowledge and experiences, better perceived control together with reduced disgust and fear of pain can decrease the probability of avoiding medical situations. Implications to treatment are discussed. Results support the importance of targeting these contextual factors in prevention to increase the likelihood of people attending regular screenings or seeking medical care when needed.

Opposite effects of estradiol and progesterone on woman's disgust processing

Background

Ovarian hormones play a critical role in emotion processing, which may be a major reason for the high rates of major depressive disorders in women. However, the exact roles of estradiol and progesterone in emotional processing remain unclear. To this end, we performed behavioral and rs-fMRI studies on the effects ovarian hormones on disgust emotion.

Methods

In Experiment 1, 95 Chinese female undergraduates completed the single category implicit association test (SC-IAT) and explicit measures of disgust intensity task, 32 in the menstrual phase, 30 in the follicular phase, and 33 in the luteal phase. In Experiment 2, A total of 25 healthy female undergraduates completed three sessions of the rs-fMRI. The menstrual group was scanned during cycle days 2-5, the follicular group during cycle during days 10-13, and the luteal group was scanned 3-7 days before the next menstruation.

Results

The behavioral results showed that women during the luteal phase had higher D scores and shorter response times (RTs) to disgust stimuli compared to the menses and follicular phases. In contrast, women during the follicular phase had fewer feelings of disgust and longer RTs to pathogen stimuli compared with that during the menses and luteal phases, but this effect was moderated by the intensity of the stimuli. rs-fMRI studies showed that women during the luteal phase have higher functional connectivity in the salience network than those in the follicular phase. Compared with the menstrual phase, women have lower functional connectivity in the amygdala during the follicular phase.

Conclusion

In summary, a more negative attitude to disgust stimuli and the enhanced functional connectivity of the salience network during the luteal phase may be associated with high progesterone levels, whereas lower disgust feelings and reduced functional connectivity of the amygdala during the follicular phase may be associated with high estradiol levels.

Similarities and differences in the induction and regulation of the negative emotions fear and disgust: A functional near infrared spectroscopy study

Affective processing, including induction and regulation of emotion, activates neural networks, induces physiological responses, and generates subjective experience. Dysregulation of these processes can lead to maladaptive behavior and even psychiatric morbidity. Multimodal studies of emotion thus not only help elucidate the nature of emotion, but also contribute to important clinical insights. In the present study, we compared the induction (EI) and effortful regulation (ER) with reappraisal of fear and disgust in healthy subjects using functional near infrared spectroscopy (fNIRS) in conjunction with electrodermal activity (EDA). During EI, there was significant activation in medial prefrontal cortex (PFC) for fear and more widespread activation for disgust, with right lateral PFC significantly more active during disgust compared to fear. ER was equally effective for fear and disgust reducing subjective emotion rating by roughly 45%. Compared to baseline, there was no increased PFC activity for fear during ER, while for disgust lateral PFC was significantly more active. Significant differences between the two negative emotions were also observed in sympathetic nerve activity as reflected in EDA during EI, but not during ER. Lastly, compared to men, women had higher emotion rating for both fear and disgust without corresponding differences in EDA. In conclusion, in the present study we show that emotion induction was associated with differential activation in both PFC and sympathetic nerve activity for fear and disgust. These differences were however less prominent during emotion regulation. We discuss the potential interpretation of our results and their implications regarding our understanding of negative emotion processing.

The Development of Disgust and Its Relationship to Adolescent Psychosocial Functioning

Experiences of excessive disgust have been implicated in several psychopathologies. Research, however, has rarely examined disgust and its role in psychosocial functioning from a developmental standpoint. This study examines the relationship between disgust expression in early life and subsequent adolescent psychosocial functioning. Data from 165 children were collected as part of a longitudinal study. Disgust propensity in infancy and childhood was assessed using a facial expressivity task and food aversion task, respectively. Adolescent psychosocial functioning was measured through several self-report measures. Results suggest that there exists a degree of consistency in disgust expression within the first year of life, and that childhood disgust propensity may be related to impairment in early adolescent psychosocial functioning. These findings highlight the potential importance of identifying early disgust expression as a marker for later psychopathology.

Excitation Transfer Between Sexual Arousal and Other Emotions in a Community Sample

Excitation transfer, the transfer of arousal from one emotion to another, might be a mechanism in the development of unusual sexual interests. In this pilot study, we investigated whether we could induce excitation transfer between various emotions and sexual arousal in a laboratory setting with 30 male volunteers. We induced low-level sexual arousal in four different emotional states (aggression/dominance, endearment, fear, disgust) and a neutral state. Sexual arousal was measured using penile plethysmography and self-report. Although there was no mean group effect, possibly due to large interindividual variations, 60% of the subjects showed more sexual arousal in response to sexual stimulation in at least one of the emotional states than in the neutral state. Excitation transfer was most prominent with aggression/dominance and least prominent with disgust. Genital excitation transfer was strongly related to lower penile reactivity and to higher self-reported erotophilia. This pilot study paves the way for further research into excitation transfer as a mechanism to increase the salience of stimuli that otherwise would not have been sexual in nature.

Is negative e-WOM more powerful? Multimodal data analysis on air passengers’ perception of COVID-19 safety measures

During the normalization stage of the COVID-19 epidemic prevention and control, the safety threats caused by improper epidemic prevention measures of airlines have become the primary concern for air passengers. Negative e-WOM related to safety perception obtained based on online multimodal reviews of travel websites has become an important decision-making basis for potential air passengers when making airline choices. This study aims to examine the relationship between potential air passengers’ negative safety perception and the usefulness of online reviews, as well as to test the moderating effect of review modality and airline type. It also further explores the effectiveness and feasibility of applying big data sentiment analysis to e-WOM management. To this end, the theoretical model of negative safety perception, review modality, and airline type affecting review usefulness was constructed. Then we select 10 low-cost airlines and 10 full-service airlines, respectively, according to the number of reviews sorted by the TripAdvisor website, and use crawling techniques to obtain 10,485 reviews related to COVID-19 safety of the above companies from December 2019 to date, and conduct safety perception sentiment analysis based on Python’s Textblob library. Finally, to avoid data overdispersion, the model is empirically analyzed by negative binomial regression using R software. The results indicate that (1) Negative safety perception significantly and negatively affects review usefulness, that is, extreme negative safety perception can provide higher review usefulness for potential air passengers. (2) Review modality and airline type have a significant moderating effect on the relationship between negative safety perception and review usefulness, in which multimodal reviews and full-service airlines both weakened the negative impact of negative safety perception on review usefulness. The theoretical model in this paper is both an extension of the application of big data sentiment analysis techniques and a beneficial supplement to current research findings of e-WOM, providing an important reference for potential air passengers to identify useful reviews accurately and thus reduce safety risks in online decision-making.

What determines online rumour sharing on COVID-19? A stimulus–response framework

Based on the stimulus–response framework, this study examines the external environmental stimuli influencing online rumour sharing about COVID-19 and considers the contingent effect of fear. A large-scale online survey was used to test the proposed research model and hypotheses. The final data set comprised 2807 valid responses. The results indicate that perceptions of community safety and infection risk negatively affect online rumour sharing, while social influence positively affects online rumour sharing. Fear weakens the negative effects of community safety on online rumour sharing but strengthens the positive effect of social influence on online rumour sharing. This study provides a comprehensive analysis by applying the stimulus–response framework to explore the underlying drivers of online rumour sharing with regard to COVID-19 and the moderating effects of fear in the Chinese context.

Exposure and Response Prevention in Virtual Reality for Patients with Contamination-Related Obsessive-Compulsive Disorder: a Case Series

Exposure therapy in virtual reality is successful in treating anxiety disorders. Studies on exposure and response prevention in virtual reality (VERP) in obsessive-compulsive disorder (OCD) are rare, and it is unclear whether distress associated with other emotions than anxiety (e.g., disgust) can be evoked. The present study aimed to investigate whether distress can be induced during VERP in patients with contamination-related OCD (C-OCD) and a primary feeling of disgust. We treated eight female patients with C-OCD with the primary emotion of disgust over six weeks with VERP and assessed their OC symptoms before and after the intervention period with the Y-BOCS. We measured subjective units of distress (SUD), heart rate and skin conductivity (arousal), sense of presence, and simulator sickness during four consecutive exposure sessions. VERP was able to induce distress and arousal. The qualitative feedback was heterogeneous and sense of presence moderate. Patients' OC symptoms reduced over the treatment period with medium to large effect sizes, but only two patients were considered responders; two patients discontinued treatment due to lack of treatment success. Although VERP was able to induce distress and arousal associated with disgust and evoked a moderate sense of presence, the low rate of symptom reduction diminishes the positive results. Possible reasons for the heterogeneous results and implications are discussed. Trial registration: German Registry for Clinical Studies (DRKS00016929), 10.04.2019.

More than just fear: Development and psychometric evaluation of the Spider Distress Scale to assess spider fear and spider-related disgust

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.

Auditory and cross-modal attentional bias toward positive natural sounds: Behavioral and ERP evidence

Recently, researchers have expanded the investigation into attentional biases toward positive stimuli; however, few studies have examined attentional biases toward positive auditory information. In three experiments, the present study employed an emotional spatial cueing task using emotional sounds as cues and auditory stimuli (Experiment 1) or visual stimuli (Experiment 2 and Experiment 3) as targets to explore whether auditory or visual spatial attention could be modulated by positive auditory cues. Experiment 3 also examined the temporal dynamics of cross-modal auditory bias toward positive natural sounds using event-related potentials (ERPs). The behavioral results of the three experiments consistently demonstrated that response times to targets were faster after positive auditory cues than they were after neutral auditory cues in the valid condition, indicating that healthy participants showed a selective auditory attentional bias (Experiment 1) and cross-modal attentional bias (Experiment 2 and Experiment 3) toward positive natural sounds. The results of Experiment 3 showed that N1 amplitudes were more negative after positive sounds than they were after neutral sounds, which further provided electrophysiological evidence that positive auditory information enhances attention at early stages in healthy adults. The results of the experiments performed in the present study suggest that humans exhibit an attentional bias toward positive natural sounds.

Common and separable behavioral and neural mechanisms underlie the generalization of fear and disgust

Generalization represents the transfer of a conditioned responses to stimuli that resemble the conditioned stimulus (CS). Previous studies on generalization of defensive avoidance responses have primarily focused on fear and have neglected disgust generalization, which represents a key pathological mechanism in some anxiety disorders. In the present study we examined common and distinct mechanisms of fear and disgust generalization by means of a fear or disgust multi-CS conditioning and generalization paradigm with concomitant event-related potential (ERPs) acquisition in n = 62 subjects. We demonstrate that compared to fear, disgust-relevant generalized stimuli (GS) elicited larger expectancy ratings and longer reaction times (RTs) reflecting stronger ratings of 'risk'. On the electrophysiological level, increased P2 amplitudes were found in response to conditioned CS+ versus CS- across both domains, possibly reflecting higher motivational and attentional salience of aversive conditioned stimuli per se. Contingent negative variation (CNV) amplitude was significantly larger for disgust-CS+ than disgust-CS-, reflecting a stronger preparation of the disgust US. Additionally, we found that the contingent negative variation (CNV) fear generalization gradient, and CNV amplitude were increased with similarity to CS+. In contrast the CNV to disgust-GS did not differ and did not reflect disgust generalization. Together this may indicate that the CNV represents a highly fear-specific index for generalization learning. This study provides the first neurobiological evidence for common and distinct generalization learning in fear versus disgust suggesting that dysregulations in separable defensive avoidance mechanisms may underly different anxiety disorder subtypes.

A cholinergic medial septum input to medial habenula mediates generalization formation and extinction of visual aversion

Generalization of visual aversion is a critical function of the brain that supports survival, but the underlying neurobiological mechanisms are unclear. We establish a rapid generalization procedure for inducing visual aversion by dynamic stripe images. By using fiber photometry, apoptosis, chemogenetic and optogenetic techniques, and behavioral tests, we find that decreased cholinergic neurons' activity in the medial septum (MS) leads to generalization loss of visual aversion. Strikingly, we identify a projection from MS cholinergic neurons to the medial habenula (MHb) and find that inhibition of the MS→MHb cholinergic circuit disrupts aversion-generalization formation while its continuous activation disrupts subsequent extinction. Further studies show that MS→MHb cholinergic projections modulate the generalization of visual aversion possibly via M1 muscarinic acetylcholine receptors (mAChRs) of downstream neurons coreleasing glutamate and acetylcholine. These findings reveal that the MS→MHb cholinergic circuit is a critical node in aversion-generalization formation and extinction and potentially provides insight into the pathogenesis of affective disorders.

Exploring the role of disgust sensitivity and propensity in selective eating

While disgust is a clinically and theoretically relevant construct for selective eating, limited research has examined how different aspects of disgust relate to selective eating severity in adults. Thus, the present study sought to 1) compare disgust propensity (how easily people are disgusted) and disgust sensitivity (how unpleasant disgust is) across a spectrum of selective eaters, 2) explore the specificity of the associations between disgust sensitivity/propensity and selective eating across selective eating and related phenotypes, and 3) explore whether the relationship between selective eating and disgust is food-specific. Participants were 554 adults recruited on Amazon's Mechanical Turk who completed cross-sectional surveys on study constructs. The sample was recruited to over-represent individuals with high levels of selective eating. Results support that disgust propensity, but not sensitivity, was elevated in the impaired selective eating group compared to non-impaired selective eaters and non-selective eaters. Only the selective eating phenotype was independently associated with both disgust sensitivity and propensity. Correlation results supported that the associations between selective eating and disgust were specific to the disgust elicited by food (i.e., animal protein, fruits, vegetables). Overall, results support that disgust propensity and disgust sensitivity play a role in selective eating. Results imply that disgust sensitivity associated with selective eating appears limited to the food domain and may be more specific to disgust eliciting food itself, rather than signs of food contamination or spoilage.

How Fear of COVID-19 Affects Service Experience and Recommendation Intention in Theme Parks: An Approach of Integrating Protection Motivation Theory and Experience Economy Theory

The unprecedented public panic caused by COVID-19 will affect the recovery of tourism, especially the theme parks, which are generally crowded due to high visitor volume. The purpose of this study is to discuss the effect of the COVID-19 on the theme park industry. This study aims to predict recommendation intentions of theme park visitors by exploring the complicated mechanism derived from the fear of COVID-19. This study uses a quantitative research method, and SPSS 20.0 and AMOS 22.0 were used for data analysis. An online survey was conducted with 420 Chinese respondents who visited Shanghai Disneyland after its reopening. The study explored the relationship between Fear of COVID-19, perceived risk, participation, service experience, and revisit intention. Results indicated the perceived risk of theme park visitors will not directly ruin their recommendation intention. Visitors' fear of COVID-19 enhanced their perceived risk, reduced their desire for active participation and impaired their service experience, which consequently affected their recommendation intention. We provide theoretical and managerial implications.

The Impact of Modifying Interpretive Bias on Contamination-Related Obsessive–Compulsive Symptoms

Cognitive-behavioural models of obsessive–compulsive disorder (OCD) propose that a tendency to negatively interpret ambiguous thoughts and situations plays a key role in maintaining the disorder. Moreover, some researchers have proposed that negative interpretive biases may share a common processing mechanism with attentional biases, with changes in one predicted to lead to changes in the other. The current study examined whether training positive (i.e., adaptive) interpretive bias of contamination-related OCD concerns using a cognitive bias modification paradigm (CBM-I) would lead to reductions in contamination concerns, as well as changes in contamination-related attentional bias. Undergraduate students with high levels of contamination-related OCD symptoms were randomly assigned to receive either positive (n = 31) or neutral (n = 33) CBM-I training. Participants in the positive training condition, relative to the neutral training condition, showed a significantly greater increase in positive interpretive bias, significantly less within-session behavioural avoidance of contaminants, and significantly reduced contamination-related cognitions (at one-week follow-up). Contrary to expectations, CBM-I training did not differentially impact attentional bias nor self-reported contamination-related OCD symptoms. We discuss future directions in applying CBM-I to contamination-related OCD.

Behavioral and neural mechanisms of latent inhibition

Fear is an adaptive emotion that serves to protect an organism against potential dangers. It is often studied using classical conditioning paradigms where a conditioned stimulus is paired with an aversive unconditioned stimulus to induce a threat response. Less commonly studied is a phenomenon that is related to this form of conditioning, known as latent inhibition. Latent inhibition (LI) is a paradigm in which a neutral cue is repeatedly presented in the absence of any aversive associations. Subsequent pairing of this pre-exposed cue with an aversive stimulus typically leads to reduced expression of a conditioned fear/threat response. In this article, we review some of the theoretical basis for LI and its behavioral and neural mechanisms. We compare and contrast LI and fear/threat extinction-a process in which a previously conditioned cue is repeatedly presented in the absence of aversive outcomes. We end with highlighting the potential clinical utility of LI. Particularly, we focus on how LI application could be useful for enhancing resilience, especially for individuals who are more prone to continuous exposure to trauma and stressful environments, such as healthcare workers and first responders. The knowledge to be gained from advancing our understanding of neural mechanisms in latent inhibition could be applicable across psychiatric disorders characterized by exaggerated fear responses and impaired emotion regulation.

Exploration of Exogenous Attention to Disgust and Fear Pictures with Different Spatial Frequencies Through Event-related Potentials

The study of the effects of fear and disgust on the capture of automatic attention is gaining interest. Most findings reveal a more efficient capture of exogenous attention by disgust than by fear stimuli, although the underlying mechanisms are not completely understood. The manipulation of their spatial frequency may provide new insight that may contribute to clarify this issue. The present study aimed to explore differential processing of disgust and fear scenes containing only low spatial frequencies (LSF) or all spatial frequencies (intact) presented as distractors in an exogenous attention task. Event-related potentials (ERPs) and behavioral responses were recorded as dependent variables from forty participants (29 women). The results showed that disgust and fear distractors captured exogenous attention equally early, as indicated by the augmented amplitude of the N2p, and later disgust distractors are the ones eliciting the highest amplitude of the LPP component. While in an initial stage, both stimuli seem to have similar preferential access to further processing allowing fast responding in both cases, disgust is more deeply processed at a later stage probably facilitating its examination. These findings suggest that exploring the temporal course of processing is relevant for the understanding of the differential capture of exogenous attention by disgust and fear distractors.

Behavioral, cortical and autonomic effects of single-dose escitalopram on the induction and regulation of fear and disgust: Comparison with single-session psychological emotion regulation with reappraisal

INTRODUCTION

Adaptive and successful emotion regulation, the ability to flexibly exert voluntary control over emotional experience and the ensuing behavior, is vital for optimal daily functioning and good mental health. In clinical settings, pharmacological and psychological interventions are widely employed to modify pathological emotion processing and ameliorate its deleterious consequences.

METHODS

In this study, we investigated the acute effects of single-dose escitalopram on the induction and regulation of fear and disgust in healthy subjects. Furthermore, we compared these pharmacological effects with psychological emotion regulation that utilized a cognitive strategy with reappraisal. Emotion induction and regulation tasks were performed before and 4 h after ingestion of placebo or 10 mg escitalopram in a randomized, double-blind design. The International Affective Picture System (IAPS) was used as a source of images, with threat-related pictures selected for fear and disease and contamination-related pictures for disgust. Behavioral data, electrodermal activity (EDA), and functional near-infrared spectroscopy (fNIRS) recordings were collected.

RESULTS

Escitalopram significantly reduced emotion intensity for both fear and disgust during emotion induction, albeit with differing electrodermal and hemodynamic activity patterns for the two negative emotions. At rest, i.e., in the absence of emotive stimuli, escitalopram increased sympathetic activity during the fear but not during the disgust experiments. For both fear and disgust, emotion regulation with reappraisal was more effective in reducing emotion intensity compared to pharmacological intervention with escitalopram or placebo.

DISCUSSION

We concluded that emotion regulation with reappraisal and acute administration of escitalopram, but not placebo, reduce emotion intensity for both fear and disgust, with cognitive regulation being significantly more efficient compared to pharmacological regulation under the conditions of this study. Results from the fNIRS and EDA recordings support the concept of differential mechanisms of emotion regulation that could be emotion-specific.

Mechanisms and Effectiveness of Imagery Strategies in Reducing Disgust in Contamination-Related Obsessive–Compulsive Disorder: Comparing Imagery Rescripting, Imagery Self-compassion and Mood-Focused Imagery

Background

Strong feelings of disgust and anxiety are maintaining factors in contamination-related obsessive–compulsive disorder (C-OCD). To this day there are not many studies that investigated strategies for changing pathological disgust. In a previous study, it was shown that imagery rescripting could successfully change disgust. However, whether imagery rescripting or more general imagery processing, helps to reduce pathological disgust, remains unclear. Therefore, the aim of the present study was to investigate how successful imagery rescripting is in comparison to imagery self-compassion and a passive positive imagery condition in reducing disgust.

Methods

For this, the three strategies were compared to each other on 2 days (within-subject) in a laboratory experiment. The study included 24 subjects with diagnosed C-OCD, and 24 matched, healthy controls (between-subject).

Results

The results show that all three strategies changed disgust, they do not differ from each other and that different traits appear to influence the strategies’ success or failure. The theoretically derived underlying mechanisms of the strategies were found in an elaborate content analysis.

Conclusions

The present study provides first indications that imagery in general can help to change pathological disgust experience.

Fear conditioning and extinction in obsessive-compulsive disorder: A systematic review

Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for anxiety-related disorders. Yet, there is limited basic research on fear conditioning and extinction in obsessive-compulsive disorder (OCD). This is surprising because exposure-based treatments based on associative learning principles are among the most popular and effective treatment options for OCD. Here, we systematically review and critically assess existing aversive conditioning and extinction studies of OCD. Across 12 studies, there was moderate evidence that OCD is associated with abnormal acquisition of conditioned responses that differ from comparison groups. There was relatively stronger evidence of OCD's association with impaired extinction processes. This included multiple studies finding elevated conditioned responses during extinction learning and poorer threat/safety discrimination during recall, although a minority of studies yielded results inconsistent with this conclusion. Overall, the conditioning model holds value for OCD research, but more work is necessary to clarify emerging patterns of results and increase clinical translational utility to the level seen in other anxiety-related disorders. We detail limitations in the literature and suggest next steps, including modeling OCD with more complex conditioning methodology (e.g., semantic/conceptual generalization, avoidance) and improving individual-differences assessment with dimensional techniques.

Generalization of conditioned disgust and the attendant maladaptive avoidance: Validation of a novel paradigm and effects of trait disgust-proneness

Overgeneralization of conditioned fear to safe stimuli that resemble a previously-learned threat-cue is a well-studied correlate of clinical anxiety, yet whether conditioned disgust generalizes remains unknown, as does the extent to which such generalization is associated with disgust-related traits and maladaptive outcomes. The present study addresses this gap by adapting a validated fear-generalization paradigm to assess conditioned disgust and behavioral avoidance to a disgust-cue (CS+) paired with a disgusting video clip, and safe generalization stimuli parametrically varying in perceptual similarity to CS+. For comparison, levels of fear generalization were also assessed using the original fear-generalization paradigm. In both paradigms, costly and unnecessary avoidance to safe threat-cue approximations analogues maladaptive outcomes of generalization. In the disgust paradigm only, disgust-proneness was associated with elevated perceived risk to safe stimuli and increases in the extent to which such elevations were accompanied by maladaptive avoidance. Comparable levels of generalization, and positive associations between generalization and maladaptive avoidance, were found across disgust and fear paradigms. Results confirm that conditioned disgust is subject to generalization, implicate generalized disgust as a source of maladaptive avoidance particularly among those prone to disgust, and suggest a potential role for these processes in the etiology and maintenance of disgust-related disorders.

Specificity of spiders among fear- and disgust-eliciting arthropods: Spiders are special, but phobics not so much

To investigate a specificity of spiders as a prototypical fear- and disgust-eliciting stimuli, we conducted an online experiment. The respondents rated images of 25 spiders, 12 non-spider chelicerates, and 10 other arthropods on a fear and disgust 7-point scale. The evaluation of 968 Central European respondents confirmed the specificity of spiders among fear- and disgust-eliciting arthropods and supported the notion of spiders as a cognitive category. We delineated this category as covering extant spider species as well as some other chelicerates bearing a physical resemblance to spiders, mainly whip spiders and camel spiders. We suggested calling this category the spider-like cognitive category. We discussed evolutionary roots of the spider-like category and concluded that its roots should be sought in fear, with disgust being secondary of the two emotions. We suggested other chelicerates, e.g., scorpions, might have been important in formation and fixation of the spider-like category. Further, we investigated an effect of respondent's sensitivity to a specific fear of spiders on evaluation of the stimuli. We found that suspected phobic respondents were in their rating nearly identical to those with only high fear of spiders and similar to those with only moderate fear of spiders. We concluded that results based on healthy respondents with elevated fear should also be considered relevant for arachnophobia research.

An exploration of the nomological network of trypophobia

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.

Interoception and Obsessive-Compulsive Disorder: A Review of Current Evidence and Future Directions

Disrupted interoceptive processes are present in a range of psychiatric conditions, and there is a small but growing body of research on the role of interoception in obsessive-compulsive disorder (OCD). In this review, we outline dimensions of interoception and review current literature on the processing of internal bodily sensations within OCD. Investigations in OCD utilizing objective measures of interoception are limited and results mixed, however, the subjective experience of internal bodily sensations appears to be atypical and relate to specific patterns of symptom dimensions. Further, neuroimaging investigations suggest that interoception is related to core features of OCD, particularly sensory phenomena and disgust. Interoception is discussed in the context of treatment by presenting an overview of existing interventions and suggesting how modifications aimed at better targeting interoceptive processes could serve to optimize outcomes. Interoception represents a promising direction for multi-method research in OCD, which we expect, will prove useful for improving current interventions and identifying new treatment targets.

Does an unconditioned stimulus memory devaluation procedure decrease disgust memories and conditioned disgust? Results of two laboratory studies

Research has demonstrated that disgust can be installed through classical conditioning by pairing neutral conditioned stimuli (CSs) with disgusting unconditioned stimuli (USs). Disgust has been argued to play an important role in maintaining fear-related disorders. This maintaining role may be explained by conditioned disgust being less sensitive to extinction (i.e., experiencing the CS in the absence of the US). Promising alternatives to extinction training are procedures that focus on the devaluation of US memory representations. In the current study, we investigated whether such devaluation procedures can be successful to counter conditioned disgust. We conducted two laboratory studies (N = 120 and N = 51) in which disgust was conditioned using audio-visual USs. Memory representations of the USs were devalued by having participants recall these USs while they performed a taxing eye-movement task or executed one of several control tasks. The results showed successful conditioned disgust acquisition. However, no strong evidence was obtained that an US memory devaluation procedure modulates disgust memory and diminishes conditioned disgust as indicated by subjective, behavioral, or psychophysiological measures. We discuss the relevance of our results for methodological improvements regarding US memory devaluation procedures and disgust conditioning.

Acquisition and maintenance of disgust reactions in an OCD analogue sample: Efficiency of extinction strategies through a counter-conditioning procedure

BACKGROUND

Obsessive-compulsive disorder (OCD) has long been considered as an anxiety disorder, disgust is the dominant emotion in contamination-based OCD. However, disgust seems resistant to exposure with response prevention partly due to the fact that disgust is acquired through evaluative conditioning.

AIMS

The present research investigates a counter-conditioning intervention in treating disgust-related emotional responses in two groups of individuals with high (High contamination concerns, HCC, n = 24) and low (Low contamination concerns LCC, n = 23) contamination concerns.

METHODS

The two groups completed a differential associative learning task in which neutral images were followed by disgusting images (conditioned stimulus; CS+), or not (CS-). Following this acquisition phase, there was a counter-conditioning procedure in which CS+ was followed by a very pleasant unconditional stimulus while CS- remained unreinforced.

RESULTS

Following counter-conditioning, both groups reported significant reduction in their expectancy of US occurrence and reported less disgust with CS+. For both expectancy and disgust, reduction was lower in the HCC group than in the LCC group. Disgust sensitivity was highly correlated with both acquisition and maintenance of the response acquired, while US expectation was predicted by anxiety.

CONCLUSION

Counter-conditioning procedure reduces both expectations and conditioned disgust.

In exogenous attention, time is the clue: Brain and heart interactions to survive threatening stimuli

The capture of exogenous attention by negative stimuli has been interpreted as adaptive for survival in a diverse and changing environment. In the present paper, we investigate the neural responses towards two discrete negative emotions with different biological meanings, disgust and fear, and its potential relationships with heart rate variability (HRV) as an index of emotional regulation. With that aim, 30 participants performed a digit categorization task while fear, disgust and neutral distractor pictures were presented. Resting HRV at baseline, behavioral responses, and event-related potentials were recorded. Whereas P1 amplitudes were highest to fear distractors, the disgust stimulation led to augmented P2 amplitudes compared to the rest of distractors. Interestingly, increased N2 amplitudes were also found to disgust distractors, but only in high HRV participants. Neural source estimation data point to the involvement of the insula in this exogenous attentional response to disgust. Additionally, disgust distractors provoked longer reaction times than fear and neutral distractors in the high HRV group. Present findings are interpreted in evolutionary terms suggesting that exogenous attention is captured by negative stimuli following a different time course for fear and disgust. Possible HRV influences on neural mechanisms underlying exogenous attention are discussed considering the potential important role of this variable in emotional regulation processes.

Exposure therapy in a virtual environment: Validation in obsessive compulsive disorder

Exposure and response prevention (ERP) is the current first-line psychological treatment for Obsessive-compulsive disorder (OCD). However, substantial inter-individual variability exists in treatment outcomes, including inadequate symptom improvements, and notable refusal and attrition rates. These are driven, in part, by impracticalities in simulating intrusive thoughts within clinical settings. Virtual reality (VR) offers the potential of overcoming these limitations in a manner that allows for finely controlled anxiety-provoking scenarios to be created within supportive clinical settings. To validate the potential of VR for treating contamination-based OCD, 22 patients undertook a VR ERP session and a matched session of the current gold-standard of in vivo ERP. In VR, patients were immersed within a contamination environment that permitted flexible delivery of customisable, graded exposure tasks. The VR environment utilised HTC Vive hardware, to allow for patients to both interact with, and physically move through the environment. Subjective and objective measures of distress were recorded, including heart and respiration rates. These measures indicate virtual and in vivo ERP sessions provoke consistent anxiety profiles across an exposure hierarchy. Virtual exposure was advantageous for engagement and adherence to tasks, and the therapeutic alliance was upheld. VR is a promising mechanism for ERP in contamination OCD.

Contamination fear in the time of the COVID-19 pandemic: A moderated mediation quasi-experimental model of the effect of disgust on outgroup bias towards diaspora

Disgust sensitivity plays a key role in generating and maintaining outgroup biases. To test our hypotheses, we used a quasi-experimental between-subjects design, in which participants were randomly assigned to a disgust induction condition (N = 102) or a non-induction neutral group (N = 92). The induction scenario featured the return of the diaspora to their home country due to COVID-19 concerns. In one scenario, the diaspora lied about the country they arrived from, and in the other, there was no moral transgression. We hypothesized that the effect of disgust sensitivity on dehumanization and aggressive tendencies passed through contamination fear and the moderated mediation model indicated that this indirect effect was stronger for participants in the disgust-induction than in the non-induction group. This effect was found for biological dehumanization and passive aggression outcomes, both related to outgroup bias. Consistent with the role of disgust as a disease-avoidance mechanism, our results suggest that disgust could facilitate stronger outgroup bias in the context of a high health threat, such as the COVID-19 pandemic.

Evaluating the mediating effects of perceived vulnerability to disease in the relation between disgust and contamination-based OCD

Contamination-based obsessive-compulsive disorder (OCD) is thought to develop and be maintained by excessive propensity to experience disgust, particularly in response to perceived contaminants, and dysfunctional threat appraisals pertaining to illness. The present studies attempted to integrate these lines of research by testing the degree to which contamination-based OCD is associated with individual differences in disgust propensity and sensitivity, affective distress in response to perceived contaminants, and perceived threat of illness. In Study 1, a convenience sample of 185 adults completed self-report scales assessing obsessive-compulsive symptoms, disgust propensity and sensitivity, germ aversion, and perceived infectability. Multivariate regression showed that disgust propensity and germ aversion were the only significant predictors of contamination-based obsessions and compulsions. Exploratory analyses suggested that there was a significant indirect effect of disgust propensity on contamination-based obsessions and compulsions via germ aversion. Findings from Study 1 were replicated using a sample of twenty-six obsessive-compulsive participants. Despite the substantially smaller sample, the proportion of the total effects attributable to the mediating effect of germ aversion was comparable, consistent with a significant partial mediation in both samples. These results together suggest that contamination-based OCD symptoms are likely maintained and motivated by basic affective processes.

Behavioral avoidance tasks for eliciting disgust and anxiety in contamination fear: An examination of a test for a combined disgust and fear reaction

While research supports the role of disgust in contamination OCD, there is also an overlap with fear in motivating avoidance. The "heebie-jeebies" is an emotional response associated with fear and disgust that motivates avoidance of contact with skin-transmitted pathogens (e.g., parasites). This motivation aligns with characteristics of contamination OCD. From a screening of undergraduate students (N = 188), contamination fearful (n = 14), high trait-anxious (n = 14), and low trait-anxious (n = 18) groups were created. Participants engaged in disgust, fear, and "heebie-jeebies" behavioral avoidance tasks. Participants rated "heebie-jeebies" emotion, physical sensations, and behavioral urges. Duration or refusal of task was recorded. A significant interaction effect was found for disgust and anxiety. Participants with higher disgust reported higher "heebie-jeebies" emotion at high, but not low, levels of anxiety. Exploratory analyses revealed that many contamination fearful and high trait-anxious participants refused to complete the task. The interaction of disgust and anxiety significantly predicted the probability of refusal. Participants with higher disgust and anxiety were more likely to refuse to complete the task. Results suggest that the "heebie-jeebies" motivates avoidance of skin-transmitted pathogens. Future research is warranted to further investigate the "heebie-jeebies" and how it relates to contamination concerns.

Regulation of emotions during experimental endotoxemia: A pilot study

Even though dysfunctional emotion regulation is prominent in depression and a link between depression and inflammation is well established, there is little knowledge about how inflammation affects the regulation of emotions. The aim of this pilot study was to explore the effect of experimentally induced inflammation on the cognitive reappraisal of emotions, and to assess domain specificity by comparing success in regulation of emotions towards two unpleasant stimuli classes (general negative stimuli and disgust stimuli). In a between-subject design, ten healthy participants were injected with an intravenous injection of lipopolysaccharide (2 ng/kg body weight) and eleven were injected with saline. Participants performed a cognitive reappraisal task, in which they had to down-regulate or up-regulate their emotions towards general negative stimuli and disgust stimuli, 5-6 h post-injection. Contrary to our hypotheses, participants injected with lipopolysaccharide reported greater success in down-regulating emotional responses towards unpleasant stimuli as compared to the saline group. In addition, both groups were poorer at down-regulating emotions towards disgust stimuli as compared to general negative stimuli. The current pilot study indicates that cognitive reappraisal of emotions is affected during experimental endotoxemia, and suggests that disgust stimuli might be difficult to reappraise.

Reappraisal of disgust: Self-report and behavioural assessment of individuals with moderate to high contamination fears

Previous research has linked certain psychological disorders, including obsessive-compulsive disorder (OCD), to the experience of disgust and how it is interpreted/appraised. Therefore, the present study examined whether targeting primary and secondary disgust appraisals (i.e., cognitive reappraisal) in individuals with moderate to high OCD-relevant contamination fears can effectively reduce disgust. Fifty-two participants were randomly assigned to one of three conditions; two of which involved reading a brief script modifying either a primary disgust appraisal (i.e., likelihood of a feared outcome) or a secondary disgust appraisal (i.e., the individual's ability to cope), and a third control condition with no reappraisal script. Following this experimental manipulation of disgust appraisal, participants completed two contamination-relevant behavioural approach tasks which involved 1) increasing proximity to, and eventually touching, a dead cockroach, and 2) drinking apple juice from an unused urine sample collection container. Results indicated that the interventions successfully modified their intended appraisal targets. Furthermore, on the second behavioural approach task, the secondary reappraisal condition demonstrated significantly less disgust-related avoidance relative to the control condition and reported significantly less disgust relative to the primary reappraisal condition. Our results incrementally add to the existing literature that emphasises the potential advantages of modifying disgust appraisals and specifically secondary disgust appraisals when treating disgust-based psychological disorders.

The Role of Disgust in Eating Disorders

PURPOSE OF REVIEW

In current review, we evaluate the current literature examining the role of disgust in eating disorders (EDs), and provide a theoretical model designed to inform the study and treatment of disgust-based symptoms in EDs.

RECENT FINDINGS

Findings from this review suggest that aberrant disgust-conditioning processes represent promising but understudied mechanisms that may contribute to the risk and maintenance of core eating disorder (ED) psychopathology. In addition, preliminary evidence supports the use of interventions designed to target aversive disgust cues and disrupt maladaptive disgust-based conditioning that may maintain eating pathology. However, experimental studies designed to elucidate the role of disgust and aversive learning processes remain limited. Disgust is a promising risk and maintenance factor in EDs. Future systematic investigation is needed to examine disgust-based processes at a mechanistic level in order to better understand the links between disgust, avoidance behaviors, and EDs. Further investigation of the mechanistic role of disgust in EDs is warranted.

Subjective Experience of Disgust

Abstract. Background: Individual differences in the experience of disgust are known to influence the development and maintenance of several psychopathologies. Aims: This study examined the psychometric properties of the Portuguese version of the Disgust Propensity and Sensitivity Scale – Revised (DPSS-R). Method: The factor validity, the reliability of the Portuguese version of DPSS-R, the convergent validity, and the relationship with other scales were assessed in 229 participants. Results: The modified two-factor model, disgust propensity and sensitivity, was confirmed with good fit indexes and with acceptable convergent and discriminant validity. Overall, the internal consistency and the composite reliability of the DPSS-R were appropriate. The DPSS-R also revealed significant associations with the Disgust Scale, Maudsley Obsessive-Compulsive Inventory, Spider Phobia Questionnaire – Revised, and State-Trait Anxiety Inventory. Specifically, the disgust propensity factor was found to be a significant predictor of fear of spiders and trait anxiety, whereas both DPSS-R factors predicted obsessive-compulsive symptoms. Finally, women reported higher levels of disgust propensity and sensitivity than men. Conclusion: The Portuguese version of the DPSS-R proved to be a valid and reliable measure of disgust propensity and sensitivity and, therefore, with potential relevance for application in both research and clinical practice.

Attentional Processing of Disgust and Fear and Its Relationship With Contamination-Based Obsessive-Compulsive Symptoms: Stronger Response Urgency to Disgusting Stimuli in Disgust-Prone Individuals

Disgust has recently been characterized as a low-urgency emotion, particularly compared to fear. The aim of the present study is to clarify whether behavioral inhibition during disgust engagement is characteristic of a low-urgency emotion and thus indicates self-imposed attentional avoidance in comparison to fear. Therefore, 54 healthy participants performed an emotional go/no-go task with disgust- and fear-relevant as well as neutral pictures. Furthermore, heart rate activity and facial muscle activity on the fear-specific m. corrugator supercilli and the disgust-specific m. levator labii were assessed. The results partially support the temporal urgency hypothesis of disgust. The emotion conditions significantly differed in emotional engagement and in the facial muscle activity of the m. levator labii as expected. However, contrary to our expectations, no differences between the emotion conditions regarding behavioral inhibition as well as heart rate change could be found. Furthermore, individuals with a higher-trait disgust proneness showed faster reactions and higher activity of the m. levator labii in response to disgust stimuli. The results show that different trait levels influence attentional engagement and physiological parameters but have only a small effect on behavioral inhibition.

Involvement of fear, incompleteness, and disgust during symptoms of pediatric obsessive-compulsive disorder

Fear has been assigned a central role in models of obsessive-compulsive disorder (OCD), but empirical investigations into the emotions that underpin OCD symptoms are few, especially in pediatric samples. Using validated, clinician-led structured interviews, 124 youth with OCD reported on the presence and severity of symptoms across the main symptom dimensions of OCD (aggressive, symmetry, contamination) and the degree to which fear, incompleteness, and disgust accompanied these symptoms. For comparison purposes, the degree of fear, incompleteness, and disgust during symptoms was obtained also from youth with social anxiety disorder (SAD; n = 27) and generalized anxiety disorder (GAD; n = 28). Participants with OCD reported that all three emotions were involved in their symptoms; however, fear was most strongly linked to aggressive symptoms, incompleteness to symmetry symptoms, and disgust to contamination symptoms. Incompleteness differentiated youth with OCD from those with SAD and GAD. No differences for these emotions were found for youth with OCD with versus without the tic-disorder subtype or comorbid autism. A positive association between incompleteness and self-reported hoarding emerged among youth with OCD. Further studies of the emotional architecture of pediatric OCD, and its relationship to etiology and treatment, are warranted.