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Hain S, Stevenson RJ. Contamination in Trypophobia: investigating the role of disgust. Cogn Emot 2024:1-14. [PMID: 39120561 DOI: 10.1080/02699931.2024.2389388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024]
Abstract
Trypophobia is a relatively common aversion to clusters of holes. There is no consensus yet on which emotions are involved in Trypophobia nor in its functional utility. This report investigates the role of disgust using contamination tasks in two studies, which contrast people with an aversion to trypophobic stimuli to those without. In Study 1, participants reported their emotional reactions to imagined contamination of trypophobic images. In Study 2, participants evaluated physically present trypophobic, disgust, fear, and control stimuli. The capacity of these stimuli to contaminate other objects was established using a chain of contagion task. Across both studies, contamination was present, however, only those with an aversion to trypophobic stimuli evidenced contamination on the chain of contagion task, a hallmark of disgust responding. Elevated levels were not only reported for disgust, but also alongside fear/anxiety. Participant reports suggest an underlying disease avoidance mechanism in Trypophobia, with trypophobic participants demonstrating an exaggerated response to such stimuli involving disgust and fear/anxiety, which is also seen in small animal phobia, BII, and C-OCD. Implications, particularly for treatment are discussed.
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Affiliation(s)
- Simone Hain
- Department of Psychology, Macquarie University, Sydney, Australia
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2
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Shirai R, Watanabe K. Open biological negative image set. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211128. [PMID: 35070342 PMCID: PMC8728170 DOI: 10.1098/rsos.211128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Abstract
Scientists conducting affective research often use visual, emotional images, to examine the mechanisms of defensive responses to threatening and dangerous events and objects. Many studies use the rich emotional images from the International Affective Picture System (IAPS) to facilitate affective research. While IAPS images can be classified into emotional categories such as fear or disgust, the number of images per discrete emotional category is limited. We developed the Open Biological Negative Image Set (OBNIS) consisting of 200 colour and greyscale creature images categorized as disgusting, fearful or neither. Participants in Experiment 1 (N = 210) evaluated the images' valence and arousal and classified them as disgusting, fearful or neither. In Experiment 2, other participants (N = 423) rated the disgust and fear levels of the images. As a result, the OBNIS provides valence, arousal, disgust and fear ratings and 'disgusting,' 'fearful' and 'neither' emotional categories for each image. These images are available to download on the Internet (https://osf.io/pfrx4/?view_only=911b1be722074ad4aab87791cb8a72f5).
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Affiliation(s)
- Risako Shirai
- Faculty of Science and Engineering, Waseda University, Postal code: 3-4-1 Okubo, Shinjuku-ku, Tokyo, 169-8555, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Katsumi Watanabe
- Faculty of Science and Engineering, Waseda University, Postal code: 3-4-1 Okubo, Shinjuku-ku, Tokyo, 169-8555, Japan
- University of New South Wales, Kensington, Australia
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3
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Mason EC, Gaston JE, Pestell CF, Page AC. A comprehensive group-based cognitive behavioural treatment for blood-injection-injury phobia. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:494-509. [PMID: 34750831 DOI: 10.1111/bjc.12345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/14/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A key feature of blood-injection-injury (BII) phobia is activation of disgust responses, in addition to fear. Yet, standard treatments have largely neglected addressing disgust responses. The disorder is further complicated by fainting in 75% of sufferers. Moreover, treatments have been traditionally delivered in an individual format, which may not be as efficient as group treatment. The aim of this study was to develop a group-based programme for BII phobia, with components targeting fear, disgust, and fainting, to determine feasibility and effectiveness of such an intervention. METHODS Participants took part in an 8-session, group-based Cognitive Behavioural Therapy (CBT) programme for BII phobia (N = 40). The key outcome measure was the Multidimensional Blood/Injury Phobia Inventory, which assesses a range of phobic stimuli and responses (including fear, disgust, and fainting). RESULTS There were significant improvements, with large effect sizes, across symptoms over the course of treatment. Participants with higher disgust sensitivity reported higher pre-treatment symptom severity and greater life interference than those with lower disgust scores. Despite this, neither pre-treatment disgust sensitivity nor fainting history impacted on treatment response. For the first time, however, we showed that greater reductions in disgust to BII stimuli were associated with greater overall symptom reductions, highlighting the importance of disgust in the treatment of this disorder, and potentially others. CONCLUSION Despite the heterogeneous nature of BII phobia, this group-based, modified CBT intervention was effective in reducing a variety of phobic responses, including fear, disgust, and fainting. PRACTITIONER POINTS Disgust is a key maintaining factor in blood-injection-injury phobia, which clinicians should consider in their assessment and treatment of this disorder. There is little in the existing literature to guide clinicians in this regard. This study examined a novel group treatment for blood-injection-injury phobia which included strategies to target disgust, in addition to traditional CBT strategies to address fear and fainting. The treatment was feasible and acceptable. Symptoms of fear, disgust, and fainting reduced significantly over treatment. Changes in disgust symptoms were associated with overall symptom changes, however a control group is needed to determine the effects of individual treatment components and to make more robust conclusions about the benefits of this enhanced approach.
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Affiliation(s)
- Elizabeth C Mason
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Jonathan E Gaston
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Andrew C Page
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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A Needle-Free Jet Injection System for Controlled Release and Repeated Biopharmaceutical Delivery. Pharmaceutics 2021; 13:pharmaceutics13111770. [PMID: 34834185 PMCID: PMC8620904 DOI: 10.3390/pharmaceutics13111770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 12/24/2022] Open
Abstract
Swift vaccination is necessary as a response to disease outbreaks and pandemics; otherwise, the species under attack is at risk of a high fatality rate or even mass extinction. Statistics suggest that at least 16 billion injections are administered worldwide every year. Such a high rate of needle/syringe injection administration worldwide is alarming due to the risk of needle-stick injuries, disease spread due to cross-contamination and the reuse of needles, and the misuse of needles. In addition, there are production, handling, and disposal costs. Needle phobia is an additional issue faced by many recipients of injections with needles. In addition to a detailed literature review highlighting the need for needle-free injection systems, a compressed air-driven needle-free jet injection system with a hydro-pneumatic mechanism was designed and developed by employing an axiomatic design approach. The proposed injection system has higher flexibility, uninterrupted force generation, and provides the possibility of delivering repeated injections at different tissue depths from the dermis to the muscle (depending on the drug delivery requirements) by controlling the inlet compressed air pressure. The designed needle-free jet injector consists of two primary circuits: the pneumatic and the hydraulic circuit. The pneumatic circuit is responsible for driving, pressurizing, and repeatability. The hydraulic circuit precisely injects and contains the liquid jet, allowing us to control the volume of the liquid jet at elevated pressure by offering flexibility in the dose volume per injection. Finally, in this paper we report on the successful design and working model of an air-driven needle-free jet injector for 0.2–0.5 mL drug delivery by ex vivo experimental validation.
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Iudici A, De Donà D, Faccio E, Neri J, Rocelli M, Turchi GP. The Impact of Relational and Organizational-Environmental Aspects in Hospital Blood Collection: Clinical and Health Indications and New Training Needs. Front Public Health 2021; 9:661530. [PMID: 34113598 PMCID: PMC8185214 DOI: 10.3389/fpubh.2021.661530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/16/2021] [Indexed: 11/13/2022] Open
Abstract
This study deals with people who underwent a blood test and consequently suffered a fainting episode in the past. This phenomenon affects many people and if not adequately dealt with, it can lead to a perception of the blood test as a serious and traumatic event, which could limit its use as a preventive diagnostic tool. These experiences have been explored by research mainly on the basis of the physiological mechanisms involved in fainting, with a few studies considering the actual lived experience related to the blood test. This study explored how this experience is lived and managed, capturing aspects that could facilitate blood tests and the procedures associated with them, thus it focused on people with vasovagal syncope and was articulated through the semi-structured interview methodology. Among the significant results is the importance of the relational aspects implemented by health staff, the differing organisation of the blood test procedure, the need to make the hospital environment less aseptic and more humanistic, effective actions to counter the anxieties relating to the administration of the blood test and the importance of including the blood test with an inter-disciplinarity perspective.
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Affiliation(s)
- Antonio Iudici
- Department of Philosophy, Sociology, Education and Applied Psychology, School of Human and Social Sciences and Cultural Heritage, University of Padua, Padua, Italy
| | - Donata De Donà
- Istituto di Psicoterapia Interazionista Psicopraxis, Padua, Italy
| | - Elena Faccio
- Department of Philosophy, Sociology, Education and Applied Psychology, School of Human and Social Sciences and Cultural Heritage, University of Padua, Padua, Italy
| | - Jessica Neri
- Department of Philosophy, Sociology, Education and Applied Psychology, School of Human and Social Sciences and Cultural Heritage, University of Padua, Padua, Italy
| | - Michele Rocelli
- Department of Philosophy, Sociology, Education and Applied Psychology, School of Human and Social Sciences and Cultural Heritage, University of Padua, Padua, Italy
| | - Gian Piero Turchi
- Department of Philosophy, Sociology, Education and Applied Psychology, School of Human and Social Sciences and Cultural Heritage, University of Padua, Padua, Italy
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Olatunji BO, Taylor S, Zald D. Sex differences in the etiology of disgust sensitivity: A preliminary behavioral genetic analysis. J Anxiety Disord 2019; 65:41-46. [PMID: 31158648 DOI: 10.1016/j.janxdis.2019.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 11/19/2022]
Abstract
Evidence suggests that Disgust Sensitivity (DS) is a personality trait that may confer risk for the development of some anxiety-related disorders. To examine the origins of this trait we administered the DS subscale of the Disgust Propensity and Sensitivity Scale-Revised to 90 monozygotic and 90 dizygotic twin pairs, of which 55% were women. The DS subscale consists of two dimensions; Somatic Disgust and Ruminative Disgust. Biometrical modeling techniques were used to estimate heritability of the DS dimensions by sex. For women, each dimension was influenced by a combination of genetic and environmental factors. More specifically, 40.1% of the variance in DS was observed to be due to additive genetic factors and the remaining variance due to non-shared environment. Correlations among DS dimensions for women could be explained by genetic and environmental factors influencing the two dimensions. For men, the two dimensions were influenced by environmental but not genetic factors. These findings suggest that the etiology of DS is complex and arises as a function of dimension-specific and non-specific etiologic factors that vary as a function of sex. The implication of these findings for the sex differences in the etiology of some anxiety-related disorders are discussed.
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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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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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Martoni RM, Rancoita PMV, Di Serio C, Brombin C. Validating the Italian Version of the Disgust and Propensity Scale-Revised. Front Psychol 2017; 8:765. [PMID: 28553252 PMCID: PMC5427091 DOI: 10.3389/fpsyg.2017.00765] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 04/26/2017] [Indexed: 12/31/2022] Open
Abstract
The aim of this work is to evaluate the factor structure and psychometric properties of the Italian version of the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R, 16 items) in two samples taken from the general population. In the first study, 285 participants completed the DPSS-R questionnaire through a web-based survey. Exploratory factor analysis for ordinal Likert-type data supported the existence of four underlying factors, reflecting self-focused disgust, disgust propensity, somatic anxiety and disgust sensitivity. In the second study, an independent sample of 293 participants was enrolled as a test set to validate the factor structure obtained in the exploratory phase. The factor solution was confirmed, but showed quite highly correlated latent factors. We fitted the model and tested whether or not the bifactor structure was better than the previous one (four correlated factors). Actually, we had evidence supporting the presence of a general factor, providing a measure of disgust susceptibility, along with the four specific factors previously defined. This result could be useful also from the clinical perspective since the DPSS-R questionnaire will be used in clinical context, where underlying factors may be related to different and specific psychopathological profiles. Finally, we examined and visualized the interrelationships among the four DPSS-R factors and the external scales (Anxiety Sensitivity, Disgust Scale and Padua) using a graphical model approach.
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Affiliation(s)
- Riccardo M Martoni
- Department of Clinical Neurosciences, IRCCS San Raffaele TurroMilan, Italy
| | - Paola M V Rancoita
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele UniversityMilan, Italy
| | - Clelia Di Serio
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele UniversityMilan, Italy
| | - Chiara Brombin
- University Center for Statistics in the Biomedical Sciences, Vita-Salute San Raffaele UniversityMilan, Italy
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10
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Berge KG, Vika M, Agdal ML, Lie SA, Skeie MS. Reliability, validity and cutoff score of the Intra-Oral Injection Fear scale. Int J Paediatr Dent 2017; 27:98-107. [PMID: 27229655 DOI: 10.1111/ipd.12237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND A proper assessment tool is needed to gain more knowledge about fear of intraoral injections in children. AIM The aims of this study were to evaluate the reliability and validity of the novel Intra-Oral Injection Fear scale (IOIF-s) and to establish a cutoff score for a high level of such fear. METHODS Data were obtained from two samples of 10- to 16-year-olds in Hordaland, Norway. Sample I, 1460 pupils attending elementary and high schools, provided questionnaire-based data. The survey instruments used were IOIF-s, Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), Mutilation Questionnaire for Children (MQ-c) and Injection phobia Scale for Children (IS-c). Sample II was 67 patients, diagnosed with intraoral injection phobia at the Center for Odontophobia, Oral Health Center of Expertise in Western Norway-Hordaland, who provided IOIF-s data. RESULTS Cronbach's alpha was 0.95. The IOIF-s discriminated between subjects with and without intraoral injection phobia and was associated with the other survey instruments of similar construct. Principal component analysis revealed a two-component solution, characterized as 'Contact Fear' and 'Distal Fear'. Receiver-operating characteristic (ROC) curve indicated that a cutoff score of 38 was appropriate. CONCLUSION The IOIF-s showed satisfying psychometric properties in terms of reliability and validity.
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Affiliation(s)
- Karin G Berge
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway - Hordaland, Bergen, Norway
| | - Margrethe Vika
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway - Hordaland, Bergen, Norway
| | - Maren Lillehaug Agdal
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.,Oral Health Centre of Expertise in Western Norway - Hordaland, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Marit Slåttelid Skeie
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Nadeau JM, De Nadai AS, Viar-Paxton M, Olatunji BO, Jacobi DM, Eken SC, Kay B, Riemann BC, Storch EA. Further Psychometric Evaluation of the Child Disgust Scale. Child Psychiatry Hum Dev 2017; 48:32-39. [PMID: 27215910 PMCID: PMC6167059 DOI: 10.1007/s10578-016-0650-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study evaluated the psychometric properties of the Child Disgust Scale (CDS) among 457 youth (ages 8-17, M = 14.77 ± 1.98 years) initiating residential treatment for obsessive-compulsive disorder and anxiety disorders. Confirmatory factor analysis supported a bifactor model with two distinct factors of Disgust Avoidance and Disgust Affect, in addition to an overall General Disgust factor. Strong internal consistency was observed for the CDS total and factor scores. In addition, CDS scores demonstrated generally modest and positive correlations with child-reported obsessive-compulsive and anxiety symptoms, weaker correlations with parent-reported anxiety and child-rated impairment, and non-significant correlations with parent-rated impairment. Findings suggest that the CDS displays strong psychometric properties and is developmentally appropriate for use in pediatric clinical populations with obsessive-compulsive and anxiety disorders.
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Affiliation(s)
- Joshua M Nadeau
- Department of Pediatrics, University of South Florida, Tampa, FL, USA.
- Rogers Memorial Hospital, Tampa, FL, USA.
| | - Alessandro S De Nadai
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | | | - Bunmi O Olatunji
- Rogers Memorial Hospital, Tampa, FL, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | | | | | - Brian Kay
- Rogers Memorial Hospital, Tampa, FL, USA
| | | | - Eric A Storch
- Department of Pediatrics, University of South Florida, Tampa, FL, USA
- Rogers Memorial Hospital, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Health Policy and Management, University of South Florida, Tampa, FL, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
- All Children's Hospital - Johns Hopkins Medicine, St. Petersburg, FL, USA
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Melli G, Gremigni P, Elwood LS, Stopani E, Bulli F, Carraresi C. The Relationship Between Trait Guilt, Disgust Propensity, and Contamination Fear. Int J Cogn Ther 2015. [DOI: 10.1521/ijct_2015_8_01] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Viar-Paxton MA, Ebesutani C, Kim EH, Ollendick T, Young J, Olatunji BO. Development and initial validation of the Child Disgust Scale. Psychol Assess 2015; 27:1082-96. [PMID: 25844533 DOI: 10.1037/a0038925] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Although disgust sensitivity (DS) has been implicated in the development of anxiety disorders in children, the absence of a measure of DS specifically for children has not allowed for an adequate test of this claim. To fill this important gap in the literature, this investigation presents a series of studies on the development and examination of the psychometric properties (including reliability, validity, and factor structure) of scores on a newly developed Child Disgust Scale (CDS). Exploratory factor analysis in Study 1 (N = 1,500) found that a bifactor model, which allows for a "g" DS factor in addition to 2 distinct factors of Disgust Avoidance and Disgust Affect, was the best fit for the data. Study 2 (N = 573) confirmed a two-factor bifactor model above and beyond a 1-factor model that controlled for method effects due to reverse-worded items. Results from Study 3 (N = 50) provided support for convergent and discriminant validity such that scores on the CDS were significantly correlated with measures of anxiety and fear, but not depression. Finally, Study 4 (N = 86) found that the CDS differentiated children with a diagnosis of specific phobia (n = 43) from a matched nonclinical community sample of children (n = 43), such that those with a specific phobia reported greater DS compared with controls. Results from these studies suggest that the CDS is a developmentally appropriate measure with good psychometric properties that can aid research on the role of disgust sensitivity in anxiety-related disorders in children.
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Affiliation(s)
| | | | - Eun Ha Kim
- Department of Psychology, University of Mississippi
| | - Thomas Ollendick
- Department of Psychology, Virginia Polytechnic Institute and State University
| | - John Young
- Department of Psychology, University of Mississippi
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Schienle A, Übel S, Rössler A, Schwerdtfeger A, Karl Lackner H. Body Position Influences Cardiovascular Disgust Reactivity. J PSYCHOPHYSIOL 2015. [DOI: 10.1027/0269-8803/a000136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
It has been suggested that elevated trait disgust constitutes a vulnerability factor for fainting episodes. We tested the hypothesis that disgust-prone individuals are susceptible to vasovagal syncope by means of a tilt table experiment, during which 30 women were presented with disgusting pictures in a supine and a 70° upright position. The results showed that relative to disgust elicitation in the supine position, tilting reduced diastolic blood pressure during disgust elicitation, which could indicate increased risk for presyncope. Moreover, self-reported disgust proneness was positively correlated with heart rate during disgust induction in the tilted position. This association may point to a compensatory mechanism that aims at stabilizing mean arterial pressure. Disgust-prone individuals possibly utilized this mechanism more extensively to prevent fainting. Future investigations with a longer duration should follow up on this finding and compare the onset of presyncope between high and low disgust-prone individuals.
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Affiliation(s)
- Anne Schienle
- Department of Clinical Psychology, University of Graz, Austria
| | - Sonja Übel
- Department of Clinical Psychology, University of Graz, Austria
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15
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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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16
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Chapman LK, DeLapp RCT. Nine Session Treatment of a Blood–Injection–Injury Phobia With Manualized Cognitive Behavioral Therapy. Clin Case Stud 2013. [DOI: 10.1177/1534650113509304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The treatment of blood-injection-injury (BII) phobia has a unique treatment component as compared with other types of specific phobias. In particular, many patients with a BII phobia distinctively experience an increased susceptibility to fainting when exposed to feared medical-related stimuli due to a diphasic physiological response. Moreover, effective treatment protocols must not only include therapeutic techniques to ameliorate the patient’s fear response but also teach strategies that will allow the patient to remain conscious during exposure to feared stimuli. The current case study describes a manualized, cognitive behavioral therapy that utilized applied muscle tension techniques to comprehensively address the multifaceted components of an adult male’s BII phobia. Treatment included a combination of psychoeducation and cognitive restructuring that provided the patient with an empirically based understanding of BII phobia, practiced using applied muscle tension techniques to better manage his physiological processes during exposure followed by the utilization of in vivo graduated exposure to reduce distress and avoidance of feared stimuli. After completing nine sessions, the patient demonstrated considerable improvement as evidenced by reductions in anxiety and the willful seeking of medical care following treatment. Further implications and future directions for research are discussed.
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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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Does disgust increase parasympathetic activation in individuals with a history of fainting? A psychophysiological analysis of disgust stimuli with and without blood-injection-injury association. J Anxiety Disord 2012; 26:849-58. [PMID: 23023164 DOI: 10.1016/j.janxdis.2012.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 05/07/2012] [Accepted: 07/14/2012] [Indexed: 11/20/2022]
Abstract
People with blood-injection-injury fear can faint when being confronted with blood, injections or injuries. Page (1994) holds that people with blood-injury phobia faint, because they are disgust sensitive and disgust facilitates fainting by eliciting parasympathetic activity. We tested the following two hypotheses: (1) Disgusting pictures elicit more disgust in blood-injection-injury-anxious people with a history of fainting than they do in controls. (2) Disgust causes parasympathetic activation. Subjects were 24 participants with high blood-injection-injury fear and a history of fainting in anxiety relevant situations and 24 subjects with average blood-injection-injury fear and no fainting history. We analyzed self-reported feelings of disgust, anxiety and faintness and reactions in heart rate, skin conductance, blood pressure and respiratory sinus arrhythmia during the confrontation with disgusting pictures with and without blood content. We did not find any evidence that the blood-injection-injury anxious subjects were more disgust sensitive than the control subjects and we also did not find any evidence that disgust elicits parasympathetic activation.
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Gutner CA, Weinberger J, Hofmann SG. The effect of D-cycloserine on subliminal cue exposure in spider fearful individuals. Cogn Behav Ther 2012; 41:335-44. [PMID: 22992160 DOI: 10.1080/16506073.2012.711770] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Research on D-cycloserine (DCS) has demonstrated a significant effect on symptom reduction in human studies that utilized conventional exposure-based approaches. Recent studies have offered promising results for targeting fears through subliminal paradigms. In this double-blind, randomized placebo-controlled study, 45 spider fearful individuals received DCS or placebo pills prior to completing a subliminal cue exposure task to images of spiders. Participants completed self-report questionnaires and a behavioral approach task to a live caged tarantula. After repeated exposure to subliminal spider cues, participants in the DCS group reported a greater reduction in disgust than individuals in the placebo group. No difference was observed in fear ratings. These findings suggest that DCS augments the reduction in disgust in spider fearful subjects after subliminal exposure to spider cues.
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20
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Vossbeck-Elsebusch AN, Gerlach AL. The relation between disgust-sensitivity, blood-injection-injury fears and vasovagal symptoms in blood donors: disgust sensitivity cannot explain fainting or blood donation-related symptoms. J Behav Ther Exp Psychiatry 2012; 43:607-13. [PMID: 21906532 DOI: 10.1016/j.jbtep.2011.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Revised: 07/22/2011] [Accepted: 08/15/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Page's (1994) prominent theory for the explanation of fainting in blood-injection-injury situations holds that disgust sensitivity contributes to syncopal reactions. We investigated if blood donation-related vasovagal symptoms (1) or fainting related to blood donations (2) are associated with disgust sensitivity. METHODS In an online sample of 361 blood donors, we assessed blood-injection-injury fears, disgust sensitivity, history of blood donation related fainting and retrospective self-ratings of vasovagal symptoms. For the assessment of blood-injection-injury fears we used the BII-Q which has excellent psychometric properties and does not confound disgust and anxiety sensitivity. Vasovagal symptoms were measured by the Blood Donation Reactions Inventory (BDRI) which captures mild and strong vasovagal symptoms and has been used in previous studies with blood donors. RESULTS Disgust sensitivity did not significantly contribute to the explanation of self-reported vasovagal symptoms in a regression model with gender, blood-injection-injury fear and disgust sensitivity as predictors. We did not find any significant group differences in disgust sensitivity for blood donors with or without a fainting history (statistical power = 0.95) and a Bayesian model selection procedure showed that it is more likely that both groups are equally disgust sensitive than it is that the fainters are more disgust sensitive. LIMITATIONS Further research is required to confirm the findings in prospective studies. CONCLUSION Our results indicate that disgust sensitivity is not relevant for the development of vasovagal syncopes.
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Affiliation(s)
- Anna N Vossbeck-Elsebusch
- Westfälische Wilhelms-Universität Münster, Institut für Klinische Psychologie und Psychotherapie, Fliednerstraße 21, 48149 Münster, Germany.
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Effects of experienced disgust on habituation during repeated exposure to threat-relevant stimuli in blood-injection-injury phobia. Behav Ther 2012; 43:132-41. [PMID: 22304885 DOI: 10.1016/j.beth.2011.04.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Revised: 04/22/2011] [Accepted: 04/27/2011] [Indexed: 11/23/2022]
Abstract
Despite growing evidence implicating disgust in the etiology of blood-injection-injury (BII) phobia, the relevance of disgust for exposure-based treatment of BII phobia remains largely unknown. Individuals with BII phobia were randomly assigned to a disgust (view vomit videos) or neutral activation (view waterfall videos) condition. They were then exposed to 14 videotaped blood draws, during which fear and disgust levels were repeatedly assessed. Participants then engaged in a behavioral avoidance test (BAT) consisting of exposure to threat-relevant stimuli. Examination of outcome comparing the identical first and last blood-draw clips revealed that fear and disgust toward blood draws was significantly reduced in both groups. Disgust levels were also found to be more intense for the video stimuli relative to fear levels whereas the opposite was true for BAT stimuli. Contrary to predictions, the disgust induction did not enhance reductions in negative responses to the target video or reduce behavioral avoidance. Growth curve analyses did show that individuals with BII phobia exposed to the disgust induction showed greater initial fear levels during repeated exposure than those in the neutral condition. However, this effect was not consistently observed across different analytic approaches. Changes in fear during exposure were also found to be independent of changes in disgust but not vice versa, and greater initial fear levels during repeated exposure to threat was associated with fear and disgust levels during the BAT. The implications of these findings for conceptualizing the role of disgust in etiology and treatment of BII phobia are discussed.
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Hirai M, Vernon L. The role of disgust propensity in blood-injection-injury phobia: Comparisons between Asian Americans and Caucasian Americans. Cogn Emot 2011; 25:1500-9. [DOI: 10.1080/02699931.2010.547564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Itzhaki M, Bar-Tal Y, Barnoy S. Reactions of staff members and lay people to family presence during resuscitation: the effect of visible bleeding, resuscitation outcome and gender. J Adv Nurs 2011; 68:1967-77. [PMID: 22122510 DOI: 10.1111/j.1365-2648.2011.05883.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM This article is a report on a study conducted to examine the views of healthcare professionals and lay people regarding the effect of family presence during resuscitation on both the staff performing the resuscitation and the relatives who witness it. BACKGROUND Family presence during resuscitation is controversial. Although many professional groups in different countries have recently issued position statements about the practice and have recommended new policy moves, the Israel Ministry of Health has not issued guidelines on the matter. METHODS Study design is factorial within-between subjects. Data were collected in Israel in 2008 from a convenience sample of 220 lay people and 201 healthcare staff (52 physicians and 149 nurses) using a questionnaire based on eight different resuscitation scenarios and manipulating blood involvement and resuscitations outcome. Data were analysed using one-way analysis of variance. FINDINGS Overall, both staff and lay people perceived family presence during resuscitation negatively. Visible bleeding and an unsuccessful outcome significantly influenced both staff's and lay people's perceptions. Female physicians and nurses reacted more negatively to family presence than did male physicians and nurses; lay men responded more negatively than lay women. CONCLUSIONS Changing the current negative perceptions of family presence at resuscitation requires (a) establishing a new national policy, (b) educating healthcare staff to the benefits of the presence of close relatives and (c) training staff to support relatives who want to be present.
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Affiliation(s)
- Michal Itzhaki
- Department School of Health Professions, Tel Aviv University, Israel.
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24
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Lilliecreutz C, Theodorsson E, Sydsjö G, Josefsson A. Salivary cortisol in pregnant women suffering from blood and injection phobia. Arch Womens Ment Health 2011; 14:405-11. [PMID: 21918849 DOI: 10.1007/s00737-011-0234-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 08/25/2011] [Indexed: 10/17/2022]
Abstract
Stress and/or anxiety during pregnancy affect maternal and fetal well-being and can cause premature delivery and postnatal pathology in the child. Women suffering from phobias related to blood and injections are prone to high levels of stress, including anxiety and sometimes panic attacks, during pregnancy. Cortisol is amongst the mediators through which the neurohormonal expressions of maternal psychological factors may be transduced to the fetus. The aim of this study was to investigate whether pregnant women suffering from blood and injection phobia have raised cortisol levels or are characterized by unusual diurnal salivary cortisol profiles compared with healthy controls. The sample consisted of 110 pregnant women with blood and injection phobia and 110 pregnant healthy controls. Both groups provided morning and evening saliva samples in weeks 25 and 36 for the assay of cortisol. In gestational week 25, when blood was drawn for the mandatory blood testing, extra blood was taken to analyze corticotrophin-releasing factor, adrenocorticotropic hormone, and cortisol in serum. The diurnal decline in salivary cortisol as well as increased cortisol levels were observed during pregnancy. Pregnant women suffering from blood and injection phobia had a higher output of cortisol compared with women without the phobia (F = 6.25, df = 1, p = 0.014), but no marked difference in the diurnal cortisol rhythm was found between groups. Our findings indicate that untreated blood and injection phobia during pregnancy increases cortisol concentrations. Blood and injection phobia is treatable, and cognitive behavioral therapy can be used. Women with blood and injection phobia during pregnancy therefore need to be recognized and offered treatment without delay in early pregnancy.
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Affiliation(s)
- Caroline Lilliecreutz
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Linköping, Sweden.
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Olatunji BO, Ebesutani C, Sawchuk CN, McKay D, Lohr JM, Kleinknecht RA. Development and Initial Validation of the Medical Fear Survey–Short Version. Assessment 2011; 19:318-36. [DOI: 10.1177/1073191111415368] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present investigation employs item response theory (IRT) to develop an abbreviated Medical Fear Survey (MFS). Application of IRT analyses in Study 1 ( n = 931) to the original 50-item MFS resulted in a 25-item shortened version. Examination of the location parameters also resulted in a reduction of the Likert-type scaling of the MFS by removing the last response category (“Terror”). The five subscales of the original MFS were highly correlated with those of the MFS–short version. The short version also displayed comparable convergent and discriminant validity with the original MFS in relation to measures of fear, disgust, and anxiety. Confirmatory factor analysis in Study 2 revealed that the five-factor structure of the MFS–short form fit the data well in U.S. ( n = 283) and Dutch ( n = 258) samples. The short form also had comparable convergent and discriminant validity with the original MFS in relation to domains of disgust in both samples. Receiver operating characteristic (ROC) analysis in Study 3 demonstrated that the subscales of the short version were comparable with the original MFS in classifying participants high ( n = 40) and low ( n = 40) in blood/injection phobia. Last, structural equation modeling in Study 4 ( n = 113) revealed that the MFS–short form demonstrated excellent convergent/discriminant validity with strong associations with injection fear and no association with spider fear. These findings suggest that the MFS–short form has considerable strengths, including decreased assessment time, while retaining sound psychometric properties.
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Affiliation(s)
| | - Chad Ebesutani
- University of California–Los Angeles, Los Angeles, CA, USA
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Ditto B, Gilchrist PT, Holly CD. Fear-related predictors of vasovagal symptoms during blood donation: it's in the blood. J Behav Med 2011; 35:393-9. [PMID: 21751041 DOI: 10.1007/s10865-011-9366-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 06/20/2011] [Indexed: 11/24/2022]
Abstract
A recent theory proposes that emotional fainting developed from an earlier adaptive characteristic, fainting in response to hemorrhage. Despite potential loss of consciousness, a dramatic decrease in blood pressure improves chances of survival in animals with severe wounds by reducing blood loss and facilitating clotting. Humans may have developed the characteristic of emotional fainting as a response to anticipated blood loss. This idea suggests that people with stronger fears of blood should be especially susceptible to fainting and milder vasovagal symptoms such as dizziness and lightheadedness. Two samples of young adult blood donors (N = 276 and 663) who completed the Medical Fears Survey (MFS) were studied. Items from the MFS related to fears of blood, needles, and mutilation were used to predict self-reported dizziness and nurse-initiated treatment for vasovagal reactions. In both samples, fears of experiencing or seeing blood loss were more closely associated with both subjective and objective measures of vasovagal reactions, despite the fact that other fears (e.g., fears related to needles) were more common overall. Better understanding of the mechanisms of vasovagal reactions has both theoretical and clinical implications, such as improving means of coping with invasive medical procedures.
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Affiliation(s)
- Blaine Ditto
- Department of Psychology, McGill University, Montreal, QC, Canada.
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27
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Lilliecreutz C, Sydsjö G, Josefsson A. Obstetric and perinatal outcomes among women with blood- and injection phobia during pregnancy. J Affect Disord 2011; 129:289-95. [PMID: 20825998 DOI: 10.1016/j.jad.2010.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Revised: 08/12/2010] [Accepted: 08/12/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND Little is known about how anxiety disorders affect pregnancy outcomes. Therefore we investigated the impact of one anxiety disorder, blood- and injection phobia, on obstetric and neonatal outcomes. METHODS From a population-based prospectively collected cohort we compared an index group of 110 women with blood- and injection phobia with a control group of 220 women. Standardized medical records were used to collect data. Obstetric and neonatal outcomes e.g. elective cesarean, prematurity, and small for gestational age were used as the main outcome measures. RESULTS Women with blood- and injection phobia stated more often a fear of childbirth (p<0.001) and were more frequently delivered by elective cesarean section (p=0.032). The incidence of premature delivery (p=0.028), neonatal morbidity (p=0.001) and the risk of having a baby born small for gestational age (p=0.009) was higher among women with blood- and injection phobia. LIMITATIONS The medical records, from which all information is drawn, despite standardization, sometimes may lack some information. However, this dilemma exists in both groups. CONCLUSIONS Women with an anxiety disorder such as blood- and injection phobia are at increased risk for adverse obstetric outcomes, premature delivery and for having a baby born with higher neonatal morbidity. It therefore seems important to identify and treat women with anxiety disorders without delay early during pregnancy in an effort to minimize risks of complications for the woman herself and the child.
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Affiliation(s)
- Caroline Lilliecreutz
- Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Linköping, Sweden.
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Viar MA, Etzel EN, Ciesielski BG, Olatunji BO. Disgust, anxiety, and vasovagal syncope sensations: a comparison of injection-fearful and nonfearful blood donors. J Anxiety Disord 2010; 24:941-5. [PMID: 20667690 DOI: 10.1016/j.janxdis.2010.06.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 06/19/2010] [Accepted: 06/21/2010] [Indexed: 10/19/2022]
Abstract
Although research has implicated disgust in the fainting response observed in blood-injection-injury (BII) phobia, this finding has not been consistently observed in the literature. The present study further examines the relationship between disgust and fainting symptoms among injection-fearful (n=108) and nonfearful (n=338) blood donors. Volunteers from community blood drives provided pre-donation levels of anxiety and disgust towards giving blood and completed a standardized measure of vasovagal reactions (fainting) to blood donation after giving blood. As predicted, injection-fearful participants reported significantly more pre-donation anxiety and disgust compared to nonfearful participants. Injection-fearful donors also reported experiencing more fainting symptoms during blood donation and found the donation experience more unpleasant than did nonfearful participants. Although pre-donation disgust and anxiety levels each uniquely predicted fainting symptoms among nonfearful donors, only pre-donation anxiety uniquely predicted fainting symptoms among injection-fearful donors. Implications of these findings for conceptualizing the disgust-faint relationship in BII phobia are discussed.
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Affiliation(s)
- Megan A Viar
- Department of Psychology, Vanderbilt University, 312 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA.
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29
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Daughters SB, Magidson JF, Schuster RM, Safren SA. ACT HEALTHY: A Combined Cognitive-Behavioral Depression and Medication Adherence Treatment for HIV-Infected Substance Users. COGNITIVE AND BEHAVIORAL PRACTICE 2010; 17:309-321. [PMID: 21709737 DOI: 10.1016/j.cbpra.2009.12.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The two most common comorbid conditions with HIV are substance use disorders and depression, and individuals with comorbid HIV, depression, and substance dependence face a more chronic and treatment-resistant course. As an example of how to adapt evidence-based approaches to a complex comorbid population, the current case study examined the integration of a combined depression and HIV medication adherence treatment. The resulting intervention, ACT HEALTHY, combines a brief behavioral activation approach specifically developed to treat depression in individuals receiving residential substance abuse treatment (LETS ACT; Daughters et al., 2008) with a brief cognitive-behavioral approach to improving HIV medication adherence (Life-Steps; Safren et al., 1999; Safren et al., 2009). The current case series demonstrates the use of ACT HEALTHY among 3 depressed HIV-positive, low-income African Americans entering residential substance abuse treatment.
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30
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An open trial with cognitive behavioral therapy for blood- and injection phobia in pregnant women-a group intervention program. Arch Womens Ment Health 2010; 13:259-65. [PMID: 19859788 DOI: 10.1007/s00737-009-0126-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 10/06/2009] [Indexed: 10/20/2022]
Abstract
Around 7% of pregnant women suffer from blood- and injection phobia. The aim was to investigate if cognitive behavior group therapy (CBT) is effective in treating pregnant women's blood- and injection phobia. Thirty pregnant women with blood- and injection phobia according to DSM-IV took part in an open treatment intervention. A two-session cognitive behavior group therapy was conducted. As controls, 46 pregnant women with untreated blood- and injection phobia and 70 healthy pregnant women were used. Repeated measures ANOVA were performed. The scores for the CBT treatment group on the "Injection Phobia Scale-Anxiety" were reduced both after each treatment session and postpartum (p < 0.001). Anxiety and depressive symptoms were also reduced (p < 0.001). Cognitive-behavior group therapy for pregnant women with blood- and injection phobia is effective and stable up to at least 3 months postpartum. It seems also to reduce anxiety and depressive symptoms during pregnancy.
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31
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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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32
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Abstract
We postulate that the cascade “Freeze-Flight-Fight-Fright-Flag-Faint” is a coherent sequence of six fear responses that escalate as a function of defense possibilities and proximity to danger during life-threat. The actual sequence of trauma-related response dispositions acted out in an extremely dangerous situation therefore depends on the appraisal of the threat by the organism in relation to her/his own power to act (e.g., age and gender) as well as the perceived characteristics of threat and perpetrator. These reaction patterns provide optimal adaption for particular stages of imminence. Subsequent to the traumatic threats, portions of the experience may be replayed. The actual individual cascade of defense stages a survivor has gone through during the traumatic event will repeat itself every time the fear network, which has evolved peritraumatically, is activated again (i.e., through internal or external triggers or, e.g., during exposure therapy).When a parasympathetically dominated ‘‘shut-down’’ was the prominent peri-traumatic response during the traumatic incident, comparable dissociative responses may dominate responding to subsequently experienced threat and may also reappear when the traumatic memory is reactivated. Repeated experience of traumatic stress forms a fear network that can become pathologically detached from contextual cues such as time and location of the danger, a condition which manifests itself as posttraumatic stress disorder (PTSD). Intrusions, for example, can therefore be understood as repetitive displays of fragments of the event, which would then, depending on the dominant physiological response during the threat, elicit a corresponding combination of hyperarousal and dissociation. We suggest that trauma treatment must therefore differentiate between patients on two dimensions: those with peritraumatic sympathetic activation versus those who went down the whole defense cascade, which leads to parasympathetic dominance during the trauma and a corresponding replay of physiological and dissociative responding, when reminded. The differential management of dissociative stages (“fright” and “faint”) has important treatment implications.
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Affiliation(s)
- Maggie Schauer
- Department of Psychology, University of Konstanz, Germany
| | - Thomas Elbert
- Department of Psychology, University of Konstanz, Germany
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33
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Cisler JM, Olatunji BO, Lohr JM. Disgust sensitivity and emotion regulation potentiate the effect of disgust propensity on spider fear, blood-injection-injury fear, and contamination fear. J Behav Ther Exp Psychiatry 2009; 40:219-29. [PMID: 19041963 PMCID: PMC2895919 DOI: 10.1016/j.jbtep.2008.10.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Revised: 10/07/2008] [Accepted: 10/17/2008] [Indexed: 11/19/2022]
Abstract
Research consistently reveals a relation between disgust and specific anxiety concerns, but research has only begun to investigate possible mechanisms by which this relation occurs. The current study tested whether disgust sensitivity (DS; a specific difficulty regulating disgust) and general emotion dysregulation (GED; non-emotion-specific regulation difficulties) moderated the relation between disgust propensity (DP) and spider fear, blood-injection-injury (BII) fear, and contamination fear. A total of 594 undergraduate students completed verbal-report measures of DP, DS, GED, negative affectivity, and spider, BII, and contamination fears. Results suggest that GED potentiates the ability of DP to predict spider and contamination fears, but not BII fears. DS potentiates the ability of DP to predict BII fears, but not spider or contamination fears. These data suggest that GED and DS are possible mechanisms that strengthen the influence of DP on spider, BII, and contamination fears. The present study demonstrates the utility of incorporating emotion regulation into the theory of disgust in certain anxiety disorders.
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Affiliation(s)
- Josh M Cisler
- Psychology Department, University of Arkansas, Fayetteville 72701, USA.
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34
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Mayer B, Muris P, Bos AER, Suijkerbuijk C. Disgust sensitivity and eating disorder symptoms in a non-clinical population. J Behav Ther Exp Psychiatry 2008; 39:504-14. [PMID: 18295745 DOI: 10.1016/j.jbtep.2007.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 11/02/2007] [Accepted: 11/09/2007] [Indexed: 11/28/2022]
Abstract
In order to further explore the relationship between disgust sensitivity and eating disorder symptoms, 2 studies were carried out. In the first study, 352 higher education students (166 women, 186 men) completed a set of questionnaires measuring various aspects of disgust sensitivity and eating disorder symptoms. A correlational analysis revealed that there were few significant correlations between disgust scales and eating pathology scores. One exception was the relation between disgust sensitivity and external eating behavior, although this link only emerged in women. To investigate this relationship in more detail, Study 2 confronted women high (n=29) and low (n=30) on external eating behavior with a series of disgusting and neutral pictures. It was hypothesized that women who scored high on external eating would display shorter viewing times of disgusting pictures (i.e., show more avoidance behavior) than women scoring low on external eating. However, this hypothesis was not confirmed by the data. Altogether, the results of these studies suggest that there seems to be no convincing relationship between disgust sensitivity and eating disorder symptomatology, thereby casting doubts on the role of this individual difference factor in the development of eating pathology.
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Affiliation(s)
- Birgit Mayer
- Institute of Psychology, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands.
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35
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Mataix-Cols D, An SK, Lawrence NS, Caseras X, Speckens A, Giampietro V, Brammer MJ, Phillips ML. Individual differences in disgust sensitivity modulate neural responses to aversive/disgusting stimuli. Eur J Neurosci 2008; 27:3050-8. [PMID: 18588543 DOI: 10.1111/j.1460-9568.2008.06311.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Little is known about how individual differences in trait disgust sensitivity modulate the neural responses to disgusting stimuli in the brain. Thirty-seven adult healthy volunteers completed the Disgust Scale (DS) and viewed alternating blocks of disgusting and neutral pictures from the International Affective Picture System while undergoing fMRI scanning. DS scores correlated positively with activations in brain regions previously associated with disgust (anterior insula, ventrolateral prefrontal cortex-temporal pole, putamen-globus pallidus, dorsal anterior cingulate, and visual cortex) and negatively with brain regions involved in the regulation of emotions (dorsolateral and rostral prefrontal cortices). The results were not confounded by biological sex, anxiety or depression scores, which were statistically controlled for. Disgust sensitivity, a behavioral trait that is normally distributed in the general population, predicts the magnitude of the individual's neural responses to a broad range of disgusting stimuli. The results have implications for disgust-related psychiatric disorders.
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Cisler JM, Olatunji BO, Sawchuk CN, Lohr JM. Specificity of emotional maintenance processes among contamination fears and blood-injection-injury fears. J Anxiety Disord 2008; 22:915-23. [PMID: 17961975 DOI: 10.1016/j.janxdis.2007.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Revised: 09/11/2007] [Accepted: 09/13/2007] [Indexed: 10/22/2022]
Abstract
Research evidence consistently demonstrates a relation between disgust and anxiety-related pathology. Despite ample evidence implicating a functional role of disgust in anxiety, limited research has focused on the process by which disgust influences anxiety. Recent evidence indicates that fear of responding with disgust predicts contamination fears, thus elucidating a process by which disgust contributes to contamination fears. In the current study, we tested whether fear of responding with disgust is specific to contamination fears or generalizes to blood-injection-injury (BII) fears. Undergraduate psychology students (N=259) completed measures of anxiety sensitivity (AS), trait anxiety, disgust, contamination fears, and BII fears. Data analysis revealed main effects of both AS and disgust in predicting both contamination and BII fears. The interaction between AS and disgust (i.e., being fearful of responding with disgust), however, predicted only contamination fears and not BII fears. The results suggest that fear of responding with disgust is a unique maintenance process specific to contamination fears. Theoretical and clinical implications for both contamination and BII fears are discussed.
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Affiliation(s)
- Josh M Cisler
- Psychology Department, University of Arkansas, AR 72701, USA.
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Olatunji BO, Connolly KM, David B. Behavioral avoidance and self-reported fainting symptoms in blood/injury fearful individuals: an experimental test of disgust domain specificity. J Anxiety Disord 2008; 22:837-48. [PMID: 17920808 DOI: 10.1016/j.janxdis.2007.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Revised: 08/29/2007] [Accepted: 08/29/2007] [Indexed: 11/24/2022]
Abstract
This study examined the specificity of disgust in predicting avoidance in blood/injury (BI) phobia. Participants high (n=38) and low (n=46) in BI fear completed measures of disgust across multiple domains and severity of BI-related fear. They then completed three randomly presented behavioral avoidance tasks (BATs) that consisted of exposure to a 15'' severed deer leg (BI task), a live spider (spider task), and a 'contaminated' cookie (cookie task). Fainting symptoms associated with each BAT were recorded as well. When controlling for gender and BI fear group membership, mutilation disgust contributed unique variance to avoidance on the BI task and animal disgust contributed unique variance to avoidance on the spider task. None of the disgust domains contributed unique variance to avoidance on the cookie task. For the high BI fear group, self-reported fainting symptoms were more pronounced during the BI and spider BAT than during the cookie BAT. Although mutilation disgust was significantly associated with self-reported fainting symptoms on the BI task among the high BI fear group, this relationship became nonsignificant when controlling for BI-related fear severity. Implications of the domain specificity of disgust and its relevance for understanding fainting responses in BI phobia are discussed.
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Affiliation(s)
- Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Nashville, TN 37203, USA.
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Connolly KM, Lohr JM, Williams NL, Olatunji BO, Willems JL, Hahn KS, Cisler JM. Covariation Bias in Blood-Injection-Injury Fear: The Application of Methodological Modifications Within the Illusory Correlation Paradigm. COGNITIVE THERAPY AND RESEARCH 2008. [DOI: 10.1007/s10608-008-9189-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Armfield JM. A preliminary investigation of the relationship of dental fear to other specific fears, general fearfulness, disgust sensitivity and harm sensitivity. Community Dent Oral Epidemiol 2008; 36:128-36. [PMID: 18333876 DOI: 10.1111/j.1600-0528.2007.00379.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES People with dental fear often suffer from other psychological disorders, as well as from a number of other specific fears. Fear of going to the dentist may be associated not only with general fearfulness, but also with underlying personality dispositions. This exploratory study, therefore, investigated the associations between dental fear and 67 other specific fears, general fearfulness, disgust sensitivity and harm sensitivity. METHODS Participants were 88 Australian adults who were administered the Fear Survey Schedule III (FSS-III), the Harm Sensitivity Index and the Disgust Sensitivity Index. Principle axis factor analysis with Promax rotation was used to examine how dental fear related to other specific fears as measured with the FSS-III. RESULTS Dental fear was significantly correlated with most of the other specific fears, with factor analysis indicating that it tended to load more with fears related to lack of control rather than with what have often been classed as 'medical' fears. Significant associations were found between dental fear and the personality dispositions of general fearfulness, harm sensitivity and disgust sensitivity, although these associations were not linear. CONCLUSIONS Findings reveal extensive co-occurrence of other specific fears with dental fear, while the associations of dental fear with personality traits suggest enduring aspects to dental fear which may translate into difficulties in fear alleviation. Dental fear was more related to a diverse range of fears relating to a loss of control than to medical-specific fears.
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Affiliation(s)
- Jason M Armfield
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia.
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Armfield JM, Slade GD, Spencer AJ. Cognitive vulnerability and dental fear. BMC Oral Health 2008; 8:2. [PMID: 18218075 PMCID: PMC2266729 DOI: 10.1186/1472-6831-8-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 01/24/2008] [Indexed: 01/02/2023] Open
Abstract
Background The Cognitive Vulnerability Model proposes that perceptions of certain characteristics of a situation are critical determinants of fear. Although the model is applicable to all animal, natural environment and situational fears, it has not yet been applied specifically to dental fear. This study therefore aimed to examine the association between dental fear and perceptions of dental visits as uncontrollable, unpredictable and dangerous. Methods The study used a clustered, stratified national sample of Australians aged 15 years and over. All participants were asked in a telephone interview survey to indicate their level of dental fear. Participants who received an oral examination were subsequently provided with a self-complete questionnaire in which they rated their perceptions of uncontrollability, unpredictability and dangerousness associated with dental visiting. Results 3937 participants were recruited. Each of the three vulnerability-related perceptions was strongly associated with the prevalence of high dental fear. In a logistic regression analysis, uncontrollability and dangerousness perceptions were significantly associated with high dental fear after controlling for age and sex. However, unpredictability perceptions did not have a statistically significant independent association with dental fear after controlling for all other variables. Conclusion Results are mostly consistent with the Cognitive Vulnerability Model of the etiology of fear, with perceptions of uncontrollability, unpredictability and dangerousness each showing a strong bivariate relationship with high dental fear prevalence. However, more extensive measures of vulnerability perceptions would be valuable in future investigations.
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Affiliation(s)
- Jason M Armfield
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, South Australia, Australia.
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Olatunji BO, Cisler JM, Deacon BJ, Connolly K, Lohr JM. The Disgust Propensity and Sensitivity Scale-Revised: psychometric properties and specificity in relation to anxiety disorder symptoms. J Anxiety Disord 2007; 21:918-30. [PMID: 17236747 DOI: 10.1016/j.janxdis.2006.12.005] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2006] [Revised: 12/02/2006] [Accepted: 12/14/2006] [Indexed: 10/23/2022]
Abstract
The present study examined the factor structure and psychometric properties of the Disgust Propensity and Sensitivity Scale-Revised (DPSS-R) in a nonclinical sample (N=340). Principal components analysis of the DPSS-R revealed a two-factor structure consisting of Disgust Propensity and Disgust Sensitivity. Although the two-factor structure converged well with prior research, four of the 16 DPSS-R items did not load onto the predicted factor. The DPSS-R demonstrated good reliability and validity. The DPSS-R and its two factors were moderately correlated with spider fear and contamination fear and mildly correlated with injection fear. The relation between the DPSS-R and these anxiety disorder symptoms remained largely intact after controlling for negative affect. Regression analyses also revealed that the two DPSS-R factors demonstrate specificity in the prediction of anxiety disorder symptoms. These findings are discussed in terms of promoting a more valid and reliable assessment of disgust in anxiety disorders.
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Affiliation(s)
- Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA.
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Caseras X, Mataix-Cols D, An SK, Lawrence NS, Speckens A, Giampietro V, Brammer MJ, Phillips ML. Sex differences in neural responses to disgusting visual stimuli: implications for disgust-related psychiatric disorders. Biol Psychiatry 2007; 62:464-71. [PMID: 17306771 DOI: 10.1016/j.biopsych.2006.10.030] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2006] [Revised: 10/27/2006] [Accepted: 10/31/2006] [Indexed: 12/31/2022]
Abstract
BACKGROUND A majority of patients with disgust-related psychiatric disorders such as animal phobias and contamination-related obsessive-compulsive disorder are women. The aim of this functional magnetic resonance imaging (fMRI) study was to examine possible sex differences in neural responses to disgust-inducing stimuli that might help explain this female predominance. METHODS Thirty-four healthy adult volunteers (17 women, all right-handed) were scanned while viewing alternating blocks of disgusting and neutral pictures from the International Affective Picture System. Using a partially-silent fMRI sequence, the participants rated their level of discomfort after each block of pictures. Skin conductance responses (SCR) were measured throughout the experiment. All participants completed the Disgust Scale. RESULTS Both women and men reported greater subjective discomfort and showed more SCR fluctuations during the disgusting picture blocks than during the neutral picture blocks. Women and men also demonstrated a similar pattern of brain response to disgusting compared with neutral pictures, showing activation in the anterior insula, ventrolateral and dorsolateral prefrontal cortices, and visual regions. Compared with men, women had significantly higher disgust sensitivity scores, experienced more subjective discomfort, and demonstrated greater activity in left ventrolateral prefrontal regions. However, these differences were no longer significant when disgust sensitivity scores were controlled for. CONCLUSIONS In healthy adult volunteers, there are significant sex-related differences in brain responses to disgusting stimuli that are irrevocably linked to greater disgust sensitivity scores in women. The implications for disgust-related psychiatric disorders are discussed.
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Affiliation(s)
- Xavier Caseras
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, United Kingdom
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Olatunji BO, Williams NL, Lohr JM, Connolly KM, Cisler J, Meunier SA. Structural differentiation of disgust from trait anxiety in the prediction of specific anxiety disorder symptoms. Behav Res Ther 2007; 45:3002-17. [PMID: 17888397 DOI: 10.1016/j.brat.2007.08.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Revised: 08/09/2007] [Accepted: 08/14/2007] [Indexed: 11/20/2022]
Abstract
Research has begun to implicate the role of disgust in the etiology of specific phobias and obsessive-compulsive disorder (OCD). However, it remains unclear if the association between disgust and specific anxiety disorder symptoms is an artifact of trait anxiety or a potential mechanism through which trait anxiety effects specific anxiety disorder symptoms. The present study employed structural equation modeling to differentiate disgust from trait anxiety in the prediction of four types of specific anxiety disorder symptoms in a non-clinical sample (N=352). Results indicate that disgust and trait anxiety latent factors were independently related to spider fears, blood-injection-injury (BII) fears, general OCD symptoms, and OCD washing concerns. However, when both variables were simultaneously modeled as predictors, latent disgust remained significantly associated with the anxiety disorder symptoms, whereas the association between latent trait anxiety and the anxiety disorder symptoms became non-significant or was substantially reduced. Statistical tests of intervening variable effects converged in support of disgust as a significant intervening variable between trait anxiety and spider fears, BII fears, and OCD symptoms (particularly washing concerns). The relevance of these findings for future research investigating the role of disgust in specific anxiety disorders is discussed.
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Affiliation(s)
- Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA.
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Buodo G, Peyk P, Junghöfer M, Palomba D, Rockstroh B. Electromagnetic indication of hypervigilant responses to emotional stimuli in blood-injection-injury fear. Neurosci Lett 2007; 424:100-5. [PMID: 17714872 DOI: 10.1016/j.neulet.2007.07.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 07/17/2007] [Accepted: 07/20/2007] [Indexed: 11/20/2022]
Abstract
Blood phobia differs from other phobias and anxiety disorders in that no attentional bias for blood-related stimuli has been consistently observed. The present study aimed at clarifying this characteristic by investigating electromagnetic brain activity to blood-related and -unrelated pictures in high blood-fearful and non-fearful individuals. Relative to non-fearful controls, high blood-fearful subjects displayed more intense occipito-parietal activation 190-250ms after picture onset, which was interpreted as non-specifically enhanced sensory encoding of visual stimuli. Blood-related stimuli did not elicit different activity patterns in high blood-fearful subjects and controls, supporting the hypothesis that non-specific hypervigilance does not provide a basis for subsequent, specifically enhanced processing of fear-related contents.
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Affiliation(s)
- Giulia Buodo
- Department of General Psychology, University of Padova, Italy.
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Abstract
It has been argued that disgust has been forgotten by psychiatry. An overview of recent research on disgust is provided. Findings suggest that disgust is a predictor of the development of specific psychiatric conditions.
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Deacon B, Abramowitz J. Fear of needles and vasovagal reactions among phlebotomy patients. J Anxiety Disord 2006; 20:946-60. [PMID: 16460906 DOI: 10.1016/j.janxdis.2006.01.004] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2005] [Revised: 12/07/2005] [Accepted: 01/06/2006] [Indexed: 11/19/2022]
Abstract
Anxiety associated with blood and injections is a common problem in medical settings and, in severe cases, affects sufferers' ability to receive medically essential treatment. The present study was conducted to examine incidence of adverse reactions to venipunctures among phlebotomy patients, as well as to understand the demographic and psychological characteristics associated with such reactions. A large sample of participants undergoing venipuncture (N=3315) was recruited from hospital-based phlebotomy laboratories. Participants completed a brief questionnaire assessing psychological and physiological reactions to having their blood drawn. Results indicated that a small minority of patients experienced significant anxiety symptoms during venipuncture. Vasovagal reactions and vasovagal syncope were extremely infrequent. A tendency to experience pain, disgust, and fear of fainting during injections was associated with anxious responding to the venipuncture and a probable diagnosis of needle phobia. Theoretical and practical implications are discussed.
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Affiliation(s)
- Brett Deacon
- University of Wyoming, Department of Psychology, Department 3415, 1000 E. University Avenue, Laramie, WY 82071, USA.
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Connolly KM, Katherine O'Neill H, Flessner CA, Olatunji BO. Fear, disgust, and fainting in blood–injection–injury fears: a multi-method approach. ANXIETY STRESS AND COPING 2006. [DOI: 10.1080/10615800601055956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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